Thursday, October 12, 2017
Study Highlights Systemic And Societal Barriers As Well As Ways To Effectively Overcome Those Obstacles In Order To Pave The Way Towards Recovery For People With Mental Illness
Substance use, homelessness, and incarceration are three devastating consequences of failures at the early stages of the mental health system. The opportunity for individuals to get early and possibly lasting support for their mental health care needs can be lost when important information about treatment options is not readily available, when early symptoms of mental illness foster isolation and stigma, when insurance coverage proves hard to navigate, when costs of treatment discourage or limit access, and when effective providers are seemingly impossible to find. It is also true that by harnessing the potential of existing programs and promising opportunities to advance public policy, these barriers can be surmounted and that recovery from serious mental illness is achievable. 
"This report presents the results of a yearlong study of ongoing barriers to early mental health treatment, care, and recovery based on the insights from people in Massachusetts. The study also explores how to overcome these barriers, using the most practical, concrete and cost-effective tools possible and proposes next steps," said Amy Rosenthal, Executive Director of Health Care For All.
This work was made possible by The Peter and Elizabeth C. Tower Foundation, which funded a broad overview of the behavioral health barriers that people face when trying to get care, particularly for individuals attempting to cope with mental illness as well as their families, providers and other allies. 
"The research initially focused on insurance barriers, mostly relating to mental health parity. However, the information coming back took us in a less obvious but no less compelling  direction: early barriers to getting care can have a significant impact on a person's potential for recovery," said Stephen Rosenfeld, former HCFA interim Executive Director and project manager for the report. "It is in the earliest stages of mental illness that engagement can have the most effective outcomes, but where too often circumstances prevent people from getting the care they need."
"As a result, many individuals face an increased likelihood of months and more often years of untreated or inadequately treated mental illness. The resulting life disasters become immoveable problems in and of themselves. This makes it difficult - and sometimes impossible - for individuals to regain precious ground and access the treatment and supportive services that make recovery an achievable goal," added Rosenfeld.
The report also highlights key recommendations to overcome those barriers: 
  • Massachusetts should help promising programs grow to scale. Two immediate candidates are the INTERFACE referral service (INTERFACE) and Bridge for Resilient Youth in Transition (BRYT). 
  • The state should commit to closing the knowledge gap by creating a state-of-the-art resource helpline and promoting its use statewide. A promising project with that goal is now underway.
  • Massachusetts should expand the training and employment of people in peer support roles. One major step in that direction would be MassHealth payment for Certified Peer Specialists.
  • Massachusetts should require increased transparency of insurance, improved customer relations, and safeguards to guarantee that people receive the full measure of the mental health coverage to which they are entitled by their insurance policies.
  • The services of Emergency Services Programs (ESPs) should be available to all. To that end, all commercial insurers should include ESPs as an essential part of their behavioral health coverage.
  • The comprehensive approach to children's mental health, embodied by the Children's Behavioral Health Initiative (CBHI), should become a universal feature of commercial insurance.

Appearing throughout this report are photographic portraits of people in recovery from mental illness. These individuals are participants in the 99 Faces Project, an artistic work conceived and created by Massachusetts artist Lynda Michaud Cutrell. The goal of 99 Faces is to portray, in the words of Cutrell, "individuals whose lives are remarkable for their recovery, not their illness." As such, they exemplify and reflect the promise that timely and effective access to treatment for mental health conditions holds. This report takes an optimistic approach to our collective ability to reduce the barriers to delivery of effective mental health treatment in Massachusetts, because optimism supplies essential energy to the effort. The photographs we have included speak eloquently to why this matters.