Mental health advocates in Delaware and beyond are concerned certain practices by insurance companies are creating a crisis by hindering many patients from getting the care they need.

Studies have found a shortage of in-network providers is causing many patients to pay higher out-of-network fees or skip care altogether.

Jake Swanton, vice president of state affairs for the mental health advocacy group Inseparable, said claims denials, payment "clawbacks," and low reimbursement rates drive many providers away from insurance networks and sometimes out of business.

"It's so much more pronounced in the behavioral health space because of the constraints that we're seeing a lot of insurers putting on network participation, payment rates to the providers," Swanton explained. "It's taking an already broad-based workforce shortage across health care and making it way worse."

Studies show behavioral health patients forced to seek out-of-network care often pay much more than they would in-network. The Health Insurance Association of America said coverage decisions are generally based on scientific evidence, medical guidelines and the terms of the patient's policy.

One option for patients caught in the squeeze is to contact their state's insurance regulator.

Trinidad Navarro, commissioner of the Delaware Department of Insurance, said his agency recently examined insurers' compliance with the state's Mental Health Parity law and issued a number of fines and corrective actions.

"We did do a follow-up exam," Navarro pointed out. "We found that they did make improvements but still too many claims where they denied coverage or they shortened the amount of time for treatment without justification. They have made improvements but they're not nearly where they need to be."

Swanton argued policymakers need to do more to make sure behavioral care is as available and affordable as medical and surgical care.

"It's really important to start making changes that are going to impact patients all across the country and build good policies that will put more pressure on states and hopefully the federal government to do more broad, sweeping changes that will create mental health parity," Swanton urged.

Indiana families are preparing kids for back-to-school season, and mental-health experts say emotional readiness is just as important as school supplies.

Beth Trammell, a psychologist and professor at Indiana University East, said kids often carry anxiety into the new school year. She encouraged parents to help children identify those fears.

"We as parents or caregivers think, 'Don't worry, or don't stress.' Instead, we might want to say, 'OK, well, let's talk about what it is you're worried about. What is the worst thing you think could happen?' If we draw it out of them," she said, "it may give them space to kind of let that out."

Helping kids feel heard can reduce stress. But experts also urge balance, keeping mornings calm, easing into routines, and not overloading schedules the first few weeks.

Nicole Brady, chief medical officer at UnitedHealthcare, said mental-health support should remain a priority throughout the year.

"Though we want our kids to be involved in activities and be social," she said, "we have to watch their academic performance, their mood, those sleep patterns, and making sure that those are staying healthy."

Brady added that parents should talk regularly with kids, model healthy coping and seek help early if warning signs appear.


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After a legislative session which opened doors to expand mental health care services across Montana, a state commission said it is considering the Billings area to build the state's second forensic facility.

For people involved in Montana's justice system whom a judge has deemed not mentally fit for their own defense, there are 53 beds in the state's only forensic facility in Galen. The daily waitlist hovers at about 100 people.

Matt Kuntz, executive director of the National Alliance on Mental Illness-Montana, said it is not meeting the immense need.

"It's just a really bad situation for the people that are in the jails, for the people that are caring for them, for the taxpayers," Kuntz outlined. "It just doesn't work for anybody."

At a recent commission meeting, Montana Department of Public Health and Human Services Director Charlie Brereton said the state is identifying a location for a new facility. The department received nearly $27 million from the state in April to fund project planning.

Kuntz noted the Montana Legislature passed many bills this session centered on mental health care.

"We really were able to get big wins in access to outpatient care, access to crisis care and for people in need of forensic hospital," Kuntz explained. "Overall, it was really an amazing legislative session for Montanans with mental health conditions."

Other mental health legislation will boost school-based services, youth in residential care, the state's 988 crisis line and certified community behavioral health clinics.


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The California Parent and Youth Helpline is in serious jeopardy after Gov. Gavin Newsom cut it from the new state budget, saying the money was needed to support medical services.

Advocates said they are puzzled because the governor has championed the helpline for years, and lawmakers approved $3 million from a separate fund dedicated to mental health, which does not affect the deficit.

Lisa Pion-Berlin, president and CEO of the nonprofit Parents Anonymous, which runs the helpline, said it is still operating 24/7, for now.

"We're holding on for the next month or so," Pion-Berlin pointed out. "But we need the state to step up, or one of these well-off philanthropists who cares about having that immediate help for emotional support, which is so vital."

Advocates are hoping funding can be restored via a budget trailer bill in the next few weeks. People can call or text and reach the helpline's trained counselors at 877-427-2736. The free helpline has connected with more than 120,000 people since its inception five years ago, and the website CAParentYouthHelpline.org has reached a million more.

Pion-Berlin noted a study in the Journal of Technology in Human Services found a call to the helpline can quickly ease parents' suffering and feelings of isolation.

"The research said that 85% of the callers in less than 30 minutes feel more positive, more hopeful and able to address their issues," Pion-Berlin reported. "There is no other service or pill I know that can do that in 30 minutes or less."

Parents Anonymous also offers free weekly support groups to steer parents and kids through emotional crises of all kinds.