Friday, 5 August 2022

We Need To Talk About Mental Health

If you were listening to The Hockey Show on UMFM yesterday - if not, go back and do it! - you may have heard that Autumn MacDougall is working to start a charity game in Buffalo to benefit mental health initiatives and research. Hockey tries to lend its reach to a number of initiatives each year, but mental health is something affects people quietly and unseen. Whether it be an NHL player struggling with OCD, a high-profile women's national team member battling intense anxiety and panic attacks, or a "quirky" goalie who is bipolar, our approach to mental health needs to be at both ends of the spectrum if we're ever going to make life better for those who need help.

I say this because athletes are usually on the side of breaking the stigma around mental health which is valiant in its efforts to get people to talk about their struggles. I'm a big advocate of talking about mental health and breaking the stigma that surrounds it as well, but not a lot of us are psychiatrists, social workers, or psychiatric nurse practitioners in our spare time when someone who is willing to talk needs a professional to assist him or her. The costs associated with this professional help can be a major barrier to getting help, so it's time we start asking for more than just lip service when it comes to efforts to raise funds for mental health.

I take nothing away from Autumn's efforts or the efforts from hockey teams across North America in raising funds and breaking the stigma surrounding mental health because that's where everything starts. Those efforts should be commended, and I'm doing so here today. What you might be asking, though, is what the point of this article is when it comes to mental health initiatives, and I'm here to tell you that the professionals who work with, diagnose, and treat mental health patients aren't getting the help they desperately need to continue to make inroads in mental health care work.

If you're thinking, "Teebz, you know nothing about mental health care," I'd agree with you. I'm not in the medical profession, I don't have a medical degree, and passing an MCAT just to get into medical school seems like a daunting task. I do know, however, that there are people way smarter than I am who have much better research teams and larger budgets to devote to investigating stories like this, and this is where I turn someone who informs while being entertaining in John Oliver.

While Oliver may be a comedian by trade, his HBO television show, Last Week Tonight, has pulled back the curtain on a number of issues, and mental health has been one of those things where he's devoted more than one show to it. Last Week Tonight has likely devoted more time to mental health treatment challenges than some politicians have, and that's not what you want to hear if you're a mental health medical professional or someone seeking mental health help.

I know not everyone is a fan of Oliver's delivery on his show, but the point he makes is hard to miss. We'll start with the episode he filmed in 2015 where he addressed how US states treat - or how often they fall short in treating - mental health. And while this focuses on the US, don't pretend that it doesn't happen in similar fashion here in Canada. And, as always, all of Oliver's material is PG-rated, so viewer discretion is advised if you click the play button below.

As Oliver makes clear in that clip, funding for mental health services needs to be improved in a great way, but the services themselves also need to be expanded in a big way in order to help more people. Having hockey leagues agree to donate proceeds from charity games specifically played to benefit mental health initiatives would be a good way to get more money to those initiatives. Having the NHL, its teams, and its rather wealthy players throw some of their monies in would grow that effort tenfold as well.

This is where things take a drastic turn, though, because once people get into the system, there's a significant shortage of professionals who are available to help, and that number is growing smaller by the day thanks to health insurance providers valuing mental health professionals less than physicians and surgeons. As we heard Oliver say in the previous clip, some 44 million Americans were struggling with mental health in 2013, and that number has risen thanks to isolation due to COVID.

Here's this past week's episode of Last Week Tonight (the main story about mental health care starts at 7:03). You have to watch it via the link because the YouTube version is geo-locked for US IP addresses only. I will say that I have no affiliation with the linked site - it's just a place where non-US readers of this blog can watch the episode. Again, viewer discretion is advised in watching the episode.

If you don't want to watch the episode, the highlights of the Last Week Tonight episode about mental health care include:
  • Four in ten Americans reported suffering from mental illness during the pandemic. Do the math - that's 133 million people.
  • 65% of psychologists reported no capacity for new patients.
  • More than half of people suffering from mental health issues go untreated with minorities being more siginifcantly affected by this shortage in medical professionals.
  • Funding has historically always been low for mental health.
  • There are 6000 mental health professional shortages in the US with 60% of those shortages seen in rural areas.
  • Minorities struggle to find mental health professionals moreso than caucasians as minority mental health professionals represent just 15.53% of those professionals. And yes, this matters IMMENSELY when it comes to understanding culture differences and backgrounds.
  • Apps designed to assist with mental health are woefully ineffective and often rather useless when it comes to crises.
  • Teletherapy is worefully inadequate in assisting those seeking mental health assistance.
  • The lack of professionals is the elephant in the room in all scenarios.
  • States and the US federal government were to enforce rules to make mental health care equal to that of physical healthcare, but the US health insurance industry has been anything but helpful in granting treatment for a variety of reasons (this part needs to be watched and understood) including costs, coverage, and a lack of agreements with mental health professionals.
  • Federal and state agencies who are supposed to oversee health insurance companies to ensure they uphold their end of the deal are also failing mental health patients are they've done very little to force health insurance companies to be compliant.
  • Mental health professionals who eventually do get paid by health insurance companies, the pay is so little that most mental health professionals will no longer work with health insurance companies.
  • Psychiatry was rated at the bottom of 29 medical specialties in terms of pay while counsellors and social workers who have equivalent educations to their medical collegaues earn 33-45% less than those with a comparable education.
  • A survey in Massachusetts found that for every ten mental health clinicians hired, 13 leave clinics and the industry altogether. Again, the math in that situation simply doesn't look good.
  • The costs of not treating mental health issues affects everyone, not just those going through the mental health crisis. Mental health issues often lead to homelessness and situations within the criminal justice system which now makes prisons and jails the only place where they're treated for mental health issues. Both issues cost society an absurd amount of money to fix.
  • The solution sounds simple: attract more people to the mental health profession, and pay them what they're worth.
  • With more people asking for and seeking help thanks to efforts like "Hockey Talks", we need to invest in those who deliver that help. If we don't, we're going to find that all we're doing is providing lip service to people who truly want help.
If that's a too-long-didn't-read moment for you, the summation is that for all the good we've done in trying to remove the stigma surrounding mental health, there is a distinct and potentially devastating shortage of mental health professionals to treat those seeking help.

With NHL teams having the money to hire sports psychologists and sports therapists for their athletes, might we demand more from them in that each of the 32 franchises produces an annual scholarship for mental health professionals and people wanting to make that their profession? If the NHL teams can help to break the stigma for people seeking help, perhaps they can do wonders in helping more people find mental health professionals as well.

Autumn MacDougall should be commended for her efforts in making this mental health game into a real thing. I want to make sure she gets the kudos for making this a priority, and it will go a long way in helping the people in and around Buffalo with the money the Buffalo Beauts raise. And I want to be clear that people need to keep talking about mental health to continue to erode any and all stigmas that may still exist. All of this is progress in helping those who need mental health assistance find their way to the right people.

It's fairly clear, though, that we need more of those "right people" - psychiatrists, social workers, and psychiatric nurse practitioners - doing what they do best and being paid like the medical professionals they are. Governments will determine and monitor the payment side of the coin, but it's clear that we have an immediate, urgent need for more people doing professional mental health work. This is where sports can step in and ease the financial burdens and accessibility barriers to those medical programs so that we start filling the massive gaps in medical coverage across North America.

Autumn, keep up the great work. Readers, keep talking about mental health and breaking down stigmas. Demand more from the NHL and from your governments, though, and we can help more people. It takes all of us to make a difference, and the benefits of these improvements will be felt by each and every one of us.

Until next time, keep your sticks on the ice!

No comments: