In California mental health workers of Kaiser Permanente, major health insurance and health care provider, strikes for not enough employees for quality care.
I'm sure this sounds familiar for many mental health practitioners employed by a cooperation. Lack of staffing seemed to be an issue in where I used to work, in the substance abuse treatment center.
The issue is the following:
- The affordable care act has increased the number of patients into the mental health field.
- In response to such demands there should be an increase in number of service providers.
- However, actually there is a decrease in number of service provider.
As a result, service cannot be provided to the patients, and as a result there are people who committed suicide and possibly homicide.
This currently is named the "Mental Health Crisis" as adequate care is not available in relation to the demands. As a type of crisis, this issue it is a maturation crisis (crisis built over time) where the number of mental health problem is increasing in the nation and when it comes to a certain point it will have a tipping point "crisis."
Let me analyze the situation to see where the cause is and the possible solution to this problem.
1) Is it affordable care act or other reasons too?
Increase in number of mental health issues has been discussed a lot around 2013, now the focus seems to be on increase in mental health issue in Children. Either way, the discussion of "increased mental health issue" has been around.
The affordable care act just made it easy for individuals who originally did not have insurance to come see a professional for there challenges to see the professionals, or they thought they can see the professionals. These individuals were always around suffering from mental health issues and we as a nation did not do anything about it.
So it is not necessary the affordable care act but the underlining issue of increase in mental health must be taken care of.
2) Should there be an increase in number of service providers?
It is a simple way of resolving the issue, yet from a business perspective this cannot easily be accepted as "people" are one of the most costly expense to a business. So if they do, another problem will naturally happen, decrease in the already reduced salary of mental health professionals.
Then what should the business and employees do?
LEVERAGE! the time and human interaction.
The number of clients/patients seen in an hour must increase. Of course, that is the reason why psychiatric medications became popular (you need to see the patients one a month or so). However, we know the kick back of that problem, actual problem not resolved, increase in substance abuse, etc. etc. Moreover, there seems to be a decrease in number of psychiatrist in this nation anyways (according to the news).
Quick question when do you think mental health practitioner makes money?
When they give the service to the clients?
YEEEE (incorrect)
When we complete the paperwork for the INSURANCE COMPANY.
We just can't prove YOU (patient) that we did a great job, we need to prove the insurance company. And do they pay? HAHAHA, you tell me.
1) So cutting down on the paper work time will be essential by implementing efficient system or...
When I used to practice, I wanted to provide as much service as possible in the working hour for my client. Ended up doing multiple after hour works, up to 5 hours, doing paper work. Yes, I did provide great service, but burning out was the correct word. And majority of the paper work did not benefit any bit to my client.
There are multiple services, computer programs to make the writing paperwork more efficient as possible, does the company implement such system? and have they trained the employees in it?
By the way the reason why we like private pay client is that they pay upfront (not after like the insurance company) and no unnecessary paper works.
2) Cutting down treatment time by having ways for the clients/patient to know, like, and trust the practitioner before hands.
There has been a lot to be said about treatment time reduction. Strategies such as "brief therapy" discusses a lot about it. Legendary therapist/doctor like Dr. Milton Erickson will be able to resolve a problem in one session. Yes, there is extraordinary skills that Dr. Erickson had but what it really boils down to is
TRUST.
If the clients
trust us then the treatment goes exponentially fast.
But in order to gain trust, they need to like us, and before that know us.
The key of Dr. Erickson was in his later years, people heard about him, friend referred him, or seen on some paper and came. Clients
already knew about him, likely to like him, and possibly trusted him before the treatment started.
This cuts down on how fast we can finish the treatment.
Think about this. You opened a door, and there is a total stranger. How long would it take for you to TRUST that person? Even if you knew they are professionals, it's not like fixing your car, it's about your life and you need to collaborate in order to make the necessary change (not like a surgery where you are knocked out and the surgeon just operates).
Social psychology would say at least three interaction to have a concrete perspective about another person. Okay... that is three sessions already!
Thus, interesting enough therapists' public relation effort will reduce the treatment time. Why do you think I write blogs?
Thus solutions are:
1) Have an introductory video of the therapist on a website or places clients can see.
2) Have podcast for the company and have your therapist as a guest.
3) Each therapist should have a blog, twitter, or some sort of way to send out messages to the world.
And of course, the therapist must keep training, improving their skills, knowledge, experience, and on themselves.
3) Decreasing service provider. The cause of it.
Is there decrease in service provider? Ahh, yes and no. Yes, seems to have less psychiatrist, less people coming into our field, and no there is a lot of licensed psychologist, and alternative individuals such as healers and coaches.
General: Low pay for what we do. Salaries are originally based on the need to obtain the skills, knowledge, ability, and effort to maintain attitude and awareness of the required job. Now a days it is based on the end result we provide and who we provide to (difference between treating depression of a millionaire and depression of a homeless). The nature of the targeted population tends to be the lower income population. Yes, there is rich people who have mental illness that needs treatment but that's not many compared to the poor. Usually these rich people come to get treatment when they become broke. It is difficult to maintain wealth with mental health issues, thus natural targeted population does not bring money to this industry.
If you treat many or provide value to many, it can compensate for the low income low paying population. However, the nature of the service tends to be one-on-one or at max one-on-twelve (group therapy) and limits the income.
Rare cases are substance abuse because it requires some level of cash flow in order to sustain the habit. Many times, the family members are wealthy "enough" to pay for the treatment.
Moreover, the level of mental stress and psychological contamination risk (getting mentally ill yourself) are high.
Psychiatrist: pay is high but risk is higher. 1/3 of all sued cases for medical doctors are apparently against psychiatrists. Federal funding also was shifted from specialties to primary physician, resulting in natural drop in numbers.
Psychologist: pay is high but likelihood of being hired is slim. All the knowledge, experience, skills, and abilities seemed to be undermined and seen equal to a master level therapist. Plus you only need one to manage many below. You can find many psychologist who will provide treatment and I am sure they will provide values to you but many are like me and take private payment, or only specific insurance.
Coaches and Healers: Their pay and expense to gain the certification or skills matches for these individuals. Plus many times they deal with higher functioning individuals which means higher economic status, higher pay.
Conclusion:
Strike itself, I will support it because it shines a light on the crisis we are facing now which will become worse if it is left untouched.
1) We must reduce the number of clients to begin with by providing prevention to the community, and hopefully the insurance company pays for such prevention seminars/training.
2) Always have better efficient way to reduce the unnecessary time wasted on paper work.
3) Find and implement ways to increase visibility of the therapist so they are known, liked and trusted before the session to reduce number of sessions (overall therapist will be able to see more people in a year).
Lastly, the strike also has to do with not only the lack of therapist in Kaiser but also has to do with team development, where the business and employee do not have the same mission. Simply, they are not working as a team. If the mission was the same then people will work overtime, and be creative. The inability to create a company were mission comes first, then the team, and individuals last are the cause of the problem, which probably my mentor, a rich dad adviser, Blair Singer would say.
see: https://news.vice.com/article/employee-strikes-highlight-americas-mental-health-crisis
