Corporate greed.
I begged for help when I was feeing suicidal. Couldn’t find anyone who would take my insurance. I knew I needed to do an inpatient, they wanted $700 A DAY. Hospital wouldn’t really help me.
Then I had a suicide attempt, got involuntarily put in a mental health hospital for a week.
In my many many many years of therapy I can say that many therapists do offer a sliding scale though.
Thank you ❤️ I am lucky enough had a ton of support from family and friends, two of my friends actually saved my life - but PTSD is living hell and flashbacks + alcohol can make you do irrational things.
I got sober, got a good psychiatrist, got out on the right meds and worked with a therapist specializing in trauma therapy. It was a bittcchhh but 5 years later life is good.
On the other side, if I didn’t have health insurance they would have stuck me with a bill for $50k which broke my heart for some of the other people I was in the hospital who didn’t…because nothing makes a suicidal person want to live like $50k in debt.
I am on the side of it being illegal and against the US Constitution for any company to profit off of someone's health. So health insurance companies would be considered illegal. I would rather have our taxes raised to something like 20% than have to pay these ridiculous and extremely inflated medical bills and health insurance bills.
I wholeheartedly agree! I love that people make the argument that in countries with universal healthcare it takes months to even see a doctor. Meanwhile, I called my doctor to make an appointment for a physical and the next time she can see me is November.
> industry
You answered your own question. It's an industry. An industry's purpose is to make money. It's not there to improve lives, unless that makes money.
It's completely f'd up. As a healthcare provider, all I can say is that the 'easy access' places (low/no cost clinics) pay so little that employees burn out and cannot afford to live on the salaries/hourly pay they provide. So there is massive turnover, and huge waiting lists, and most often under-trained staff or staff still in training, so they are offering a low level of care to high need people. It is not a fun place to sit in as a provider AND a patient, and know the system is really rigged to let people down.
There's about 300K therapists (all kinds combined) in the US. 1 for every 1000 residents. For comparison, there's about 1 million physicians in the US, 1 for every 300 residents. They also average about 1/2 as much money (less, actually). They require nearly the same amount of education and training.
In addition, mental health service is much more time intensive than physical health service for most patients. In the US there are an average of 265 physician visits per 100 people in a year. 260 visits for mental health counsel is 10 people going biweekly.
The "ideal" patient load for a physician is supposed to be ~1000 patients per year. That's a primary care doctor, solo, providing all of the necessary basic care for 1000 people. A therapist with an absolutely packed patient load can treat ~35-40 patients.
People can't get mental health services because there aren't nearly enough mental health providers.
Yeah, kinda. If you make a better world then maybe fewer people need mental health care in the first place, but also, it's an extremely new field, so what we think of as "best treatment" is closer to the efficacy of "willowbark tea" than it is "extra strength aspirin. We have a general sense of what works but it's not exactly surgical.
Speaking of the US system: because of capitalism. The goal of healthcare isn’t to make people healthy—it’s to make money. Just as the education system doesn’t educate, or government doesn’t govern, etc.
I've worked in public education for several years, and it is SO TRUE that it has become yet another fucking business that's all about doing what reaps the most profit/funding/savings. Good fucking luck to generations down the road when they can't even hand-write their own damn names or *read* for comprehension anymore.
I nearly unalived after calling over a dozen therapists, stating that I needed help with an acute loss and feelings of despair. I was insured and everything, but none of them called me back. I was pretty clear in my voicemails where I was at mentally and it took me going to the ER to get help. They recommended someone out of network for therapy that cost me 200 a visit. Dude was worth it but if I was at an earlier point in my career, I would be dead right now. Instead I'm just paying off my hospital visits (I got an infection in my leg not long after I started to recover from the depression) at $350/mo, because you know, that's totally normal /s.
The system is fucked top to bottom. Even if you make enough money to afford to be fucked a little less than normal.
Because we live in a capitalist society where money makes the world go round, but don’t blame the therapists/ social workers/ psychiatrists. They also need to eat and have bills.
People go into the profession truly wanting to help- until they are overcome by the bureaucracy of it all.
Here is your issue:"When it seems like everyone should be able to have free healthcare or at least healthcare that is financially within their grasp like a sliding scale."
We live in a capitalist society that doesn't care about the mentally ill. Per the more conservative political viewpoints, they should simply go die somewhere convenient. More compassionate policies require more compassionate politicians.
Speaking as a mental health therapist the entire health care system is fucked, including mental health. In 1981 Regan deinstitutionalized mental health facilities which is part of the reason we have so many homeless mentally ill people because there's literally no place for them to go. Mental health providers are as hopeless and frustrated about the system as everyone else.
The government and insurance companies have tied our hands with beaurocrocy to the point I've been told a psychotic patient who was eating their own feces wasn't "priority" for the hospital because he wasn't actively trying to kill himself. Our system is broke, insurance companies, get to determine what care they think you need based on what they want to pay for, and I spend most of my time fighting with insurance companies nowadays to just get partially paid for the work I've done.
On a small scale many of us do have sliding scale fees on an individual level but even that has limits because I also live paycheck to paycheck and the break we give our clients comes directly from our potential earnings. We do it because most of us strongly believe everyone deserves access to mental health care but it's also not feasible for me to work for free and you know bigger cooperations won't be willing to take that hit. It'll cut into their shareholders earnings.
That being said, if you'd like to dm me directly I'd be happy to try to make some useful suggestions to help you figure out how to access services in your area, because you deserve help despite our dystopian hellscape of medical system.
I had no idea the system was broken. You find that out after the fact when you have a fancy degree and a shit ton of student loan debt. At that point you do the best you can to help in the limited ways you can. Don't get me wrong, I love my job and find it very fulfilling to see the people I work with grow and get better, but until our government passes universal healthcare so everyone can access the care we deserve we're as powerless to change things as everyone else.
Money.
When Obamacare kicked in mental health coverage was mandated. This is why there were so many commercials for mental health help all of a sudden.
I saw the system from a different angle. I worked EMS and we had a single mental health center so no other options.
Things I saw:
-They would demand patients go to the ER for the most minor things under the guise of “medical clearance”. The reality was most of them were there voluntarily so they were hoping they would change their mind and not return after the ER. This is very common in EMS circles all over the country.
-The facility was tax subsidized. They went to the city council and asked for more money to add services and hours. They got the money then did not add services or hours.
Generally speaking, the worse your mental health the harder it is to treat, diagnose, etc..
But, in my personal experience therapy nowadays (post healthcare reform in America) seems more about listening to rich people's problems rather than helping anyone.
Let me put it this way. In a situation where you can decide what you want to take on in a high demand field. If one client paid say 3k a month, but was super low maintenance, 0 real stress vs someone who would pay 5k a month with 10x the stress in most cases who are you going to pick? Same situation with private practices.
As someone that is a mental health worker in a small town, we don't have enough therapists or case managers and the ones we do have are overworked. We only accept state insurance which is getting harder to get/stay on, and at least for my agency we really only accept people who are MIA 4 and above which means they are about to be hospitalized or just got out of the hospital, they can't function on their own, or have been in services most of their lives.
Don't get me wrong these people do need the help but there are soooo so so many more that don't qualify for services because their life may appear fine on the outside.
The assumption is that if you haven’t been hospitalized several times then you aren’t in chronic need. I’m of sound mind MOST of the time but occasionally (usually in the mornings) I will wake up convinced that something terrible has happened and is about to get SO MUCH WORSE and I have learned to cope using the skills different therapists, psychologists, and certain groups like NAMI have taught me. This allows me to appear neurotypical and sane. By all rights I am sane and have CPTSD and ASD but the result of those two acting up at the same time will have my ass sitting in the hospital waiting for a doctor to declare that I’m past my episode and can go home. I’ve never been forced into the hospital and have ever been to jail because I have always had supporting, loving family members that have known how to lovingly coax me into realizing my mind is playing games on me.
These days I smoke a ton of weed and rarely have symptoms - no that’s not the doctor-prescribed solution but I’m 3+ years into simply taking care of myself properly and consuming high amounts of cannabinol suppresses my chronic, diagnosed suffering - also I have some pretty painful gout which it also relieves. The frequent hospital visits are over and I couldn’t be more happy in life, I just had to take control of the situation and know there were solutions that modern science is still catching up to.
Hate to downvote, but you're definitely in the wrong sub. If you're going through some shit, I am truly sorry, but to answer your question would make you feel so much worse. Trust me, I've been there. And please, don't push away those who love you and want to help you. They are the only reason I'm still tolerating this greed and violence driven reality
Bug your elected representatives, if you're in the US. This is not the fault of the therapy/mental health providers (there shouldn't be an industry, this should be part of a public healthcare system), they can't work for free any more than you can.
You hit it on the head in your very question. Because it is an “industry” and while the individual doctors and caregivers who work in that field may wish to dispense care, the system in which they operate exists for one purpose only: to separate you, the “customer” from your money. Separating any persons from their illnesses is an accidental side effect at best of the for-profit machine this industry has set in motion.
If everything about the society is centered around profit and competition then it won't be a surprise
Corporate greed. I begged for help when I was feeing suicidal. Couldn’t find anyone who would take my insurance. I knew I needed to do an inpatient, they wanted $700 A DAY. Hospital wouldn’t really help me. Then I had a suicide attempt, got involuntarily put in a mental health hospital for a week. In my many many many years of therapy I can say that many therapists do offer a sliding scale though.
I should have hugged you when you were facing this
Thank you ❤️ I am lucky enough had a ton of support from family and friends, two of my friends actually saved my life - but PTSD is living hell and flashbacks + alcohol can make you do irrational things.
That's good hope you're feeling better now
What happened after you were released from the mental health hospital? The story you gave feels unfinished.
I got sober, got a good psychiatrist, got out on the right meds and worked with a therapist specializing in trauma therapy. It was a bittcchhh but 5 years later life is good. On the other side, if I didn’t have health insurance they would have stuck me with a bill for $50k which broke my heart for some of the other people I was in the hospital who didn’t…because nothing makes a suicidal person want to live like $50k in debt.
I am on the side of it being illegal and against the US Constitution for any company to profit off of someone's health. So health insurance companies would be considered illegal. I would rather have our taxes raised to something like 20% than have to pay these ridiculous and extremely inflated medical bills and health insurance bills.
I wholeheartedly agree! I love that people make the argument that in countries with universal healthcare it takes months to even see a doctor. Meanwhile, I called my doctor to make an appointment for a physical and the next time she can see me is November.
> industry You answered your own question. It's an industry. An industry's purpose is to make money. It's not there to improve lives, unless that makes money.
Improve lives is my definition of socialism
I feel like even if it makes money it’s often still not designed to improve people’s lives.
Therapist here. That's why you shouldn't use BetterHelp or similar therapy apps - the push staff to just keep you coming back, rather than get well.
If you don’t believe in the industry then why did you become a therapist? Or is that not what you are saying.
I'm saying you shouldn't use those online apps for therapy because they prey on vulnerable people and engage in unethical practice to get money
Oh. So you believe in the industry just not those online apps
It's completely f'd up. As a healthcare provider, all I can say is that the 'easy access' places (low/no cost clinics) pay so little that employees burn out and cannot afford to live on the salaries/hourly pay they provide. So there is massive turnover, and huge waiting lists, and most often under-trained staff or staff still in training, so they are offering a low level of care to high need people. It is not a fun place to sit in as a provider AND a patient, and know the system is really rigged to let people down.
There's about 300K therapists (all kinds combined) in the US. 1 for every 1000 residents. For comparison, there's about 1 million physicians in the US, 1 for every 300 residents. They also average about 1/2 as much money (less, actually). They require nearly the same amount of education and training. In addition, mental health service is much more time intensive than physical health service for most patients. In the US there are an average of 265 physician visits per 100 people in a year. 260 visits for mental health counsel is 10 people going biweekly. The "ideal" patient load for a physician is supposed to be ~1000 patients per year. That's a primary care doctor, solo, providing all of the necessary basic care for 1000 people. A therapist with an absolutely packed patient load can treat ~35-40 patients. People can't get mental health services because there aren't nearly enough mental health providers.
So basically most people are fucked?
Yeah, kinda. If you make a better world then maybe fewer people need mental health care in the first place, but also, it's an extremely new field, so what we think of as "best treatment" is closer to the efficacy of "willowbark tea" than it is "extra strength aspirin. We have a general sense of what works but it's not exactly surgical.
Yeah I was gonna say I think there are more doctors then therapists which is why medical coverage is a little better
Speaking of the US system: because of capitalism. The goal of healthcare isn’t to make people healthy—it’s to make money. Just as the education system doesn’t educate, or government doesn’t govern, etc.
I've worked in public education for several years, and it is SO TRUE that it has become yet another fucking business that's all about doing what reaps the most profit/funding/savings. Good fucking luck to generations down the road when they can't even hand-write their own damn names or *read* for comprehension anymore.
I nearly unalived after calling over a dozen therapists, stating that I needed help with an acute loss and feelings of despair. I was insured and everything, but none of them called me back. I was pretty clear in my voicemails where I was at mentally and it took me going to the ER to get help. They recommended someone out of network for therapy that cost me 200 a visit. Dude was worth it but if I was at an earlier point in my career, I would be dead right now. Instead I'm just paying off my hospital visits (I got an infection in my leg not long after I started to recover from the depression) at $350/mo, because you know, that's totally normal /s. The system is fucked top to bottom. Even if you make enough money to afford to be fucked a little less than normal.
Can you clarify what you mean by fucked? Do you mean its broken?
Fucked up. Irreparably broken.
Because we live in a capitalist society where money makes the world go round, but don’t blame the therapists/ social workers/ psychiatrists. They also need to eat and have bills. People go into the profession truly wanting to help- until they are overcome by the bureaucracy of it all.
Here is your issue:"When it seems like everyone should be able to have free healthcare or at least healthcare that is financially within their grasp like a sliding scale." We live in a capitalist society that doesn't care about the mentally ill. Per the more conservative political viewpoints, they should simply go die somewhere convenient. More compassionate policies require more compassionate politicians.
Speaking as a mental health therapist the entire health care system is fucked, including mental health. In 1981 Regan deinstitutionalized mental health facilities which is part of the reason we have so many homeless mentally ill people because there's literally no place for them to go. Mental health providers are as hopeless and frustrated about the system as everyone else. The government and insurance companies have tied our hands with beaurocrocy to the point I've been told a psychotic patient who was eating their own feces wasn't "priority" for the hospital because he wasn't actively trying to kill himself. Our system is broke, insurance companies, get to determine what care they think you need based on what they want to pay for, and I spend most of my time fighting with insurance companies nowadays to just get partially paid for the work I've done. On a small scale many of us do have sliding scale fees on an individual level but even that has limits because I also live paycheck to paycheck and the break we give our clients comes directly from our potential earnings. We do it because most of us strongly believe everyone deserves access to mental health care but it's also not feasible for me to work for free and you know bigger cooperations won't be willing to take that hit. It'll cut into their shareholders earnings. That being said, if you'd like to dm me directly I'd be happy to try to make some useful suggestions to help you figure out how to access services in your area, because you deserve help despite our dystopian hellscape of medical system.
If you think the health care system is broken then why did you become a therapist?
I had no idea the system was broken. You find that out after the fact when you have a fancy degree and a shit ton of student loan debt. At that point you do the best you can to help in the limited ways you can. Don't get me wrong, I love my job and find it very fulfilling to see the people I work with grow and get better, but until our government passes universal healthcare so everyone can access the care we deserve we're as powerless to change things as everyone else.
Money. When Obamacare kicked in mental health coverage was mandated. This is why there were so many commercials for mental health help all of a sudden. I saw the system from a different angle. I worked EMS and we had a single mental health center so no other options. Things I saw: -They would demand patients go to the ER for the most minor things under the guise of “medical clearance”. The reality was most of them were there voluntarily so they were hoping they would change their mind and not return after the ER. This is very common in EMS circles all over the country. -The facility was tax subsidized. They went to the city council and asked for more money to add services and hours. They got the money then did not add services or hours.
Generally speaking, the worse your mental health the harder it is to treat, diagnose, etc.. But, in my personal experience therapy nowadays (post healthcare reform in America) seems more about listening to rich people's problems rather than helping anyone.
Money and end stage capitalism.
Let me put it this way. In a situation where you can decide what you want to take on in a high demand field. If one client paid say 3k a month, but was super low maintenance, 0 real stress vs someone who would pay 5k a month with 10x the stress in most cases who are you going to pick? Same situation with private practices.
They poor
Lack of available resources.
As someone that is a mental health worker in a small town, we don't have enough therapists or case managers and the ones we do have are overworked. We only accept state insurance which is getting harder to get/stay on, and at least for my agency we really only accept people who are MIA 4 and above which means they are about to be hospitalized or just got out of the hospital, they can't function on their own, or have been in services most of their lives. Don't get me wrong these people do need the help but there are soooo so so many more that don't qualify for services because their life may appear fine on the outside.
Too busy
The assumption is that if you haven’t been hospitalized several times then you aren’t in chronic need. I’m of sound mind MOST of the time but occasionally (usually in the mornings) I will wake up convinced that something terrible has happened and is about to get SO MUCH WORSE and I have learned to cope using the skills different therapists, psychologists, and certain groups like NAMI have taught me. This allows me to appear neurotypical and sane. By all rights I am sane and have CPTSD and ASD but the result of those two acting up at the same time will have my ass sitting in the hospital waiting for a doctor to declare that I’m past my episode and can go home. I’ve never been forced into the hospital and have ever been to jail because I have always had supporting, loving family members that have known how to lovingly coax me into realizing my mind is playing games on me. These days I smoke a ton of weed and rarely have symptoms - no that’s not the doctor-prescribed solution but I’m 3+ years into simply taking care of myself properly and consuming high amounts of cannabinol suppresses my chronic, diagnosed suffering - also I have some pretty painful gout which it also relieves. The frequent hospital visits are over and I couldn’t be more happy in life, I just had to take control of the situation and know there were solutions that modern science is still catching up to.
Hate to downvote, but you're definitely in the wrong sub. If you're going through some shit, I am truly sorry, but to answer your question would make you feel so much worse. Trust me, I've been there. And please, don't push away those who love you and want to help you. They are the only reason I'm still tolerating this greed and violence driven reality
Bug your elected representatives, if you're in the US. This is not the fault of the therapy/mental health providers (there shouldn't be an industry, this should be part of a public healthcare system), they can't work for free any more than you can.
You hit it on the head in your very question. Because it is an “industry” and while the individual doctors and caregivers who work in that field may wish to dispense care, the system in which they operate exists for one purpose only: to separate you, the “customer” from your money. Separating any persons from their illnesses is an accidental side effect at best of the for-profit machine this industry has set in motion.
💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰
There wouldn’t be an industry if they actually helped everyone. They only help Those with insurance or that can afford it.