More than 3 million New Yorkers have a diagnosed mental illness but only around one in three can get the care they need to treat it.

The barriers stem from many factors, like so-called "fail first" policies, which require people to try an insurer-preferred medication first, before covering the original prescription.

Matthew Shapiro, senior director of government and cultural affairs for the New York State Chapter of the National Alliance on Mental Illness, said another issue is what are known as "ghost networks."

"In some cases, up to 75% of providers that the insurance company gives to their client don't actually exist," Shapiro pointed out. "They're no longer practicing in the area. We call that 'ghost coverage,' where they're telling you coverage is there and it's not."

A 2023 New York State Attorney General report found 86% of providers listed on health plan networks are not valid listings. The report recommended state regulators crack down on insurers to maintain consistent and accessible levels of care for all. Another barrier is low mental health care reimbursement rates for providers.

As mental health issues rise nationally, insurance coverage needs to meet the moment. Federal laws like the Mental Health Parity and Addiction Equity Act and the Affordable Care Act ensure behavioral health coverage is on par with other health care.

David Lloyd, chief policy officer for the mental health advocacy organization Inseparable, said loopholes in the laws still have to be closed.

"What mental health advocates across the country and in states are pushing for is to make sure when a doctor is recommending treatment, the health plan has to cover those services when they're consistent with what the standards of care are," Lloyd explained.

The biggest challenge to closing loopholes is lawmakers finding the political will to do so. Lloyd added the overall goal is to align providers' and insurers' standards of care, so patients get the treatment they need.

As youth mental health challenges rise and federal restructuring threatens key programs, former Ohio Gov. and 2016 Republican presidential candidate John Kasich is urging Congress to act.

He co-chaired a bipartisan task force calling for early intervention and stronger support for young people struggling with behavioral health and substance use issues.

Kasich stressed the need to remove stigma and integrate mental health care into routine pediatric services.

"If we can intervene early, then we can get kids to be able to overcome the challenges, to be stronger, to be able to have healthier, more positive lives," said Kasich. "And there's nothing more important than our children."

The report warns that proposed changes at Health and Human Services could result in funding cuts to programs - like youth violence prevention and crisis response, which are currently supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Bipartisan Policy Center CEO Margaret Spellings warned that youth-focused programs could suffer if federal changes move forward without safeguarding behavioral health investments.

"There may be funding cuts ahead that could put critical programs at risk," said Spellings, "including those focused on youth violence prevention, adverse childhood experiences, crisis response, and support for a very much needed workforce."

The report recommends integrating mental health into pediatric care, supporting the behavioral health workforce, and expanding school-based services - steps mental health experts say are vital to improving the outcomes for youth in Ohio and nationwide.

May is Family Wellness Month, and Minnesota households are encouraged to work on goals beyond the surface level of success.

One expert said family members can explore dimensions that go a long way in shaping wellbeing.

In a post-pandemic world, University of Minnesota Extension Department of Family, Health, and Wellbeing Educator Sharon Powell acknowledged that society isn't as laser focused on career or academic success in defining how well a person or family is doing.

Physical health should be near the top. But Powell added that with mental health a bigger priority these days, it's one way in which households can get a sense of whether or not loved ones are thriving.

She said a good frame of mind opens more doors.

"You feel happy and content and like you're contributing to your family's wellbeing," said Powell, "and to your community and even beyond."

Powell said if you notice sudden mood changes or a family member becomes withdrawn, it might be good to inquire about their emotional state, and whether it needs to be addressed.

On the topic of money, Powell said amassing wealth isn't the key, but financial stability is important. She said financial literacy guidance from nonprofits is a good place to start.

She said when families get ahead of the situation by setting spending goals aligned with their income, they have better sense of autonomy in this area.

"People feel better about their finances," said Powell, "when they feel that they have some choice in where their money's coming and going from."

Lastly, Powell said family members can't take daily communication for granted.

Saying hello to each other every day, or occasionally asking how things are going can help, but Powell said there's more you can do. That includes the often shared pieced of advice of being an active listener.

"Being an attentive and curious communicator," said Powell, "is a great way to show love for people."




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Mental health counselors focused on Nebraska's high rate of binge drinking during Alcohol Awareness Month, which just wrapped up.

Alcohol abuse is often associated with other addictions. Nebraska's binge drinking rate is among the highest in the nation and the number of alcohol-related deaths is on the rise. Alcohol was blamed for at least 720 fatalities in 2020, the latest year data were available.

Aileen Brady, CEO of the Community Alliance in Omaha, said alcohol abuse and addiction affects families and friendships but can also lead to safety issues among employees who may be alcohol dependent.

"If their reactions are not as sharp, if they're not sleeping well and if they're distracted with the sense of needing to have that drink, it's going to affect our workplaces, as well," Brady explained.

Brady adds alcohol and other substance abuse disorders affect at least 65% of Nebraskans seeking mental health treatment at Community Alliance. Nationwide, the National Survey on Drug Use and Health said more than 224-million people 12 and older report having consumed alcohol during their lifetime.

Brady added it is common among alcohol addicted people or those who abuse it to assume drinking will improve their mood, which she said can happen temporarily, but long-term, has the opposite effect.

"That might last for a period of hours, and then once they stop the drinking and they are coming down off of that use of alcohol, then the depressant sets in," Brady observed.

Brady added Community Alliance continues to dispel myths about the effects of alcohol and raise awareness about the negative physical and mental health outcomes of drinking too much.


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