Feeling depressed and suicidal, a girl called the crisis line of Uplift Family Services, a nonprofit with several Bay Area locations that helps children.
The girl said she felt like killing herself and was admitted for an immediate psychiatric evaluation and care.
In another case, the nonprofit received a call from a teacher who was concerned a student had missed the first days of school. When contacted by a treatment provider, the youth spoke about his depression and suicidal thoughts and came out as non-binary. He said not being able to admit it to himself and his family contributed to his depression.
“Over the last three years, there’s been a 34% increase in teen suicides among California youth between ages 15 and 19, significantly higher than the national increase of 25%,” said Eva Terrazas, vice president of public policy and special initiative at Uplift Family Services.
As additional stress related to COVID-19 has increased mental health issues, Terrazas said calls to hotlines have increased dramatically.
“In San Jose, we’ve seen a spike in issues like depression and anxiety and people with mental health conditions,” said Terrazas. “With COVID-19, people are feeling grief, anxiety, desolation and fear.”
Michelle Humke, executive director of Almaden Valley Counseling Service, said she also has seen a rise in calls, including referrals for students in school. Humke said those who previously suffered trauma are even more vulnerable to COVID-19 related anxiety and depression.
“COVID-19 has definitely increased the need for mental health services,” Humke said.
Yet, many people don’t get those services because of the cost, especially if services are not covered by insurance.
“Even with insurance, people sometimes have high deductibles or their insurance covers the bare minimum of sessions,” Humke said, “and sometimes mental health issues are not quickly cured. Frequently, families will avoid going for services because of these concerns. Addiction issues are particularly difficult to treat. Sometimes, people will get treatment and need treatment again.”
Terrazas said substance use treatment and private mental health insurance needs to be expanded to reach parity with public coverage.
To address this need, the state Senate recently passed several bills that are now awaiting the governor’s signature.
Assembly Bill 2112, authored by Assemblymember James Ramos (D-Highland), establishes an Office of Suicide Prevention, which would help providers share their best practices in treating children and youth contemplating suicide.
State senators Jim Beall (D-San Jose), Scott Wiener (D- San Francisco) and Assemblymember Cecilia Aguiar-Curry (D- Napa) co-authored bills to improve mental health and addiction treatment coverage.
Senate Bill 855 strengthens the California Mental Health Parity Act, closing gaps in the law by requiring insurance companies to cover all medically necessary mental health and addiction care.
Wiener said the Mental Health Parity Act failed to encompass the range of mental health and substance use disorders contributing to overdose deaths from opioids and methamphetamines, the increase in suicides, and other “deaths of despair.”
“Our current mental parity law has major loopholes in it,” Wiener said. “It doesn’t cover many disorders. It’s just not strong enough.”
Senate Bill 854 removes insurance barriers for people requiring medication-assisted treatment for addiction. It prevents health plans from requiring prior authorization or trying less expensive options before stepping up to more costly FDA-approved medications.
Beall said addiction is one of California’s toughest mental health challenges and a public health crisis.
“It’s wrong to allow insurance companies to delay or deny life-saving medication-assisted treatment prescribed by a doctor,” Beall said. “We must break the stigma of mental health care and ensure patients receive medically necessary mental health care without obstruction.”
Wiener said insurance companies often refuse to cover mental health and addiction treatment unless people are in crisis.
“No one should have to forego mental health care until they’ve deteriorated to the point where they’re in crisis and in the emergency room,” Wiener said. “That’s no different than telling someone you can’t get treatment for Stage 1 cancer: You have to wait until you’re at Stage 4.”
Wiener said people should not have to suffer from mental illness or substance use disorder without support, resources and medical care or go into debt to pay for care.
“People are struggling on our streets and in their homes in silence,” the senator said. “People lack access to treatment, can’t afford it and their insurance usually won’t cover it. This has only gotten worse with COVID-19.”
Contact Lorraine Gabbert at [email protected]