Coakley: Mental Health Care Is Next Great Mass. Challenge

Attorney General Martha Coakley

Attorney General Martha Coakley

As WBUR’s Martha Bebinger reported, Massachusetts attorney general (and gubernatorial candidate) Martha Coakley is calling for the state to build “a behavioral health system for the 21st century.” Coakley spoke this morning to the Massachusetts Association of Health Plans. She recalled her brother, Edward, who began to struggle with depression at 17 and committed suicide at 33. We asked her office for the prepared text of her speech; it is excerpted below.

“…Which brings us to the third great challenge that I would like to pose to everyone today – improving access to quality behavior health care for everyone who needs it.

This is no small challenge.

There are millions of families dealing with the effects of mental illness across our country.

According to the National Institute on Mental Health, one in four adults suffers from a mental disorder in any given year. It’s probably higher.

And in a time when soldiers have returned from two separate wars, studies have shown that 20% of returning Iraq and Afghanistan veterans report symptoms of PTSD or major depression. It’s also most likely higher.

On Veterans Day, I learned that there are 22 suicides a day by veterans.

Some of you may know that my family dealt with the impact of mental illness.

My younger brother Edward was a brilliant person – he was smart, funny, a great pianist. He also suffered from depression, onset around 17 or so.

He struggled with it for much of his adult life, and my family struggled with how to help him.

When he was 33 years old, he committed suicide.

My parents had died just 1 and 3 years earlier. It was difficult for me and my sisters.

It is why I know first-hand – as many of you do – that behavior health care is as vital to the treatment of many patients as physical health care.

Providing timely, effective behavioral health services is a health quality issue, it’s a health cost issue, it’s a prevention issue, it’s a veteran’s issue, it’s a family issue. And it’s time to make it our issue.

It’s why we must commit as a Commonwealth to breaking down the barriers and ensuring behavior health services are available and accessible to all who need it.

I know many of MAHP’s health plans have been ranked the best in the nation for care quality and member satisfaction.

Your high rankings for both physical and mental health care are among the best in the country, and it shows your commitment to the well-being of our residents.

But I believe we can and must do better.

That begins with ending the stigma of mental illness.

Too many patients resist seeking treatment, and too many families feel pressure to do the same. We’ve seen that especially with many of our veterans who deal with their injuries silently.

Congresswoman Tammy Duckworth talked about working with a young officer, suffering from PTSD who would not get treatment because he blamed himself for being weak. She told him:

If you had a bullet in your leg, you would have it removed and you would get treatment.

We know there are capacity issues. There are vast regions of our Commonwealth where access to emergency and non-emergency services is incredibly difficult; especially for our children.

The issue of prior authorizations, and the delays that have all too frequently occurred, is one that I know we are all grappling with. We need to commit to getting the full facts around the causes of those delays and then act to fix them.

There are other parity issues. Parity laws, including the regulations just passed on the federal level, will help. But those regulations will only be as effective as the providers and insurers who implement those changes.

That means adhering not only to the letter of the law, but the spirit of the law which is to treat access to mental health treatment with the same imperative as physical health care.

These are just some of the challenges we face.

I don’t think we have all the answers yet, but we know the questions to be asked and I’m confident we’ll develop the right solutions, together.

We have worked as a health community to tackle major challenges before. I am proud of that, and am so proud to say I am from Massachusetts.

We were first in the nation to act on access. We were first in the nation to act on costs.

And now I’m asking for your commitment to throw our hats over that wall one more time to build a behavioral health care system for the 21st century.

We owe it to the patients who are silently suffering, we owe it to our veterans who return home with injuries we cannot see, and we owe it to families who have loved ones they are trying to help but may not know how, like my own.

Massachusetts, if we have the will, has the ability, as we have done so many times before, to lead the nation in this important mission. I know we can do it.

Readers, thoughts?

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  • Liseuse

    I have MassHealth and very few quality providers accept it, probably because they are paid so little. I wish we could somehow change that. After many, many attempts (the last “therapist” I went to offered to pray over me, as long as I wasn’t Jewish)!

  • ed

    Way too many drugs given out like candy. These drugs have serious side effects but the drug companies make so much money they can buy immunity.

  • Lawrence

    Yes, I agree about approaching this with compassion, psychotherapy, mediation, exercise. All these have demonstrated huge and lasting benefits.

    The problem I can foresee is that this new found spotlight on mental illness will be a quick road to the dangerous medication so many find themselves on now. They are pushed on those who don’t need them and are abused.

    Gwen Olsen and many others that once were in the business of selling these meds, have now confirmed what many knew all along, that the abuse of these drugs is mind boggling and dangerous. Sure, some need them, but not all that are on them, surely not the majority of children and many others.

    Even Michael Moore now sates that what was missing from his Academy Award winning film ” Bowling for Columbine’ was the role of psychotics as a motivation for the mass killings that occurred in that devastating event.

  • RMM

    I am a psychotherapist , and I have a comment. How about reimbursing mental health services at rates that enable providers to make a living? Payments for psychotherapy are so low that no sane person would consider going into the field. There are not enough providers, and the inadequate income they are paid is the reason why.

    • Beto Ben

      correct me if I’m wrong, is the reason why you call yourself a psychotherapist because you don’t any kind of licensure? look this business of mental in enforced nor regulated the way is designed to be implemented and as usch people lie yourself “psychotherapist” provide very little or no service at all under the protection of someone else’s licensure. The bottom line is, I believe that this mental health business needs to regulated strongly than what it is now because in the end the only one who actually suffer are the patients by ciontinually being treated by unlicensed, unsupervised and uncredentialed individuals who have no business to begin with treating the chellenges the mentally ill faced on a daily basis here in the Commonwealth. I believe the Attorney General ought put more emphasys on prosecuting individuals and companies whose only goal are to get rich omn the back of taxpayers funds and at the same provide no service to the mentally ill here in our State. I believe the rates that people in the mental health industry receive are exactly according to that professional qualifications and licensure.

      • most888

        Of course he or she is licensed! As am I, for over 25 yrs…And yes as a LICENSED, very skilled provider of mental health care it is essentially impossible to stay in the field and also support rent/mortgage, childcare, and the basics of a struggling middle-class living. And as most of you can imagine, it’s a field that takes more than 40 hours a week of care, time, thought, education in which to stay updated, keep apprised of our patients’ struggles, and respond in often life-saving/after-hours ways. All Licensed Psychotherapists in MA who have decided to work with insurance reimbursements do a great deal of work for free– given the insurance companies refusal to reimburse us at deserved rates.

      • RM

        Yes, I’m licensed. In fact, I have a Ph. D. in social work, and 30 years in the field. I have continuously added to my skills and expertise through continuing education, well beyond licensure requirements. It is a sad point that none of this matters to the rates of reimbursement I receive. Perhaps I could choose, as some therapists I know do, to refuse insurance altogether, and charge $200.00 an hour out of pocket. I don’t want to practice that way.