[MUSIC PLAYING]
Welcome back to the show.
The pandemic has taken a toll on all of us-- disrupting
our physical health, our routines,
and, of course, our God-given right to toilet paper.
For the first 90 days of quarantine,
my entire family just held it.
But the pandemic has been especially punishing
to another component of our health.
The mental health wave of this pandemic
has been like a second wave.
REPORTER: A 24% increase in child emergency room visits
for mental health, a 31% jump for teens.
WOMAN: 56% of people said worry or stress tied
to these outbreaks have led to at least one negative effect
on their well-being, including things like trouble sleeping,
eating, and alcohol use.
Even fictional people are having a hard time coping.
For example, no one has suffered more than Miranda Hobbes.
She's an entirely different person now.
If she goes to one more comedy concert,
there's no coming back.
Of course, our mental health system wasn't exactly
perfect before the pandemic.
More than 43 million Americans suffer from depression,
anxiety, or other mental health issues, but more than half
never get help.
There is a huge shortage of child psychiatrists.
There is a huge shortage of therapists.
REPORTER: Is your insurance enough to cover
the health care needs?
For a residential center, it probably will only cover 50%
and that's not cheap.
That's like $3,000 a day.
$3,000 a day?
No wonder Charlie Brown keeps going back to Lucy.
It sure ain't because she's a good listener.
All she hears is [GARBLED SPEECH]..
The health care industry has historically
treated mental health as an afterthought,
far less important than physical health
and, of course, that outlook is largely motivated by money.
WOMAN: If you make things too difficult to access,
then patients will stop trying to seek
the therapy and the treatment that they need.
And, I guess, part of me thinks that that's
probably, a good thing for the insurance companies.
Insurance companies used to be able to charge higher co-pays
for psychiatric care than for other medical treatments
and limit the number of visits all the way up until 2008,
when the Mental Health Parity and Addiction
Act forced insurers to cover mental illness equally.
That's not to be confused with the Mental Health Parody
and Addiction Act, which funded Weird
Al Yankovic's potato dependency anthem, Addicted to Spuds.
That song saved a lot of lives.
Even though the Mental Health Parity Law and the Affordable
Care Act require certain plans to provide mental and physical
health benefits equally, mental care
continues to lag far behind.
Being hospitalized for mental illness
can cost thousands of dollars and even regular talk
therapy can easily cost $300.
For most people, their best chance of getting therapy
is being cast on "Queer Eye."
People say Antoni barely does anything,
but he's still helping more people
than the insurance companies.
When you're experiencing a mental health crisis,
it can seem impossible to shop around and navigate all
of the obstacles of your insurance, which may set
unreasonable criteria for you to qualify for coverage,
like when an insurer decides someone isn't depressed enough
to be hospitalized.
That's like saying, sorry, buddy.
No cancer treatment till you bulk up that tumor a little.
There's also, a critical shortage of psychiatric beds,
forcing patients with severe mental illness symptoms
to be held in emergency rooms and jails
while they wait, sometimes, for weeks.
This leaves people with serious mental illness
even more vulnerable.
To make matters even worse, many mental health providers
don't accept insurance at all because companies
don't reimburse them enough.
Like Frasier, he only accepts tossed salads
and scrambled eggs.
In the US, 129 million people live in areas with a shortage
of mental health professionals so even if you have coverage,
finding help can still be difficult.
REPORTER: She has insurance through Blue Shield.
They emailed me a list of providers.
They all have a three-month waiting list.
REPORTER: I called 100 psychologists in San Francisco
who take Natalie's insurance.
Half said they're no longer taking
insurance or new patients and 1/4 never even called back.
Yeah, but she was leaving voicemails for all of them.
If someone leaves a voicemail, [INAUDIBLE],,
you don't deserve a callback.
While therapists were in short supply
even in the before times, the pandemic
has led to a spike in demand, along with burnout
among mental health workers.
Patients may also face difficulty based on geography,
thanks to an unequal distribution of psychiatrists,
psychologists, and psychiatric nurse practitioners
across the United States.
Contrary to the traditional image
of the friendly, small town, Freudian analyst,
mental health workers are sparse in rural areas.
DOCTOR: I probably have well over 350
patients in my case files.
My receptionist turned down eight people
for requesting new appointments to come and see me.
Despite our best efforts, we haven't been able to attract
psychiatrists here.
Maybe you should try nagging them?
Just say, that's a cute couch--
not hot, cute-- then walk away.
The lack of adequate mental health care
is even worse for Black patients, who
can only see a therapist who looks like them
on every single show on TV.
At a time when millions of Black people
are in desperate need of therapists who can identify
with their struggles, only 3% of the psychology
workforce in the US is Black.
The other 97%?
Billy Crystals.
So what can save us from the mental health crisis?
Well, the internet sure is trying
or at least, they're trying to monetize it.
If you've ever listened to a podcast,
you've heard ads for therapy apps.
WOMAN: This is my game face.
But this?
This is my real face and my keeping it together face.
That's when I find my online therapy face.
If you're curious what that is,
online therapy face is literally,
the opposite of your oh face.
Therapy apps advertise themselves
as making mental health care instantly available
and easy to access, although the bot capture test
I took was oddly, very cruel.
I spent my first two sessions just talking about that.
Believe it or not, there are an estimated 10,000
to 20,000 mental health apps, but only
one app for Farmers Only.
How is that fair?
And while it's great that people who aren't rich
or characters in a "New Yorker" cartoon can talk to someone,
many apps blur the line between health providers
and tech bro ventures with little oversight
of their practices.
Former employees on one app claimed
they were pressured to keep clients in their system,
rather than refer them to outside resources
and that seemingly private therapy transcripts were
mined for marketing purposes.
That is so unethical.
Your therapist is telling you staying in bed all day is
a sign of depression, but your algorithms are telling you,
here's another ad for the weighted blanket that could
be your one reason for living.
Then there are apps that don't connect you to a human.
They're just automated self-help programs
offering mood trackers, daily affirmations, and even
artificial intelligence to talk you through your problems
because there's no better way to fix the damage inflicted
by your cold heartless parents than by pouring
your heart out to a robot.
These apps may offer short-term help,
but they lack the depth of a human who can listen
to your problems, offer thoughtful feedback,
and try not to cringe when you tell them
the weird shit you did with the dude you
met at the Pensacola Stuckey's.
A robot simply cannot process that degree of shame.
Our lack of affordable, accessible mental health care
has serious consequences, especially
in these uniquely hellish times with surging rates
of depression and anxiety.
Who knew actual clinical help couldn't be replaced
by making sourdough bread?
One in five adults in this country and one in six children
experience mental illness, yet half go without treatment.
People shouldn't have to suffer or go into debt
because our health system treats a well-functioning brain
as a luxury.
This may shock you, but studies show the brain is actually,
one of the most important parts of the body, right up there
with parts that are more widely covered by insurance,
like elbows and anuses.
We need stronger enforcement of the Mental Health Parity Law,
we need insurance companies to increase reimbursement rates
and include more providers in their networks,
but most of all, we need to acknowledge that all illness is
illness and deserves to be treated, whether it's
a mind-suffering anxiety or a body-suffering injury
after a sudden fall.
Isn't that right, America's favorite therapist?
[INAUDIBLE] it's a small world, pretending
I was a UN interpreter.
[CRASH]
Oh, good Lord.
We'll be right back. [MUSIC PLAYING]
Sorry.
Dear Lord.