The pandemic has made people more open to seeking help, a new survey finds, but cost and difficulty in finding a mental health care provider are still big obstacles.



More than a year into the pandemic, people have become more open to discussing their mental health. But getting help for mental illness remains a big challenge, with cost being a major hurdle. Those are the main findings of a new national survey. NPR's Rhitu Chatterjee reports.

RHITU CHATTERJEE, BYLINE: The survey asked respondents a range of questions about mood disorders.

KEN DUCKWORTH: And mood disorder is defined as depression, postpartum depression, bipolar disorder, seasonal affective disorder - kind of the spectrum of mood.

CHATTERJEE: Dr. Ken Duckworth is a psychiatrist and the medical director for the National Alliance on Mental Illness, or NAMI, which conducted the survey.

DUCKWORTH: The public is beginning to recognize in a new way that mental health is a health care priority, and a large percentage of people seem to appreciate that it could happen to anyone.

CHATTERJEE: However, Duckworth says the survey also found that access to care was still a big problem. Many weren't sure how to access services, and a majority felt that the cost of care was inhibitive.

DUCKWORTH: Fifty-two percent of people said cost prevents them from trying a treatment they're interested in, and the population of uninsured people reported 74% say cost prevents them from trying a treatment (ph).

CHATTERJEE: Over 6 in 10 people who sought treatment stopped because they couldn't afford it anymore. Sika Yeboah-Sampong is a staff attorney at the advocacy group Legal Action Center. She says most people who are insured and seeking mental health care often start with a list of in-network providers.

SIKA YEBOAH-SAMPONG: But the issue with that is that the directory isn't always accurate or up to date.

CHATTERJEE: She says it's not uncommon to find providers who have died, moved away or retired. And she says these directories for mental health are often narrow to begin with.

YEBOAH-SAMPONG: One reason that the lists are narrow - it's that, historically, reimbursement rates for mental health providers have been much lower than for physical health providers.

CHATTERJEE: And it continues to be low even today, she says, which is why many therapists and psychiatrists aren't part of insurance plans. And providers who are in-network are often overworked and have long waitlists. All of this forces people to seek out-of-network care.

YEBOAH-SAMPONG: So they're paying more out of pocket. And maybe they're able to do that for a couple of months, three months, and then the funds run out, right? And then you have no care.

CHATTERJEE: Untreated mental illness can have devastating consequences on people's lives. Marty Parrish lives in a suburb of Des Moines, Iowa. And at one point, he lost everything because of his depression.

MARTY PARRISH: I ended up actually losing marriage, family and home and business, and I became homeless.

CHATTERJEE: That stopped the treatment he could afford when he was employed.

PARRISH: I could go to a free county mental health clinic. I could even get a prescription for medication, but I couldn't pay for the medication.

CHATTERJEE: He eventually got better, he says, because his now-wife stood by him and helped him get the care he needed. David Lloyd is a senior policy adviser for the Kennedy Forum, a mental health advocacy group.

DAVID LLOYD: We're foolish if we think we're saving money by making these types of health care, you know, unaffordable to people.

CHATTERJEE: He says untreated mental illness can add to other societal costs.

LLOYD: You know, higher costs associated with unemployment, disability. And of course, you know, we've seen huge spikes in the - you know, in fatal overdoses over the last year.

CHATTERJEE: And with the rise in symptoms of mental illness during the pandemic, Lloyd says it's even more urgent to improve access to care for everybody. Because as the new survey shows, of the people with mood disorders who did get treatment, the vast majority found it helpful.

Rhitu Chatterjee, NPR News.