Insurance Network Instability Leads to Break in Mental Care for North Carolinians

CHAPEL HILL, N.C. – A study released by the National Library of Medicine in October 2021 revealed that 21 percent of participants reported that at least one practitioner had left their insurance plan’s network in the past three years. This disruption in care can greatly impact an individual’s everyday life, according to UNC senior Nyami Aghedo, who experienced a loss of access to mental health care when she transitioned to her school’s insurance plan.

For Aghedo, finding a therapist covered by her insurance involved extensive research and phone calls, highlighting the difficulties in accessing mental health care under certain insurance plans. Even services offered by the university, such as UNC’s Counseling and Psychological Services, present barriers to access for students seeking longer-term or specialized therapy needs.

The obstacles in accessing mental health care are further compounded for individuals with disabilities. Nan Allison, a paralegal-advocate for the Charlotte Center for Legal Advocacy, explained that the process to be deemed legally disabled and therefore Medicaid-eligible can take years, creating challenges for those seeking financial assistance for mental health care.

Moreover, Allison pointed out the long wait times for appointments with therapists, especially for child psychiatrists. Despite nearly 1 in 5 children having a mental, emotional, or behavioral disorder, only about 20 percent of those children receive mental health care from a provider, as reported by the Centers for Disease Control and Prevention.

Medicaid is seen as a solution for providing comprehensive mental health services, but many people do not meet the financial criteria to access it. However, the program offers access to Local Management Entity/Managed Care Organizations, which coordinate services for North Carolina Medicaid beneficiaries seeking treatment for mental health disorders, substance use disorders, intellectual/developmental disabilities, or traumatic brain injuries.

While these resources are available, many Medicaid users are unaware of them or struggle to find time to coordinate with the facilities, hindering their ability to access the necessary care.

In summary, the challenges in accessing mental health care under various insurance plans, particularly for individuals with disabilities, highlight the need for increased awareness and improved systems to ensure equal access to essential services.