Opinion: Too many Floridians experience barriers to mental health care. It’s time for solutions

America is facing one of its worst periods of mental health decline, Dr. Debra Barnett writes.

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With the 2023 Florida legislative session in full swing, it is critical for our lawmakers to prioritize efforts to address our state’s mental health epidemic. 

Nearly one in four Florida adults experienced a mental illness in 2022, and 15% of Florida youth had at least one major depressive episode in the past year, according to Mental Health America

As a decades-long practicing psychiatrist, I see first-hand that America is facing one of its worst periods of mental health decline. Barriers to care, including insurance protocols that interfere with the ability of patients and physicians to make critically important care decisions, are only making this issue worse.   

In particular, a complicated health care practice called “step therapy,” or “fail first,” creates unnecessary obstacles in patients’ access to the treatments they need. This leads to harmful outcomes for countless Floridians – especially those with serious mental illnesses. 

Treatment for a serious mental illness is not a one-size-fits-all process. Individuals struggling with mental illnesses don’t all present the same symptoms and experiences. Many factors are considered when prescribing these medications, and psychiatrists work together with patients to determine the best treatment for them. 

Step therapy protocols impede this process by requiring patients to first try multiple options before their insurance or Medicaid will cover their recommended medication. Because step therapy delays access to professionally prescribed mental health treatments, patients are at greater risk of prolonged or worsening symptoms, leading to an increased likelihood of hospitalization, disability, or worse. 

Fortunately, legislation has been filed to help address Florida’s harmful step therapy protocols for mental health treatments. Legislation (SB 112, HB 183) introduced by state Sen. Gayle Harrell and state Rep. Karen Gonzalez Pittman, would help ensure that Floridians with serious mental illnesses can get the treatment they need – when they need it. 

It’s time to bring Florida’s mental health care system into the 21st century and acknowledge that mental health requires the same specialized and thorough approach to care as physical health. Mental health is not a personal weakness or failure that can be fixed with a change of mindset.

It’s hard to admit that one’s mental health issues won’t go away on their own and may require professional care. The least we can do is make it easier for Floridians to access the care they need. I hope the Florida legislature helps address our mental health crisis by passing this legislation and limiting barriers to care.

Dr. Debra Barnett is President of Associates for Behavioral Medicine and chairs the Florida Psychiatric Society's Legislative Task Force. Views expressed are those of the author and not of the City & State Florida editorial staff.

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