Mental Health Care for Those Who Can’t Afford It


What would I like to see more of in the mental health world? Well, among other things, mental health care for those who cannot afford it. At least in America, there’s been this huge disparity in who receives care and who doesn’t. Not surprisingly, the rich do and the poor don’t. 

Specifically one of the huge issues pertaining to this situation is deinstitutionalization, which has lead to a massive demographic of people with mental disorders, especially those with schizophrenia, to live on the streets of cities. Urban cities and poverty are two huge factors that are formed by, and cause, negative affect to schizophrenia, causing this cycle of anxiety that worsens the disorder in people. This just makes it all the more difficult to live their lives and squashes their chances of improving their socio-economic status as well. What is deinstitutionaliszation? Wikipedia’s definition of it is as follows:

 “Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the late 20th century, it led to the closure of many psychiatric hospitals, as patients were increasingly cared for at home, in halfway houses and clinics, and in regular hospitals.”

These facilities that patients where being kicked out of were actually extremely helpful places for them and actually gave them a chance to improve greatly. Having a stable environment with resources and support can be very helpful to someone with schizophrenia, from what I understand. This “deinstitutionalization” partially occurred in the face of lack of funding and insurance help. It became very expensive to keep these people in such places.

This doesn’t sound all too bad, and it wasn’t the direct cause of this rampant homelessness, but it was the way it was carried out that led to this problem. It seems that the mental health care world generally cared and tried to be there for all of these patients, but, “the lack of planning for structured living arrangements and for adequate treatment and rehabilitative services in the community has led to many unforeseen consequences such as homelessness, the tendency for many chronic patients to become drifters, and the shunting of many of the mentally ill into the criminal justice system,” according to the National Center for Biotechnological Information.

At this point, this schizophrenic demographic has been cast so deeply into poverty and derision that it has become a massively hefty problem to solve, and often times funding still ends up going other places than mental health in most cities. The police end up being in contact with them most, forcing them off the main streets, arresting them, and/or putting them in jail in many cases.

I’ve seen this happen in Portland where the police just go straight down the streets, sweeping them for homeless people who they promptly move off the main streets, forcing them farther away. They cannot even find a shred of their much needed consistency with where they sleep because of law enforcement. Law enforcement that, at least in the City of Portland, is told to do this to brighten up the streets and make the city look better to the many people from out of state looking to visit and/or move there. At this point, cities like Portland are literally just sweeping their problems under the rug.

Apart from the homelessness issue, there is simply an issue of limited access to basic mental health care for the economically disadvantaged. In fact, anybody who isn’t upper middle class in America is much less likely to seek or receive care, at least that's what I’ve witnessed. A lot of old friends back home who are economically disadvantaged and have dealt with a lot of trauma and experience mental illness can’t afford the necessary resources and end up only getting worse, and in some cases turning to unhealthy coping mechanisms, mainly substances.

I’ve seen this greatly cripple their lives, substance issue or not, for they are already in need of financial stability, so there is no time to take care of their mental troubles and those troubles only get added on to. Being a student and a client within the psych world, it has become very apparent that there is a major wealth gap in terms of care received. Mood and anxiety disorders, considered the common colds of mental illness (in that they are very common and very treatable), often go overlooked when mental health care isn’t an option and it only lingers.

So overall I would make mental health much more of a priority among the greater American community and therefore make mental health care more affordable. It is a much needed thing for all people in America (and elsewhere), but it is especially critical for the impoverished and homeless who need the help the most. These are people struggling to survive daily, only worsening their illness while having no resources to turn to, not even a friend or family member, who are the most basic and immediate forms of support.

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Now it’s your turn! Comment below and tell us what you think a perfect world would be for mental health!



About the Author: Andrew M. Essig

Rather new to Vienna, Andrew has been getting involved in the social scene: going to clubs, concerts, making friends with Vienna’s artistic youth, and attending any sort of festival that he can afford! When not with others, he can be found pondering modern art exhibits or wandering around in nature.

Being an intern in another country is teaching Andrew to find balance in his life, taking care of himself and operating as a fully functional adult, while still getting the most out of Vienna. When he goes back home to the U.S. he hopes to bring with him the lessons he learned in U!Shine Vienna as he gets further in his psychology studies in University. For now Andrew looks on his past experiences with mental and emotional health as well as his comprehensive knowledge on the subject to connect with others and help them find the tools within themselves to build a more balanced and healthy life.