Mental Illness

Those seeking mental health treatment must navigate obstacles

Hard to get help
2013-02-06T06:23:00Z 2013-05-24T09:11:15Z Those seeking mental health treatment must navigate obstaclesTESSA FOX tessa.fox@journaltimes.com Journal Times
February 06, 2013 6:23 am  • 

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.

Availability

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

Hueller.

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.

The stigma

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.

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(6) Comments

  1. SineadOShucks
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    SineadOShucks - February 06, 2013 8:13 pm
    A lot of good things have been mentioned. I do agree, that if someone has committed a crime, they would be the first in line for treatment. Whereas, some of us who don't care to choose crime as a life style, we fall through the cracks.

    “There is a huge shortage of psychiatrists, particularly childhood psychiatrists.”

    This quote may explain the shooting epidemic by the untreated. Although, I agree illnesses are not ones fault but nor is it an excuse to infringe on society and its people along with shooting children massively. What concerns me, is the "targeting" of the mentally ill that Obama seems to be focusing on. I'm almost certain there are many people driving automobiles that are mentally ill and background checks are not done. BTW, what ever happen to "medical privacy laws"?

    With all this said, it does boil down to money I'm afraid and the numerous barriers to be leaped over. Sure wish there was an immediate solution. All I can say is that money talks and doo doo rolls up hills! Let us not forget the ones also, who have fallen through the cracks such as myself and those who won't even attempt the fight for help due to barriers and stigmas.

  2. Django
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    Django - February 06, 2013 3:39 pm
    “They like to look for jobs in Chicago or Milwaukee and we’re Racine. We’re Racine.”

    That says it all.
  3. Racine79
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    Racine79 - February 06, 2013 11:31 am
    when i see my Wheaton Psychiatrist every three months for med managment i have to pay a $35 co pay for a 5 minute visit. I'm thankful i have a job with insurance I dont know what I would do if i didnt. the mediction is so expensive.
  4. ggodmuls
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    ggodmuls - February 06, 2013 9:48 am
    Take a look around you. Happy, healthy productive people can't find employment and the level of taxation and government regulation makes most small businesses unprofitable from Day one start-up. Once the loans and grants have been burned through and now the payments and taxes are due.... Revenue doesn't equal expenses - business fail - or in the case of the local taxing authorities - John Dickert, Bryan Albrecht, and David Hazen, you increase the VIG.

    Where is all this money supposed to come from? Maybe Jesus will rain pennies from heaven?
  5. concerned
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    concerned - February 06, 2013 9:15 am
    Years ago an initial appointment with a mental health practitioner cost $350.00. If the patient needed medications, follow-up appoints were required. An appointment might be less than 20 minutes, but still the charge could be easily over $150.00. The cost of hospitalization for mental health and addiction services skyrocketed over twenty years (or so) when most insurance DID cover mental health care. The insurance industry nolonger would cover treatment care with no measurable results, and huge costs. There are only two facilities in Wisconsin that are non-proft. I think that's Mendota and Winnebago. Practitioners need to make a living, or make a profit. I don't think medical students will want to go into the field of psychiatry if they can't make a living.

    It all seems to have to do with money, and how individual communities decide to address citizens with mental illness. I don't think Racine has made it a priority, but with too much poverty, and too much crime funds go elsewhere. If somebody had commited a crime, then they could get a casemanager. If they hadn't entered the criminal justice system HSD really didn't have the staff to help.

    Will Obamacare help this? I'm not betting on it. Having worked in this field, I know even the practitioners who did take people on Medicare could limit the number of patients they saw within that group.

    I hope Obamacare may remedy some of these issues.
  6. Joeboy5471
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    Joeboy5471 - February 06, 2013 8:29 am
    This is the standard throughout the US. It has been this way for years. We have approximately 3-4 million folks walking the streets of the US who need mental health services, some under critical care. How can they get the services, when some cannot even provide rational thought to simple life experiences, let alone the resources are not available. The President just signed an executive order relating to gun control and the mentally ill. Does anyone think that the US government is going to make the situation any better? Pigs will play soccer in the Olylimpics first.
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