FEAR FACTOR: Public health anxieties may be getting worse. A recent study shows that the more a society promotes healthy lifestyles, the more people worry about their health and the sicker they feel.
with another. In the case of phobias, fears involve tension and tension is incompatible with relaxation.
- 2. The patient creates a "fear grading" starting at stimuli that create the least anxiety (fear) and building up in stages to the most fear-provoking images.
- 3. The patient works their way up the "fear grading" starting at the least unpleasant stimuli and practicing their relaxation technique as they go.4 Example: "Fear grading" for spiders"4
| Behavior | Fear Rating |
|---|---|
| Think about a spider | 10 |
| Look at a photo of a spider | 25 |
| Look at a real spider in a closed box | 50 |
| Hold the box with the spider | 60 |
| Let a spider crawl on your desk | 70 |
| Let a spider crawi on your shoe | 80 |
| Let a spider crawl on your pants leg | 90 |
| Let a spider crawl on your sleeve | 95 |
| Let a spider crawl on your bare arm | 100 |
THEN THERE ARE COST FACTORS
"It has been nearly a decade since Congress passed the Mental Health Parity and Addiction Equity Act, with its promise to make mental health and substance abuse treatment just as easy to get as care for any other condition. (emphasis added) Yet today, amid an opioid epidemic and a spike in the suicide rate, patients are still struggling to get access to treatment. (Nevertheless) health insurers are still skimping on mental health coverage."5
Among the study findings:
- "In 2015, behavioral care was four to six times more likely to be provided out-of-network (health insurance rates) than medical or surgical care… The high proportion of out-of-network behavioral care means patients with mental health or substance abuse problems were far more likely to face the high out-of-pocket costs that can make treatment unaffordable, even for those with insurance… For years, insurers have maintained that they are making every effort to comply with the 2008 federal mental health parity law, which was intended to equalize coverage of mental health and other medical conditions…
- Insurers paid primary care providers 20 percent more for the same types of care than they paid addiction and mental health care specialists, including psychiatrists.
- State statistics vary widely. In New Jersey, 45 percent of office visits for behavioral health care were out-of-network. In Washington, D.C., it was 63 percent." 5
SO HOW DO INSURANCE COMPANIES WORK? FOR EXAMPLE:
- A required diagnosis of a mental illness: "The rule is that insurance companies only pay for services that are considered 'medically necessary'. This means that in order to utilize your medical insurance for mental health treatment, you must be diagnosed with a mental illness disorder. Additionally, the clinician must prove that your mental health condition is affecting your health and overall functioning on a daily basis." 6
- It has to be medical necessary: "This is the term used by medical insurance to describe procedures or treatments they