Mental Health Care: Last Week Tonight with John Oliver (HBO)

I was actively suicidal at the beginning of 2020 and got admitted into a psych ward. The first person I talked to when I arrived was the billing department. A day later I talked to a overworked psychiatrist for about 5 minutes who just asked what meds I was on. A week later I was discharged with no follow up plan just a hefty bill to pay off for the next 6 months. Since then I know not to talk about my sucidality with anyone, especially a health care professional. What they do for you ends up feeling more like a punishment than help.

not to mention if you’re put into a psych ward for having a mental health emergency, it’s EXTREMELY traumatic. not only do they not treat you properly, but in my experience i was even harassed by other patients, particularly men.

I wish there would be a Supreme Court decision on making an insurance company accountable for a bad patient outcome.

I work in healthcare. These insurance companies and benefit managers are designed to operate this way. They exist to make money, not to provide you adequate care. The pharmaceutical and medical device companies share much of this blame with them.
On the other hand, I’ve seen one therapist myself for several sessions and she was a nice lady, but utterly useless. We need more mental health care providers, but competent and effective ones.

As a mental health provider, I can't think of anything to add to this John. Great job. I take most insurances and am barely paying bills. It's rewarding, but exhausting work. Yes we need a lot of changes!

I thought privatized healthcare meant we were getting quality healthcare, quickly. Turns out, we're getting terrible healthcare, slowly, at an exorbitant cost.

Finding a therapist
Finding a therapist who takes your insurance
Finding a therapist who has an opening
Finding a therapist that you are comfortable talking to.....it's a nightmare

As a healthcare professional this is absolutely accurate. Therapist feel and see the need in the community, are burned out, underpaid, and are also simply human beings with their own lives and troubles. Mental health is a large part of the foundation for overall health. If you can not take care of those providing care everyone will suffer.

I'm a therapist and I agree with this. The system is horrendous.

I’ll never understand why people continue to vote for the same politicians over & over and expect anything to change.

I'm a therapist and I have to say, he really summed it up quite well. The only thing I would say is that the problems actually run quite a bit deeper than this. An entire hour could be dedicated to unpacking all of this but I appreciate that he covered this.

As a psychology major, I am saddened that there is so much stigma around mental health care. It is also appalling that there is not enough help available. My heart goes out to those who are suffering.

To anyone who argued against Medicare-for-all on the grounds that "other countries have long wait times whereas we do not", I await your response. Our system is indefensible.

It's pretty depressing how we keep saying mental health is such a big issue, and how we care and how it's okay to open up and acknowledge mental health as a thing that exists, but at the same time trying to actually find someone to talk to is just impossible.

I was once in a Psychiatric ER for about a month while in active psychosis. Just waiting for a bed. When you're stuck in a small room with nothing to do, no-one to talk to, and the walls are laughing at you (among other issues), it’s not fun. Especially when you're 12 and people refuse to believe that a 12 year old could have schizophrenia. I'm 20 now and doing better but it was hell for a while.

The real problem is that the number one antidepressant is financial security

The amount of comrades in the military who just need someone to talk to, someone who listens and understands their pain is astonishing. I am happy to provide this small service for everyone in my unit without talking about anything I've heard , so by now I get visits quite frequently.
My point is - if one of your family, friends or aquaintances suffers from depression, anxiety or something else - at least have an open ear for them. It seems that talking about your problems with someone non-judgmental has at least a small positive effect, and that is way better than nothing. Help your fellow man, you might need some help yourself someday.
Hope y'all have a beautiful day, and if you are suffering : you are not alone. Even if it feels like you are alone - Someone is there for you. You are in my prayers too - keep your head up, things are never as bad as they look ! =)

I had a therapist during the early parts of COVID-19 if not before. I only went enough to count on one hand, including a couple phone call sessions and I found out from my insurance that he was billing my insurance for sessions that never happened for several months. I'd love to consider seeing one again but after the ordeal of disputing this, I don't wish to end up in the situation again.

"Doctors will spin the data and make things seem more serious than they are because they feel strongly that patients need that care." Think about what that man just said. He said, "We, a health insurance company, wouldn't pay for healthcare, and so doctors started lying to us to get people the care they need. And because the doctors lie, we, a health insurance company, are now using that as an excuse to continue to not pay for healthcare."

I tried to use a community clinic yesterday but the intake process was clearly trying to get rid of me. It was very traumatic. It reminded me of the John Oliver episode recently. I have a disability & Medicaid & asked to use Zoom. The intake person mocked me for this and tried to focus on my medical problems & push me to get psychiatric medication from my GP dr. Or go to the ER for my disability. I told her I would never manage my disability through a GP or the ER. She mocked me no matter what I said. I wanted counseling & to see a psychiatrist who accept Medicaid but she kept saying I would never get through the waitlist & arguing with every answer I gave to her questions.
It was very rude & upsetting. I started crying because she kept telling me why I was not a good fit to get counseling or see a psychiatrist!! I was told to go there by everyone bc they accept Medicaid and have disability case managers!! I could not find a single therapist or dr who accepts Medicaid. It was so traumatic bc I waited months and already went there once and lost my therapist, then was told they do not have zoom when they do. Never again.

I'm bipolar and from the time I was nineteen until I was 27 doctors kept misdiagnosed me as being depressed and prescribed medication that threw me into manic episodes. I remember so many of my friends complaining about my erratic behavior and asking me why I didn't just go get help ...

I've called dozens of doctors and therapists over a two-year period that blue shield said were taking patients and covered in my plan, and none of the ones who ever answered or called back were taking patients. At one point my mother and I sat down with the entire list and called everyone in one day and got four answers, none of them currently taking patients.

My sister spent months in an Eating Disorder clinic and during that time we watched so many families come and go before treatment was finished because their insurance cut out essentially saying that one week was good enough. Those kids went home and starved ending up in hospitals their parents couldn’t afford.

If you DO have a physiologist or therapist that accepts your insurance,
*You need to thank and appreciate them, because they deserve better*

I think 80% of American horror stories are about the US healthcare.

“As bad as our situation is now, it’s only getting worse” should be the tagline of this show.

A few weeks ago I took my friend to the ER so he could admit himself for severe depression and suicidal thoughts. We waited in the lobby for an hour, and witnessed the hospital staff blatantly disregard its patients, even joking with each other behind the glass as people on the other side with us pleaded for help. Eventually we left and found a better hospital, but yeah, not a great experience.

As someone who studied psychology and is trying to help her mother with a substance abuse problem, this episode could not have come out at a better time. 😬

This episode highlights every single issue that has led to my burnout as a counselor. I’ve wanted to be a therapist since high school after the lack of quality care I received when I was suicidal. As a black woman, I recognized the absolute need to have more cultural representation in the MH field. So I got my BA and then MS and have been working in the field for 11 years (I am counting my grad school internship as I had two caseloads- the on-site clinic at school and my off-site location working with teens). I’ve loved helping and guiding people in crisis yet the work is exhausting. I knew that going in as I, initially, worked with children of trauma and their families and currently work with individuals in early recovery. While grad school educated me on the importance of self-reflection, self-care and supervision, it doesn’t prepare you for the truly demoralizing experience of insurance reviews. Insurance companies are ruthless in finding any way to not pay. The criteria they use to identify appropriate levels of care are bare-bones.
As stated, I work at a community residential program (it’s a hybrid of sober living and group/individual therapy where the clients can leave for work) and with the County government’s CSB which he used the term community mental health. Same thing, different name. I mention this because the population I work with are low-income thus we typically take Medicaid. Working with the reviewers means I have to go to battle and scrape for every penny daily, up to 4x. A patient presents with obvious signs/symptoms that deem continued care necessary but oh no! “They’ve been sober for 90 days and haven’t had a craving in two weeks. They’re stable and can go.” Um, the person hasn’t seen their doctor or psychiatrist yet, isn’t med compliant because appointments are hard to come by and they wait for weeks, nor have they been able to utilize their coping strategies as they begin to experience their emotions and/or re-live their trauma. But they are stable? Okay. So, I end up embellishing to get my clients more time.
The counselors are tired, drained and burning out because we are short-staffed. Our supervisors are stressed and leaving for private practice because they don’t have to deal with insurance appeals or budgets or BS. And the clients coming in are more and more severe in their MH because there isn’t enough resources provided to them before they reach our program. I could go on for days. But what I’ve shared is just the tip of the iceberg. And it’s enough. I am burnt out and will be leaving my jobs (and the field) in January 2023. I don’t regret my decision to go into this field yet now I have to figure out what I want to be when I grow up…again. 🤦🏾‍♀️

As someone in my final year of an MSW degree (Masters of Social Work) we are having these conversations often. Doing therapy as part of unpaid internships required for our programs, it is obvious that some of the most severe and underprivilege members of our society are having assistance by the most overworked and least experienced professionals (interns and new social workers going for licenser). If we want to make any kind of sustainable income and keep some kind of sanity with caseloads, many who are not looking to work in private practice are forced to move into that field and are still overworked. When I tell people I am going into the field of social work I get a laughing wince as they tell me I won't be making money and the attitude is that I should get out and trying to go into psychology or a more "science" field if I want to make a living. How about instead of feeling bad that I won't make money, and telling me I'm kind for doing this work, you help advocate for mental health's importance and support us and our clients/patients?

"This would have been a good idea... _had we funded them properly."_ -America in a nutshell
Also, the quote "this is truly the 'different look, same great taste' of America's failures" is pure gold.

Carl Jung on his "The Practice of Psychotherapy" notes that the need for mental healthcare is so large that it would require a lot of therapists and, therefore, practical tools should be created to train these healthcare workers. Jung, for instance, wrote two books on Personality Typology: one is a prog rock album - thick as a brick - and one for Spotify. The thick one is where he describes the reasoning behind his typology and the shorter one is just on application of the typology.
We should also never forget Emile Durkheim's work "On Suicide". If incapacitating mental illnesses start to appear in larger numbers what we may be facing is not a problem with the patients but with society. Durkheim studied suicide rates and showed how a change from the historic data represents a social phenomenon. Durkheim calls these events - when the numbers are very different from the historic series - "Significative Events".
We should also learn that the idea of "normal person" was invented in the 1970s - before that the concept was "well adapted" or "adapted person". Adaptation is the hability to lead a regular life - work, pay bills, live descently. "Normal", however, requires people not to be weird, excettric nor 'different'. In the 1970s psychiatrists developed questionaires to diagnose mental illnesses and what that created is a set of answers that showed a person had no mental illness - a normal person. If you try to normal you'll surely go crazy, btw. No one is normal.
Disclaimer: I'm not a specialists - I'm just a curious person who has friends who are specialists in some of these fields. I also like documentaries and one that I like the most is called The Century of The Self from the BBC and available on KRclip.

My girlfriend is a social worker for children and teenagers, most of whom are hospitalized for extreme cases like suicidal tendencies or violence, and the horror stories I have heard from her is horrendous. I want to also make it clear that she is still shadowing; she technically has not even finished her training, despite having multiple years of experience in the field And her masters degree (I shudder at her student debt), but because the hospitals she works at are so understaffed she often ends up the only social worker there, with maybe two nurses, and a tech if the kids get violent. No matter how much she cares or wants to help there are Too Many kids for just one person to handle! So they slip through the cracks.
That doesn't even Begin to cover the racism - the times she's had to tell a boy - a Child - that he's going to jail because he had a psychotic episode and rather than receiving help from the state he's being arrested cuz he's black and the state doesn't care about him has happened far more than it fucking should. She's been in the field for less than two years and she is already so exhausted. It's as bad as the crisis happening with our schools and the under-staffing and lack of care there.
The way we treat mental health in this country is horrendous, and millions of people are suffering for it.

Allowing the private industry to have any say at all in the care of human beings is not just infuriating, it's immoral. At no point should the question of cost effectiveness ever enter into the conversation of the medical care of anyone. Health care should not be a business.

I think another important thing to note is that even when you do manage to jump through all those hoops to recieve mental health care, that care is not always great.
For example, I was hospitalized earlier this year at an inpatient facility, and the stay traumatized me. I was isolated from my friends and family, locked in a communal living space full of strangers, had another patient walk into my room while I was trying to sleep several times, and didn't actually get any one-on-one sessions with a therapist. I felt unsafe and paranoid while staying there, which obviously did not help my situation. The only one-on-one care I received was meeting with a couple doctors to change my medications.
I still have frequent nightmares about inpatient. It definitely was not nearly as bad as it could have been, but it still left a huge negative impact.
Not only are we facing a crisis of accessing and affording mental health care, we are facing a quality crisis too. Many, if not all, of the factors presented in this episode contribute to this issue.

My sister was a psychology major in college because the field really interested her, but now she has no idea what to do with her degree because the pay for any job her degree qualifies her for is terrible. At best, she would have to go back to school and get (and pay for) a masters to get a better paying job in the field.

I had my insurance company decide my chemotherapy "wasn't medically necessary" when I had cancer. Wound up getting it sorted out but it really pissed me, my family, and my doctors off.

This entire episode is relatable- from struggling to find a therapist that's relatable, to struggling to find proper help as a teen, to struggling to find a therapist that my insurance covers or even finding someone taking new patients, to constantly hearing "just be positive" from people who have no idea what it's like dealing with depression/anxiety/PTSD, to the cops sending me to an adult mental hospital as a teen without my mom's consent...
This country is terrible at helping people dealing with mental health problems.

This was probably the most bitingly close-to-life story you guys have ever covered for me personally. It took me months to find a therapist with workable availability, who also accepted my insurance and was in the same state and I've still have never met her in person (we exclusively use telehealth). It's a fucking nightmare.

"You're stuck waiting for care, and you can't. Get. It." That's it. That's the whole thing. I've had several bouts of depression where I've been on the phone in tears calling every psychiatrist/psychologist/counselor in my area that would take my insurance, come to find out that even if they ARE taking new patients, the first available appointment is weeks, sometimes, months later. And when you're in a crisis state, that can be devastating. I am SICK of insurance companies being able to practice medicine without medical licenses

I looked for a therapist during the pandemic because I was really down, but wasn't even diagnosed with depression or anything. I can't imagine doing all of this searching being severely depressed!! Looking through the capital blue cross website (and yeah the lists on there even suck, I basically took them all to google to confirm everything), calling people, getting waitlisted, getting one place who set me up with an 80 year old man, it's truly trying on your very soul. When you are not feeling well that is all the LAST thing you want to do. Thank goodness I have a wonderful friend who found one for me, I just had to call them.

Can we appreciate, for a second, how important this show actually is? This show has changed my far right dad's mind on a lot of shit. Including his views on Donald Chump, and the rest of the GOP, and the flaws in our country that needs repaired. Not only that, but how many of us would pay attention to these subjects if not for this show?

When I hit 65 I found that my therapist's licensure was not excepted by Medicare. She is a Licensed Professional Counselor. She kept me on, I pay $50 a month and see her every two weeks, because she wants to help me. I am so grateful. She has helped me so much.

This video made me so grateful I have a mother who cares about my mental health and a therapist who I have such great chemistry with and who cares about my problems so much and the financial stability to afford it. To whoever is out there that is struggling, I promise it will get better. Maybe not tomorrow, or next week, or next year, but it will. Someone always cares about you. I hope everyone eventually finds the help they need. I know this may all sound dumb coming from someone that seems fortunate, and I don’t blame anyone for feeling that way, but I promise it’s the truth. If any of you need a friend, I’m here.

As someone who has been tossed around the mental health care system like a baseball since I was 12 (going to be 29 this year), I'm extremely thankful that this topic is being discussed in more detail, and I hope you do more pieces about it in the future. In 2017 I was in a psychiatric hospital 5 times throughout the year, and some of the people I met and the experiences they had with doctors mistreating them or getting them addicted to medications ... it just broke my heart. I've had psychiatrists tell me to "just get over it", to "take 3 or 4 pills", etc. The system is overloaded and people are suffering. Sorry to ramble, would just really love to hear more about this and have the public hear more about it as well. Thank you again to the LWT team!

The new Joker movie does a *great* job of showing us what happens when we don't care or *want* to care about the mentally ill. Or, more to the point, what happens when the *government* doesn't care or doesn't want to care about the mentally ill.
Your episode, here, does a greater job by examining and telling us about the finer points of the problem concerning the American side of mental health care.

I relate to the "suck it up" thing. I'm not in the US, so I have some access to mental health care. But I've been told to become an alcoholic because that's how everyone else manages. And it's kinda true in my field.
I'm working towards going to school to be a counsellor as a side gig, hopefully that'll curb both money issues (paid better in my country) and being able to help people (for free as well).

I love how insurance companies are not medically trained but are allowed to remotely practice medicine without ever seeing the patient...

The situation of mental health care in Sweden is very similar. The fact that even here it doesnt work is very sad. Atleast we dont have to fight an insurance company. But waiting times are long, and options are few

That man really just said "The doctors who went through a decade of medical education with degrees to prove it believe the patients need more care, but we the insurance providers know better!"

Thank you for also talking to therapists. Something that wasn't mentioned, we have 90 days to submit a bill or the insurance company won't pay it BUT they can take back money at any point. And they do. Also, when therapists have to call the insurance company (yes, call because they evade emails) it is not unusual that we have a 2 hour wait time on hold, during which, we cannot see clients and are therefore not getting paid. Private practice therapists are gig workers.

I was at Aspen dental couple years ago. The person next to me was getting some serious work done. In the middle of the process they stopped and told the guy his insurance wasn't going to cover it. They started asking him what he wanted to do, with a whole bunch of tools in his mouth and barely able to talk. I didn't see how it all played out.

When everyone gets the care they need, they can return to their life and maximize their talents again.

Thank you John, I’m a licensed psychologist in a rural setting and literally everything you talk about is facing the people that I treat. I wish I could take them all on, but it’s just not feasible. Also, to the insurance asshole, yeah, we do embellish, you’re right. Because if we tell the truth, even if that truth is severe, you still deny our claims!! If you viewed mental health care as the necessity that it is, we wouldn’t have to embellish!

Such an essential conversation. Thank you for raising this issue.

I was having a lot of trouble processing some of my identities with my white therapist. One example: she had to stop the session once to ask me to explain the term "Latinx". So, yeah, therapists of color ARE NEEDED!! Had a hell of a time finding a Latinx therapist after that, but I live near a big city so I was lucky I eventually found one.

Mental illness is the biggest crisis we are facing today. We need to help these people and make it a priority and do it humanely

AMEN! It’s next to impossible for unhoused people to get the help they need and a large portion of society looks at unhoused people as less than human. It’s incredibly sad and it’s wrong.

As an EMT I have had patients that are supposed to go to the county approved facility for mental help, but those facilities are so overbooked and understaffed that we end up transporting the patient to the ER. At the ER they are placed in a secure room and everything taken from them while they wait for a case worker. That case worker may not so up for days. That patient really gets no care while they wait. They are watched to make sure they don't harm themselves but they are basically in hospital jail till a case worker comes.

Finding a black therapist in the SF Bay Area took me nearly 3 years. When I finally found one and got comfortable with her, she quit because she was overwhelmed during the the COVID pandemic. Thank you for this piece.

This is so true. I went through this. When you already are suffering with severe anxiety and depression it's outrageously hard to muddle though this system.

For 30+ years, I've had to deal with absolutely *ALL* of my own health care alone. If anything, involving others made things FAR, far, far worse. As in waaayyy worse. I have many horror stories which I won't even go into, but one instance involved a "doctor" who saw me for all of 10 minutes, and without even ONE clinical test, she made a phone call and my driver's license was instantly revoked. 😳 I am not joking. This is "the system". No evidence nor tests are required. ONE PHONE CALL. She laughed. No joke.
It was the first time in my existence on Earth where I'd ever considered throwing bricks through the windows of a facility and setting the entire place aflame. $3000+ and maybe 6-8 months later (along with a cheesy, sleazy lawyer I had to deal with), and I got my license back.
IT'S A FUGGIN' CARTEL AND EVERYONE KNOWS IT. 😡

Thank you for highlighting this issue. Mental illness is so misunderstood and is therefore highly stigmatized. And the umbrella of mental illness covers a huge variety of types of mental issues, so this only creates more problems with stigma and misunderstandings. For anyone who has never experienced any type of mental illness has a high probability of not understanding to such a degree that the mentally ill are seen as weak, or has to be committed, or even seen as criminal and dangerous. I've seen and heard a LOT of really strange things or downright horrible things over the years. And this very often includes just the general public, but also includes professionals. But worse yet is when others do not listen to, or trust the mentally ill to, accurately convey information or to be honest about their own feelings or experiences. When a family member was released from a hospital (when COVID began and was shutting everything down) she was put into an UBER with an address to another facility. The Uber driver took her to a place in a different city that shared the same address. When she said it was the wrong place, the driver would not believe her and refused to verify with anyone else if he was in the right or wrong place. He kicked her out of the car and she was forced to try and find someplace open, who also had a phone. She walked for several miles before she was eventually able to get home. It was not long after that she finally committed suicide. Though she was tortured by inner demons and was suicidal over many years, it was this experience that I feel drove her over the edge and she finally succeeded in ending her own life. It has been extremely hard on the family to deal with her loss. My heart often weeps for her. My only consolation is knowing her personal struggles are now over, but it does not do anything to relieve the pain of losing a beautiful soul who deeply loved and cared about others, and who was exceptionally gifted in intelligence and creativity. She is deeply missed. There really needs to be more attention given to this subject, so I really appreciate you talking about how we are failing as a society to address mental illness and the people who experience one or more forms of it.
Also, just so you know, it has more recently been discovered that the appendix does actually have a purpose: it is part of our immune system. It can also present more problems than bursting and creating significant life or death problems, but I've discovered through experience that it can also be a place in which cancer can form. It's super rare, but deadly, and hard to diagnose until it's too late. Anyway, the point is that the appendix, in spite of potential problems it can have, does actually serve a useful purpose.

As someone who grew up in and out of psyche wards- I was still in outpatient therapy when the COVID hit. I haven't been in it since. The horrors stories I have with both insurance and underfunded care is a therapy session of it's own.
Not to mention you can be denied your practicing license in mental health fields if you have a history of mental health issues. Meaning the people with the deepest understanding and want to help are being barred from even entering the field

While it's not perfect here in Canada this says a lot about our system, when I needed to be admitted for hearing things I went to emergency, within hours I was admitted with a temporary diagnosis. I was gonna have to wait a weekend till Monday to be able to see a doctor until I lucked out. A psych saw my name was Hispanic on an intake sheet and being a fellow Latino himself he came and saw me on the saturday instead, turned out to be a mix of stress and medication, was discharged that day and started seeing him a couple times a month. Life's been great ever since, while it was a bit of a slower process in terms of hours, compared to that kid and his parents, it's night and day

Lastly, I think it’s important to remember that Capitalism actively creates/worsens mental health issues. People will have mental breakdowns if they work full-time and still live paycheck to paycheck. Almost everyone is just one emergency away from a mental health crisis.

I am in happy tears that this is finally being addressed publicly. I have been in the middle of the mental health care system for 21 years. I watched my parents struggle to find ways to help me afford it & I tried to find free or low cost solutions. I've been on better help, but couldn't afford multiple sessions and I could never talk to the AI about anything serious. As a child I constantly felt like I had to convince my teachers and doctors that I was in a rough place. My parents were only able to pay for therapy by asking for help and we were lucky enough to receive it from some family. Still therapy helped me be introspective but it didn't actually help me. when I did find a treatment that worked, insurance stopped covering the treatment half way through deciding it was pseudoscience despite the practice having the most proof. when I did start becoming suicidal & went in for an evaluation I spent 7 hours in waiting room before having my phone and personal belongings locked away from me and sitting in an empty room for 2 more hours with nothing to do. I was only showing warning signs and hadn't made an attempt yet, but I know what to worry about. they were severely understaffed & couldn't even see everyone. It felt like the experience was designed to make you crazy. Mental health on all directions has needed to be taken more seriously for a very long time, from funding the places who provide support and keeping drug & insurance companies accountable to funding research and properly screening and educating special ed teachers & schools. matching appropriate accommodations to a kids conditions and work benefits providing more than just random counselor numbers you can call where you might get a few sessions for free. As well as the fact that many people mental health issues aren't able to easily obtain a job or go through the process for applying for disability. even if they have the motivation, if you are maybe a child in the same house as an abuser, you don't have your own money to use. there are warning signs for suicide but they are treated like most as someone who is just lazy and attention seeking. And then people have the nerve to say we don't ask for help. The reality is many of us deny help because we are exhausted from looking for it only for the people who are supposed help us to tell us or do something to us that deteriorates it further. I am so grateful to you for finally acknowledging the elephant in the room. I have been screaming my lungs out trying to prove it but maybe something will actually get done about it if it comes to someone like you. Seriously thank you

Universal Healthcare and Free College, that would help with a lot of these horror stories we have to deal with all the time in this country.

I'm studying to be a psychologist in Mexico. Even though our education and regulation of psychology here in Mexico is lacking, more often then not I ran into Mexican psychologist that have started giving teletherapy to Americans because it's way much cheaper to pay 800 Mexican pesos (aprox. 40$ USD) then to hire a psychologist in the US of A

Headway is an amazing company. I have been in therapy for over 30 years for severe trauma, PTSD, etc. and my old therapist. Pardon the expression is 93 years old so it was time to find a new one. I had no idea how to go about this, so I searched on the Internet and found this company. I found an amazing therapist who contacted me almost immediately And we hit it off immediately and she’s just simply fantastic. Her name is Margarita. Everyone’s biography and specialty is on the website with their photos.

When a person has been struggling with depression or similar issues, just getting the courage to reach out and try to contact a therapist can be a major struggle. Finally making that step, only to be told "we don't deal with your kind of problem, go away", or flat out being ignored, can be very hard to handle. The last thing a suffering person needs to hear is a message that the professional world doesn't care about their problems.

I can definitely relate to what John has talked about in this video. I remember calling so many psychiatrists to find one that met my needs, specifically OCD. I couldn't really find one until I really looked out of network, and that was pretty difficult, too. Having to pay out of pocket for every visit especially as a young man in his later college years, and struggling to land a good-paying, decent job in the midst of COVID. In reality, it shouldn't be like this. It's against the law, but what good are laws without active enforcement?

Mental health care in this country is abhorrent, and everything covered here is absolutely true. Another issue I’d like to see covered in more depth is the relationship between addiction treatment and mental health care. It’s really hard to find anyone who will treat both, because various restrictions mean someone can either get addiction treatment with a sprinkling of mental health care if they’re lucky, or mental health care with a sprinkling of addiction treatment if they’re lucky. The two are extremely comorbid and extremely closely intertwined. But when people with both seek help, they can be bounced between addiction treatment and mental health treatment with each saying that the other needs to help with the problem.

i’ve gone through 4 therapists throughout the past year and a half under my insurance with kaiser. kaiser is so bad that even the therapists are frustrated. the moment i felt i was getting comfortable and forming a connection with my therapist, they left. they even admitted to me they left because they were frustrated with the system. now i have to wait over a month to get a 30 minute session

Part of the problem is not just mental health stigma, but also the prejudice against psychiatry in medical school... Being treated like you're choosing psychiatry because you couldn't handle a "real" specialty.

I literally just look at the Uk’s NHS’s website for any medical issue I may be experiencing and it’s just…magnificent. I can’t tell you how much I’ve been grateful for another country’s access to diagnostic info and medical papers from studies from this very year, and the options or alternatives to current treatments that I have already been given with no success. See for yourself how pathetic the CDC is to the NHS just from their websites!

As a therapist, thank you so much for raising awareness on these issues, John. Every issue you brought up in spot-on.

Watched Jonathan Oliver’s segment and what not and have to agree that America’s mental health system is likewise as much of a labyrinth and a game of snakes and ladders as whatever issue or crisis one may deal with.
I can empathize personally with the crisis portion: I had daily panic attacks at work back in 2021, including thoughts about suicide and needed to take months off work for disability leave. It worsened after I had no work and all time to think! I had panic attacks hourly and feared I was going insane and began fearing thoughts until I had actual headaches that blocked out thoughts. Not sugar coating - those months were despair, it was horror and fear. So when you want immediate and precisely useful help, it’s because you need an *immediate* good or great solution. Most of the time you don’t get any solutions since you have to wait for a therapist. If it is like this, you may be behaviorally learning bad habits which can take LONGER to fix then had you originally had the right care immediately. The worst is when you look for your online self help blindly searching for what can help (bloom, headspace, etc) that are truly designed just for a general populace not one’s suffering from anxiety etc and, like prescription medication, become a literal Guinea pig while you mix and match in a wicked learning environment.
Eventually through a combination of multiple therapists and self-therapy, etc and about 1 year through, I discovered the most life changing therapy that should be THE go-to first line called Acceptance Commitment Therapy (ACT)
I also found actually helpful methods to respond and behaviorally treat thoughts prior to fusing consciously with them emotionally but not struggling with them or emotions with ACT.
Likewise DARE book and app have been invaluable. Just as helpful for me in overcoming panic thoughts and fusing to them easily, is with “Hope and help for your nerves” by Claire Weekes.
A significant portion of panic disorders (PTSD, GAD, etc) and mental health disorders can be easily prevented and more difficult but possibly cured through cognitive behavioral therapy, namely acceptance commitment therapy. I’ve been able to get my life back and become a stronger person and character through it!
Knowing that and spreading it to everyone who suffers and doesn’t want to suffer from the above alone is a life changer. Awareness of go to solutions

I worked for the post office for 8 months. They said in training we qualify for 6 free sessions with an approved therapist. The first list of 10 therapist sent to me either didn't exist anymore or didn't take new patients. The second list of 16 had one that agreed to see me. I worked 8-14 hours a day, 14 days a week so I couldn't schedule a day to see them. I finally was able to because I broke my foot working on a rainy day and was bed ridden for months. She said after the first meeting I wasn't in network and I'd have to see someone else. A federal job with access to a federal database and free mental healthcare wasn't able to hold up its end of the shaky bargain.

Beginning of 2020 I went into a clinic because I was suicidal. They in turn called the local authorities to do a wellness check on me while in the clinic in the observation room. They set me up for an “emergency therapist” at a building in my town called “The Block”. I first had to wait 2 weeks for my first appointment and this building was mostly used for disfunctional members of society, it was like a big rehab center. I went into the building and immediately felt uncomfortable and I never felt like the feelings I had were ok around the therapist they “assigned” to me. She was very judgmental. Luckily I was redirected to a therapist in the hospital of my hometown and HE WAS AN ANGEL SENT FROM HEAVEN. I pray everyone can find a person like this man because he helped change my life. But back to the point. Before they gave me the first person I had been looking for openings since august of 2019, and i admitted myself for suicidal thoughts in late January of 2020, and even then in January most therapists were booked out for 4 months at a time. I got REAL lucky finding that one man, without him I most likely would have just killed myself. I think there’s too many requirements to be a Psychiatrist/therapist. Too many people need that kind of help and not enough people offer it.

Thank you so much for this!!! I'm a Licensed Professional Counselor who recently went into private practice and struggle to fill my caseload due to insurance denials and people not being able to pay out of pocket. I am still recovering from burnout and would love to see you guys do an episode on agencies (including non compete clauses and them taking half of clinician's pay and not providing what they promise). There are so many other issues that I could write a full paper on but getting the word out can spark change! Thank you again for advocating for us.

Thank you, John Oliver! The past few years in particular have been harsh for people. Most people who reached out to me said I was the 10th person they called and sometimes the only one who answered their voicemail. It's bad enough so many people were depressed during the pandemic, but then they had to deal with feeling like no one cared enough to even answer their call. And I'm sure many of those numbers were outdated and the wrong number, hence the no return call. Not that the person on the other end couldn't have reached out and told them they had the wrong number, but that person probably a) Was dealing with their own mental health challenges mid pandemic, and b) Was tired of fielding calls from people given the wrong number by the insurance company. Insurance companies being willing to pay for online therapy allowed people to search their entire state for a therapist rather than just someone they could drive or otherwise travel to. I had people in online forums chew me out because I said I wasn't going to return to an office after the pandemic slowed down. Why would most therapists spend hundreds of dollars a month to rent an office when insurance companies often don't pay enough for what we do already? (Not to mention the impact on the environment of each therapist driving to and from an office every day and all of their clients driving to and from their appointments.) Everyone is burned out, including us therapists. I need a vacation!

Back when my son was young and having emotional issues, we found a great therapist that he liked. I was so pleased he would get the help he needed. 2 months in our insurance no longer covered her and we were told only of one psychiatrist he could see and be covered by ins. We gave it a shot. The doctor talked to us for 2 minutes, told us there is nothing wrong with him, that there were children much worse off and sent us on our way. I was so angry. At age 21 my son tried to commit suicide with drugs giving himself stroke that he never completely recovered from. He is often moody and angry. I still get so angry when I think that if had been allowed to continue with the therapist, his life could have been so much better.

I can say this is so sadly true. We need more help for mental illnesses. It’s horrible that people have to struggle because of it. I have ptsd and a bunch of other mental illnesses. I have been in and out of therapy for years. And I agree with everything being sad.

John, I’m new to your show but you certainly have a brilliant way of delivering information on a serious topic with such great wits and humor.
Now that I’m a little more rested up and recovered from dealing with a recent client-related crisis at work, let’s see how much I can expand on some of the concerns that are highlighted here.
• As a MH clinician/clinical SW who has worked in public mental health and practiced in various community settings, school campuses, locked facilities, and MH/medical clinics over the past many years, I’ve seen and experienced the injustices and the hierarchy within our healthcare system, as evidenced by the fact that MH clinicians have been poorly compensated and inadequately supported for being called to accomplish such tall orders, and highly stressful tasks and many times, work in unsafe/hazardous environments, especially when faced with high-risk MH clients/populations.
• Additionally, many of us have had to endure the incivility and the inhumane treatment within the very own system we work in, being mistreated by other healthcare providers and our very own colleagues-1) those who carry a sense of entitlement, arrogance, hatred and contempt towards others because of certain privileges and many times, because of their own unresolved generational trauma/MH issues; 2) those who are promoted into positions of power, not necessarily based on merits, talents or good work ethics, but rather, based on their political/social affiliations or loyalty to certain folks.
• The history of psychotherapy is rooted in a very White patriarchal system. So it is obvious that the MH field has long been predominantly filled with White therapists, and plagued with racism, sexism and other -isms/biases against people of color and immigrant groups.
• From my personal/professional experience and observations in the MH field, the oppression and discrimination start as early as in graduate schools, particularly more so towards those of us cultural beings who are first-generation immigrants, whose primary-spoken language in the home is not English, and those who have already been exposed to or experienced other forms of trauma (ie., third-world poverty, war, genocides) and oppression prior to our arrival in the US of A.
• To become licensed MH clinicians, many of us have to continue the arduous clinical journey following the completion of our graduate schools. (It is important to note that different disciplines within the MH profession have different focuses, trainings and requirements for their programs).
• For people of color, English learners and first-generation immigrants, not only have we had to jump through more “hoops” in pursuit of our clinical supervised experience to collect hours to be eligible for licensure, we have had to overcome far more social/cultural/language/systemic barriers than our White colleagues, and individuals who are US-born, English speakers, or those who have been well acculturated and assimilated here in the US for more than 1.5 generation.
It is no wonder that there is a huge shortage of well-trained, healthy, system-aware, culturally sensitive and highly empathetic therapists of color in our MH field. Many have either left the field due to high burnout, systemic abuse, and/or compassion fatigue. Or, they have changed career for other high-paying gigs, because the reality is, at the end of the day, many of us still have rents/mortgages, bills, and student loans to pay off, and for others, a family to feed. 🧡

I was fortunate enough to have a job in 2020 and worked tirelessly through the pandemic. I was able to move back to my home state of California and work from home, this was before Covid implemented all of us to work from home. It was a very conflicting time, trying to sell to our clients and pretend that there’s nothing going on the guilt of still having a secure job. There was absolutely no work life balance, plus there was some fighting going on within my family that was mentally painful & taxing. Then came September 26, 2020 my dad ended his life and this was just too much shy of the eight year anniversary of my sons father ending his life. Come June 2021 I was miss diagnosed with kidney disease and took a short leave of absence to figure that out then when I came back after that time off I was not doing well and clearly needed some help with my mental health. I went on an unpaid leave of absence and started going to a outpatient program for mental health. That was in October 2021 when the psychiatrist gave my return date to my employer of January 1, 2022 I was immediately terminated. I lost the disability I was on which was 750 every two weeks I was and no longer able to stay with the outpatient program because my insurance is what was covering it they did extend my time until March 2022, though my coverage ended immediately December 1 of 2021. The outpatient program insisted I was covered but I was not and I now owe them $45,000. They recommended me to a psychiatrist that takes Medi-Cal and insisted that they would continue my disability in which they did not and I have been unemployed and an in worse shape than I was when I initially took the time off. If I could’ve done it different I would’ve never taken that time off and never gone to the outpatient program I regret it immensely.

When I was 17 I had a massive psychotic break after a year of being completely disabled by my untreated mental disorders. I spent months fighting my insurance, they finally agreed to give me four one-hour therapy sessions of the course of two months, BUT I had to get my father who doesn't believe in mental health to agree because I was a minor. I was desperate, I was extremely ill, and I saw absolutely no way out of the hell I was experiencing. The only way I got proper help was after a suicide attempt and I called the police on myself. I had to almost die, have a traumatic head injury, have a police officer come to my house, have to explain to my dad why there was a police officer to my dad, be taken away in front of all my neighbors, have a panic attack because he had a gun (great idea btw), and I was scared he was gonna shoot my barking dog, and then be legally required to be taken to a psych hospital and have a permanent mark on my record to get basic help.
I'm currently in a situation where I could very much lose my coverage for care that I very much need (although I'm much better now, thanks to years of treatment). "Thankfully" my condition is severe enough that with enough kicking and screaming I should be able to get some kind of treatment, but what if it wasn't? What if I didn't want to fight for help? Most people in my situation, including myself at many points, don't have that kind of energy. Or suicidal people for that matter. The situation is if you're not willing to go bankrupt, attempt suicide, or physically fight your insurance company, you can't get real care. What the actual fuck America

Thanks for addressing this crisis, maybe our politicians will do something if you run a couple more segments, you could save millions of lives! Kudos!

As a psychologist, I want to thank LWT for covering this important issue. Spot on in every argument. Just need to add that while working for a school for traumatized students and then a residential program for autistic teens in crisis, I can tell you that the public system of funding (i.e. the education system and Medicare) are woefully underfunded and over-regulated. The audits, absurd documentation requirements, constant reports, and draconian bureaucratic requirements, all for scraps, make working within such systems a burnout mill for care givers. It is seemingly designed to be as miserable, inefficient, and untherapeutic as possible. These public funding systems need a major overhaul if we want to use public funds to cover mental health services.

Single-payer health care is actually high on the shelf. To get it, don't use a ladder, use a guillotine

When I was in (adolescent) residential eating disorder treatment, it was common to see patients get discharged early because their insurance suddenly stopped covering their treatment. Those of us lucky enough to have the full treatment covered by insurance were all jealous of the others, and if that's not a statement to someone's mental health not being stable enough to leave treatment then I'm not sure what is.

I hope things brings more awareness to the mental health needs and the ridiculousness of insurance coverage for those services.

What kills me is that even when there ARE therapists available, proper care still isn't guaranteed!
I started therapy at 8 years old. It took 6 more years, 6 mental health professionals and me DIRECTLY ASKING FOR TESTING for anyone to suggest that I miiiiight have autism. Me, who graduated highschool three years early, with major social anxiety, "weird" behaviors and "weird" interests. All because I'm a girl! (and I'm white, i don't even want to imagine what it is like for a POC).
In the meantime, therapists have called me uncooperative, cursed me out for being mutic (a symptom of autism...whatever at this point), put me on the wrong meds, and accused my very supportive parents (mainly my mother) of taking bad care of me as a child.
The fact that ACCESSING care is so complicated that you can't even start to breach the topic of said care's QUALITY is deeply concerning.

After 8 years of insurance bureaucracy horror, I went out of network to get the help I needed. I used one of those big four teletherapy companies, and I lucked out with a therapist that worked with me, and has done so, so much. I've made progress, with regular therapy and an out-of-network psychologist, but the cost of staying alive and healing is astronomical. American healthcare insurance treats its patients like a walking pricetag.

As someone who’s dealt with autism/bipolar for most of my life I can say this is so nice to hear someone talk about the hell that is our mental health treatment system

I am dead serious when I say, thank GOD I have healthcare through the VA. I also have private insurance through my work which pays first before the VA covers the rest. I don't need private health insurance, but making them fork out money for my medical treatments that were free to me anyway just feels good.

An intake with a psychiatric nurse practitioner at my facility is 475.00 out of pocket. And intake with a therapist is 179.00. You are required to have both to get any psychiatric meds.
I currently work in patient accounts and the denials I’ve worked for “not medically necessary” are outrageous. I’ve sent so many appeals that just list the consequences of mental health issues or substance abuse. Like, “We’d like the client not to die?”

Dealing with health insurance has probably caused many mental health issues; Mostly when they refuse to pay and the patients and their families have to go into debt. Having lots of debt can be seriously stressful, and stress is a major component in mental health.

My poor son suffers from schizophrenia and on his third hospitalization for symptoms of his illness, I pleaded with the hospital to give him another week, they only wanted to keep him one week, so instead of releasing him in critical condition in a week, well, he was released in critical condition after two weeks. They needed that hospital bed! Heartbreaking. Every day. It was written right there on his discharge papers! “Critical condition.” He is my child! He deserves better!

I had to switch psychiatrists because my great one wasn’t in network and was too expensive. My new one literally told me to quit college because I clearly wasn’t cut out for it and it wouldn’t amount to anything. Bless my mom for telling me he was completely wrong and that we weren’t going to see him again but damn that hurt