I’ve written a lot about the looming mental health crisis in this country. The writing has been on the wall for years: Masters in Psychology and Social Work consistently ranked as being the worse Masters degrees to get, decreasing numbers of new professionals, decreasing reimbursements from insurance, followed by increasing paperwork and liability. Add to this that as a society we are becoming sicker, and the mental health crisis is no longer looming, it’s here.
I can’t speak for other States, and I haven’t been able to find any National data on this, but I can say that in Massachusetts psychiatric hospitalizations are double what they were ten years ago. This coincides with the closing of outpatient counseling clinics. Why are the clinics closing? Because they simply can’t afford to stay open, even when on average they are only paying their counselors $35,000 per year, even when business is comparatively good with more people seeking counseling than ever before. The insurance reimbursements are just not enough to cover overhead. So agencies are closing their outpatient clinics and are opening more intensive treatment centers like PACT teams, step-down facilities, and private inpatient units. These treatment modalities are not intended to prevent crises like outpatient clinics do, but rather react to the crisis at varying levels of intensity.
My philosophy as a professional has always been to focus on prevention. I believe that prevention is better for both the individual and society as a whole. Prevention is also less expensive. A hospitalization costs about $40,000 per month. A step-down program (this is what comes after the hospitalization) costs about $12,000 per month. Sometimes a step-down program is then followed by receiving services from a PACT team, which is a service that can go on for years. Unfortunately, I don’t know how much that costs, but I’m going to assume that it’s also expensive. And then there’s counseling, which prevents hospitalizations, step down programs, and PACT teams. You can’t even spent $12,000 in a year on counseling.
The human toll of hospitalizations, some of which can last 6 months or longer; the toll on society; the broken families; the suffering; the increase in crime; we’re seeing it more and more. When, as a society, will we stop being reactive and start being preventive? It has to change now.