Nearly two million adults in Pennsylvania are living with a mental health condition— including depression, anxiety, bipolar disorder, schizophrenia and ADHD — and more than half of them are not getting the help that they need. That lack of care doesn’t stem from a lack of trying to get help or a lack of desire for it. Instead, it’s born of a broken system characterized by a lack of access to far too few mental health professionals and exacerbated by other missteps in social infrastructure.
Mental Health America reports that of those Pennsylvanians who did not access psychiatric care in the past year, the cost of that care was the primary contributing factor for 20% of them. And while just 6.9%— 134,000 people— of those who did not access care are uninsured, having health insurance doesn’t necessarily make it easier to get help, and in some situations can make it more difficult. According to the National Alliance on Mental Illness (NAMI), insured Pennsylvanians are over 5x more likely than people in other states to select out-of-network providers over those covered by their insurance because their in-network providers are unavailable or because they don’t meet the patient’s needs.
Adding what may very well be insult to injury, more than 1.7 million Pennsylvanians live in areas that don’t have enough mental healthcare providers to meet the needs of their individual communities. This highlights the need for mental healthcare to be both affordable and accessible, throughout all of Pennsylvania.
“Pennsylvanians are struggling with their mental health, and current resources may not be enough, to help everyone in need,” said Dr. Chris Pagnani, MD, Founder and Medical Director of Rittenhouse Psychiatric Associates, which treats approximately 10,000 Pennsylvanians struggling w/ various mental health conditions. “Not having enough providers, or enough accessible and affordable providers, puts our community at risk.”
That risk is multi-faceted. More than 1.5 million Pennsylvanians report having a substance abuse disorder in the past year, and more than 485,000 report having serious thoughts of suicide. Because people living with general mental health conditions are disproportionately impacted by addiction and risk of suicide – the dangers of limited mental health resources are compounded. Finally, stigma only makes these issues worse.
“Despite the many strides that we’ve made recently in making mental health a socially acceptable topic of conversation, there are still cultures and communities, including many across Pennsylvania, where it’s just not something you talk about. Not to your friends, not to your family, and not to 10 or 15 doctor’s offices that you have to contact – to find a practice that’s accepting new patients,” said Pagnani. “The arduous task of finding a provider, coupled with distress caused by the process of doing so, can lead patients to feeling worse, before their treatment even begins.”
Untreated mental health conditions, including substance abuse disorders, may also lead to other negative outcomes. Those living with mental health conditions are disproportionately impacted by arrest and incarceration. According to NAMI, more than two million people with a serious mental illness are booked into jail each year, and two out of five of those adults currently in jail or prison are living with or have a history of mental illness.
“Poor mental health and time in the corrections system are often two stopping points in a vicious cycle. Untreated mental illness, and the traumas that it can cause, can lead to addiction, which often leads to incarceration,” said Pagnani. “Incarceration, and the traumas that it can cause, can lead right back to further substance use.”
Pagnani added, however, that the goal for mental healthcare is to reach patients long before their symptoms become severe, and certainly long before they become part of the above cycle.
“Pennsylvania and its communities are making progress, but still have a way to go, to fully support its residents and ensure their mental wellbeing now, and well into the future.”
That’s why Pagnani has been focused on growing Rittenhouse Psychiatric Associates; "We’ve created a more-affordable option for many Pennsylvanians, by teaming with academically oriented and incredibly well-trained Psychiatric Nurse Practitioners, who can see patients in-office and virtually (throughout all of Pennsylvania), at significantly lower fees than many out-of-network local Psychiatrists. We’ve also hired specialists in Women’s Mental Health, Substance Use Disorders and Child & Adolescent Psychiatrists". Pagnani adds, “by increasing services and locations throughout our state, we hope to turn the tables on the mental health crisis and make our community an additional two million strong.”