Is Our Mental Health Care System Getting Better or Worse?

Ever since our book about surviving bipolar disorder was published, my son, Max Maddox, and I have been speaking to many, varied audiences about mental illness, telling our personal story about his illness and my role as his mom and advocate.  As I speak from my perspective, I always talk about how difficult and sometimes impossible it was to find help and good treatment and how broken our mental health care system is.  Max and our family have been lucky in that we’ve stumbled our way through, fought for what we needed, and sometimes succeeded in what always felt like a hit and miss process.  Too often we missed.  It took years before Max found a good doctor and the treatment that works for him.

I go on to tell those in the audience that too many aren’t as lucky.  They never find access to treatment and as a result somewhere between 30-50% of those in our prisons suffer from mental illness and our jails have become our mental health care institutions.  It costs us plenty—certainly it costs the taxpayers for the exorbitant and rising costs of housing prisoners — worse is the cost for those the mentally ill who languish in jails, untreated and isolated.   Others who live with untreated mental illness end up homeless (an estimated 25%).  It’s a tragedy that so many with mental illness are never able to reach their full potential and join their rightful place in our communities.

When we ask for questions, someone in the audience always asks, “Do think the mental health care system is improving?”

I hate that my answer is “No.” That funding for mental health care continues to be cut instead of increased.  That the past ten years have seen some of the biggest cuts in history.  That sequester has only made it worse. (I wrote a blog about the effects of sequester on those with mental illness a few months ago.)  I don’t like answering with such pessimism so I go on to say that I find hope in grassroots movements and non-profits like NAMI (National Alliance on Mental Illness), Mental Health America, and DBSA (Depression and Bipolar Support Alliance) who lobby in Washington and who provide support for those with mental illness and their families.  And I find hope in the fact that many of those with mental illness and their families are speaking out.  I think that’s huge.

But my answers never feel adequate or encouraging enough.  I wish that I could be more hopeful.  Which brings me to the heart of this blog post:

I’d like to hear from others who have been involved with the mental health care system.  What would you say if someone asked you whether things in mental health care are improving?

I hope you’ll comment here or contact me at my website:



Is Our Mental Health Care System Getting Better or Worse? — 3 Comments

  1. I feel like dealing with mental health care is a battle. I am a well-educated woman in my early 30s. It should not be this hard to find quality care or navigate health insurance. When one of my old psychiatrists quit his practice I had to go off my meds for a few weeks because I couldn’t get in to see a new doctor in a timely fashion because everyone had a month-plus waiting list. Because I had insurance I couldn’t receive help from the community program. I was stuck without the meds I need. I have had so much trouble since the beginning of my diagnosis of Bipolar I in 2008 and if I, a resourceful, smart person can’t figure it out, what about those in a state of psychosis or severe depression? I don’t know what the answer is but I hope I can be a part of the solution.

  2. As both a consumer and provider of mental health services I have experienced nothing but a decrease in the quality and availability of services. So many providers, from psychiatrists to counselors, are moving toward an all cash practice. They no longer accept insurance because the reimbursements are too low for their business to remain financially viable. This movement severely limits those that can take advantage of mental health services. And so many of our psychiatric hospitals are turning to a “medicate and discharge” treatment philosophy rather than a “treat to improve stability and quality of life” model. Again, because there’s so little money in providing psychiatric care. The stigma of mental illness continues to impact the value we place on those with mental illness and the treatment they need. Until we embrace mental illness as a “real” disease that deserves as much acceptance and compassion as things like cancer and cardiac disease then our mental health system will languish without improvement.

  3. I think that by more famous, influential people coming out about their illness it is helping a little with the stigma. Hopefully, some day people will seek help without feeling like they could lose their jobs, friends, and family.

    I have been attending a lot of meetings lately put on by agencies dealing with the mentally ill and what I have been hearing is that things are getting worse not better, unfortunately.

    I think to make things better that all the mental health advocacy groups need to unite because then we would have a bigger voice. With that bigger voice we would have a better chance at seeing change.

Leave a Reply

Your email address will not be published. Required fields are marked *