How Does Insurance Coverage Impact Therapy and Medication?
The impact of managed care on psychological services is clearly expressed by the following letter to the New York Times, written by a very experienced psychiatrist (https://nytimes.com/2019/07/30/opinion/letters/drugs-depression-psychiatry.html). The letter speaks eloquently for itself:
To the Editor:
In “It’s Not Just a Chemical Imbalance” (Sunday Review, July 28), Kelli Maria Korducki describes her personal experience over many years seeking professional treatment for her mental health challenges. She laments that psychiatry has become “an industry of medication management.” This opinion is widely shared – alas justifiably so.
But it’s not the psychiatrists who are the force behind this shift.
As a past president of the American Psychiatric Association, I have encountered the same lament from fellow psychiatrists across the country. Instead, it’s the insurance industry and the managed care world that relegate psychiatrists to the 20-minute “med check” role.
Don’t get me wrong: Psychiatric medications are valuable components of treatment. But mental illnesses are complicated. Medications can do part of the job, but the rest must be done by a careful partnership between psychiatrist and patient, a thoughtfully crafted treatment plan that includes psychotherapy and/or high-quality psychosocial interventions.
It’s respect, compassion, genuine interest and professional expertise that psychiatrists must bring to the patient, to form a therapeutic relationship and then have enough time to do the job.
John M. Oldham
(Chief of staff at the Menninger Clinic)
The implication for clients and subscribers to insurance plans is clear: be careful and attentive to what you sign up for. If your plan is a managed care plan, your access to genuine therapy may well be seriously limited. The same is true for the time you can spend with a psychiatrist evaluating and then monitoring medication choices.
Alan M. Solomon, Ph.D. is a clinical psychologist in private practice in Torrance, CA. A member of the Independent Psychotherapy Network, he can be reached at 310 539-2772 or firstname.lastname@example.org
Copyright 2019 by Alan M. Solomon, Ph.D.