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An Epidemic of Silent Suffering

Mental illness is the “big secret.” It’s the public health crisis most people want to ignore. Men, women and children of all ages, races, faiths and economic levels suffer from it. They hope it goes away. And, they hide it because of widely held misunderstandings that surround those with mental health diseases.

Because so many people with mental health challenges live in the twin shadows of shame and stigma, we aren’t able to get a clear picture of what mental illness really looks like. In fact, the public sees it as the random person on the street, or the guy at the end of the bar, or the quiet woman at work. They don’t see it as a family member, a friend or a neighbor. Our picture is distorted.

The fact is, 47% of us will face a mental health challenge in our lifetime. Many of us will have trouble finding a qualified mental health care provider and paying for thousands of dollars in medical care that insurance generally doesn’t cover.

Mental illness is real illness. It’s a disease of the brain marked by measurably changing brain chemistry. It has physical markers and physical symptoms. So, like physical illness, it can be treated.

And, we can all be a part of making that happen.

Shame & Stigma

shame-and-stigmaIt’s incredible to think stereotypes associated with mental health disease still exist. The ideas that it is “self-inflicted” and those with problems are weak continue to run through our culture — adding fuel to prejudice and discrimination.

Whether it’s a direct remark or subtle avoidance, stigma has devastating consequences for those who suffer:

  • Reluctance to get help
  • Lack of understanding from family and friends
  • Limited work and housing opportunities
  • Bullying and harassment
  • Self-doubt and shame

Research shows that the most effective way to reduce stereotypes is to meet someone with mental illness face-to-face. Knowing someone with a lived experience is two to three times as effective as educational programs in terms of changing attitudes.

We need to continue to spread the word that mental illness is real and it’s treatable. In fact, with a combination of pharmacological treatment and psychosocial support, 70-90% of individuals who suffer from mental health disease experience a significant reduction in symptoms and improved quality of life.

Rogers InHealth was created to help reduce stigma in Wisconsin and beyond. Its programs are supported by generous donations made through Rogers Foundation. Check out their groundbreaking work at rogersinhealth.org.

Access to Quality Care

access-to-quality-careThe need for high quality psychiatric care far exceeds the resources available.

  • The American Hospital Association reports that more than 50% of US counties “have no practicing psychiatrists, psychologists or social workers” and only 27% of community hospitals have an organized, in-patient psychiatric unit.
  • Mental health experts have determined that there is a critical shortage of psychiatric beds nationally. At minimum 50 beds per 100,000 U.S. citizens are needed. According to The Treatment Advocacy Center, the national average is 14.1 beds per 100,000 citizens resulting in increased homelessness, emergency room overcrowding, and use of jails and prisons as de-facto psychiatric hospitals for people suffering with mental illness.

At Rogers Memorial Hospital, we know that quality and timeliness of care are of the utmost importance and can mean the difference for a lifetime of recovery.

Rogers Memorial Hospital is Wisconsin’s largest, not-for-profit mental health and addiction services provider and the fourth largest in the nation. We are nationally known for our outstanding treatment services for eating disorders, depression and mood disorders, obsessive-compulsive disorder and other anxiety disorders, chemical dependency, as well as child and adolescent mental health concerns.

Over past 100 years, Rogers has grown from a single hospital in Oconomowoc to a system of health care facilities with programs designed to meet the growing needs of children, teens, adults and older adults suffering mental illness. Through our partnerships with the Medical College of Wisconsin, Children’s Hospital of Wisconsin, Froedtert & Medical College of Wisconsin, and Columbia St. Mary’s Hospital, Rogers provides more than 45% of Wisconsin’s inpatient mental health care.

As the need for specialized mental health care grows in Wisconsin and throughout the country, Rogers is expanding its locations to offer greater accessibly to our exceptional treatment programs. Locations include:

  • Oconomowoc, WI
  • West Allis, WI
  • Brown Deer, WI
  • Kenosha, WI
  • Madison, WI
  • Tampa Bay, FL
  • Nashville, TN
  • Chicago, IL

Limited Resources

limited-resourcesProper care for mental health disease is essential to recovery. However, that can be difficult considering that 45 million Americans live below the poverty rate, and millions more lack the financial resources required to pay out-of-pocket for their mental health care needs.

Rogers Memorial Hospital is committed to charitable care and bringing quality treatment to as many people in need as possible. Toward this goal, the hospital provides care to many patients  without adequate insurance or the financial means to cover their expenses.

In 2013-14, the hospital wrote off about $2 million in non-reimbursed care.

  • Of this total, $1 million was outright charity care.
  • An additional $220,000 was covered by patient care grants given by the Foundation.
  • $1 million in patient debt was written off for families for patients who were unable to pay for treatment in full.

Here are a few more interesting facts:

  • The hospital provided nearly 18,000 days of publicly funded care. Wisconsin Medicaid accounted for 14,000 of these days making Rogers one of the largest Medicaid mental health inpatient providers in the state.
  • Of the 10,000 patients treated last year, 40% of those patients were 18 years old or younger.
  • 70% of those patients 18 years old and younger met the poverty threshold for Medicaid or Medicaid HMO reimbursement.

Insurance Coverage

insurange-coverageLimited insurance coverage makes it difficult for patients to receive adequate treatment for long-term recovery.

There are huge inequities between medical and mental illness coverage making it next to impossible for those suffering to receive the level of care needed to regain a healthy and productive life.

Here are three examples:

  1. There is a significant difference between medical and mental illness coverage. It is not unusual that an insurance policy sets a lifetime limit of $1 million for medical care, but less than $50,000 for lifetime mental health treatment.
  1. Small businesses with less than 50 employees are not required to provide mental health coverage at all, leaving countless individuals unable to get the help they need.
  1. Many insurance agencies only provide coverage to individuals who are suicidal, homicidal, or unable to function. At Rogers Memorial Hospital, these patients are admitted to the inpatient unit. Once the patient has overcome these severe conditions, coverage ends and the patient leaves within an average of seven to ten days. At this point, the patient is only temporarily stabilized. This often lends itself to a crisis-stabilization-crisis pattern in which only the patient’s most critical and immediate needs are met, but long-term goals fall short – leaving the patient and the patient’s family to suffer.

How Rogers Responds

To combat this issue, Rogers Memorial Hospital created a Utilization Review Department. The purpose of this department is to evaluate a patient’s medical needs at the time insurance denies coverage for treatment.

They determine when it’s appropriate to go back to the insurance company to make the case for coverage. They have reported that the inpatient denial rate for coverage is 3%, partial hospitalization denial rate is 10% and residential denial rate is 25%. The department conducts 20,000 reviews each year.

Because of the rate of denial, Rogers has also hired two financial counselors to work with families to help navigate the insurance process and to create payment plans when needed in order to ensure admission to or completion of the treatment process. Families know ahead of time that if/when insurance ends, there is a backup plan already in place.