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  • Writer's pictureMissy Fogarty, LCAT

World Mental Health Day

World Mental Health Day is October 10th, the day of this writing. I didn't know about it, but being a health care professional, it was brought to my attention (this year, anyway!) Take a look at my past blog about Mental Health Awareness Month and you'll get an idea of my sense of humor around such designations (maybe it's also Pizza Day or Cute Cat Picture Day! Okay, so there's a taste of it for you). But the designation comes from somewhere, and I was curious about its origin, especially since it's such extremely important topic. Turns out this day is not new. It's been around since 1992, and was brought about by the World Federation for Mental Health, a global mental health organization with members and contacts in more than 150 countries. It's an important opportunity to spread awareness of the topic of mental health and its impact and challenges at a global level. There is a theme to the day as there is every year on this day of World Mental Health. This year's theme is Mental Health is a Human Right.

Mental Health is a Human Right

It ought to be. I mean, I know it is. Or at least it should be. Where, though? But what does that exactly mean? I understand that it means that as human beings we have a right to have our mental health taken seriously (and that does need a lot of education as there is still a lot of stigma around mental health. In fact, since there's emphasis on World here, here is an interesting blurb on that illustrates stigma). It also means humans have a right to treatment. I agree with that and as a mental health practitioner I need to, and will, right here on this page soon enough, grapple with what that means and how I contend with that.

The State of Health Care

Here in the United States there is a serious problem with health care. The people who can afford it get better care, so clearly there is a disparity. It's that time of year here in the US where many people either need to renew their health care plans (if they have one. Many don't because they can't afford it). I actually have sitting in my email box a letter from my insurance company that is informing me that my monthly premiums will be going up. But they are not saying how much. I believe that the one clear piece of information it gave me is how much my annual deductible is going up. Otherwise, it's very vague. It makes clear that I have to renew it by such and such a date or look elsewhere. So it's suggesting that if I need to shop around, I better start. But how can I do so without having information about my current plan? It will come in, sure, closer to the date of renewal. So if I do need to make a change, then I'll have to scramble. But not before I call my doctors to see if they take any plan I might be switching to. Wait a minute. How do I know that they will be taking the plan I have next year? Here's a bit of insider information by way of a family member. Right now, anyway, the doctors won't be able to say right now because they don't know. Something tells me that the way these insurance agencies operate at least ought to be illegal.

Good for mental health?

And don't get me started on getting information on cost. You need this test or procedure or drug. How much is it going to cost? Will it be covered? The questions abound; the answers, not so much. Everyday shopping requires us to comparison price shop. It's not really possible in the world of health care, although like so many appliances, say, or even a cup of joe, prices vary wildly. But you can choose whether you want a $6.50 coffee at café or a $1.50 at a bodega. Whatever the drug price or test price is at whatever hospital or doctor based on whatever plan you happen to have is what you are stuck with. How can this type of stress be good for your mental health? Sometimes figuring out what things cost or what's going to get covered or what other medication might be available because insurance doesn't cover it takes a ton of time on the phone. Imagine if you are sick and you have to deal with doing that. In fact, it's often those people who are sick who do! The system is broken. For-profit health care is not healthy.

And how about that mental health coverage?

I haven't even gotten into that. But as a therapist, I know it's a real problem, for both seekers of therapy and therapy providers. Again, there are disparities. First of all, if people want to use their insurance, which certainly makes sense to me, they often have problems finding a health care provider who takes their insurance. I found an excellent post about why that is the case, so if you want to read further about that, I recommend the reading this. In short, because of poor reimbursement rates, hassles with getting paid, and having to often provide insurance companies with justification for treatment, even though that can be difficult to document, puts many therapists off to accepting insurance. Then there are those who have licenses which allow them to practice psychotherapy, but they are not recognized by certain companies, so these types of therapists (for example, LCATs such as myself, MHC's and LP's) might not even get on panels, or worse. Those with out-of-network benefits might not be able to use them if their provider's license is not recognized. This is a travesty that contributes to a shortage of care.

Making mental health accessible

I am fortunate enough to be on an insurance panel that works well on all accounts, most of the time (fingers crossed!). The majority of my clients have that insurance. For those who are uninsured and need a sliding scale, I offer a variety of slots to make therapy as affordable as possible for them, while still being aware of how it fits in with an overall business plan that relies on insured clients and those who can afford to pay full fee so that I can offer good care, and be compensated fairly. But serious changes to the overall system need to happen in order to at least have a sense that everyone who needs some type of mental health care will receive it.

From local to global

I realize that at this moment, I'm pontificating on health care from an American perspective, and even more so from a New York City one, where I give and receive care. Of course, many countries across the globe have no access to mental health care, and certain cultures lack understanding of certain mental health care conditions, how they affect the people experiencing them, their families, their societies. We are in a particularly perilous place in the world in terms of mental health: there is the crisis of war, of refugees, on top of so many other crises contributing to global mental health.

I did a little bit of research on what this day means. What is its purpose? What does it hope to accomplish? What impact has it had? I didn't find much about this year. If past years are any indication, it seems like this year is a launching pad to the next level. What I do know is the past two years have had similar themes, perhaps underscoring an enormous challenge/

2022's theme was Make Health and Well-Being A Global Priority for All. In 2021, it was Mental Health in an Unequal World. Here is the impact report for 2022. For me the takeaway is awareness awareness awareness. I will try to be hopeful about how awareness might bring around desperately needed change, and not just about mental health care. It's not World Mental Health Care Day. That aspect is very important but it's also about preventing mental health condition's root causes, such as violence and abuse. In terms of the little microcosm of mental health services I offer, and based on my own mental health journey, the possibility of awareness starts with recognizing the problems. In terms of this year's agenda, I hope good solutions are offered, seeds are planted and actions are implemented to truly make mental health a right for all in this broken, fragmented world.

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