RACINE — If you’re seeking mental health care services in Racine County, you’ll need patience and persistence.
There’s help out there, but getting to it might require more resilience than you can muster.
Experts agree that access to mental health care is limited by various barriers, including a lack of available professionals, insufficient reimbursement rates for Medicare and Medicaid and the enduring stigma that keeps patients away.
Racine psychiatrist Dr. Joseph Bergs believes one of the biggest barriers in accessing mental health care is the limited number of clinicians compared to the number of people seeking help. His office gets at least six calls a day from new patients trying to get an appointment.
“Even if there weren’t any funding issues, there just aren’t enough people,” Bergs said. “There is a huge shortage of psychiatrists, particularly childhood psychiatrists.”
There are about 10 to 12 psychiatrists in
Racine County, but not all of them are accepting new patients, according to Michelle Goggins, the county’s manager of behavioral health services.
Mary Wilson, 55, is the community outreach coordinator at the National Alliance on Mental Illness of Racine County, and has experienced this shortage of available mental health specialists firsthand.
Soon after Wilson was diagnosed with bipolar disorder in 1997, she began seeing a psychiatrist through a community support program.
Community support program psychiatrists are meant for patients who are having a difficult time with their illness, according to Wilson. So when she started managing her symptoms well, she began looking for a new psychiatrist.
Wilson had trouble finding a new psychiatrist with appointment openings, so she began seeing a nurse practitioner approximately five years ago. She hasn’t seen much of a difference as a patient, but recognizes that there are some drawbacks.
“If I do have a relapse, I wouldn’t be seen by my nurse practitioner, I
would be seen by her supervising psychiatrist,” she said. “But that could be really bad because the psychiatrist wouldn’t really know me or how my medications affect me.”
Psychiatrists and nurse practitioners perform similar services, but the primary difference between them is the amount of training they require. A psychiatrist must complete medical school, whereas a master’s
degree is the minimum requirement to be a nurse practitioner.
This use of nurse practitioners is occurring in Racine and across the country, according to Julie Hueller, vice president of operations for Wheaton Franciscan Healthcare-All Saints. She attributed this shift to the lack of psychiatrists and the affordability for hospitals to hire nurse practitioners.
“The recruitment of physicians is difficult because everyone is looking for psychiatrists,” Hueller said. “They like to look for jobs in Chicago or Milwaukee and we’re Racine. We’re Racine.”
Medicare and Medicaid
Wilson also started seeing a nurse practitioner because she could not find a psychiatrist who was accepting new patients with Medicare and Medicaid, a struggle that many of the programs’ recipients may face.
When University of Wisconsin–Parkside students in Helen Rosenberg’s sociology of mental illness class surveyed 17 mental health providers in Racine County last fall, they discovered only six of them were accepting patients with Medicaid and just eight were taking patients with Medicare. A reporter with The Journal Times called several providers and found similar results.
Bergs explained that some clinics do not accept new Medicare or Medicaid patients because of the programs’ low reimbursement rates. These rates are set by the state, but vary among clinicians based on their education level and the services provided.
“If individuals with straight Medicaid reimburse roughly 25 cents on a dollar charge, and Medicaid HMO reimburses roughly 45 cents on a dollar, it’s tough to take many of those patients,” Bergs said. “By the time you paid for staff and rent and other considerations, you wouldn’t make a penny, and you’ve got to be able to keep the doors open.”
Larger facilities such as the counseling center at the Wheaton Franciscan-All Saints Wisconsin Avenue campus are able to accommodate more Medicare and Medicaid patients than smaller, private practices, according to
She said that over the past six months, 36 percent of visits at the counseling center were from patients with Medicaid, and 34 percent of them were from patients with Medicare.
Logistical barriers are not all that prevent people from getting mental health care. The societal stigma against mental illness also prevents people from seeking help.
“There’s this idea that you’re going to be seen as crazy if you take medication for a mental illness, but if a child was on medication for asthma, people wouldn’t blink twice,” Bergs said.
Wilson said she would never put that she has a mental illness on a job application because she believes it would be thrown in the trash.
“The more people understand that it’s not our fault, that it’s just a regular illness like anything else — then I think people with mental illnesses would have more access to employment, housing and health care,” she said.