The Healthcare System is Failing Young Adults in America

In all the reforms and discussions on healthcare, young adults and their mental health are rarely addressed. This is alarming as there has been a 71% increase in the serious psychological distress for young adults between 2008 and 2017. Not only are 18-25 year olds more likely to report having mental health challenges, but under half of these young adults with major depression actually got the treatment they were looking for. Even while it has become less stigmatizing to seek mental health treatment, young adults face a number of barriers and problems to finding support. For young adults who are also dealing with the stress of a rare or chronic disease, it’s imperative to find a reliable support system including mental health. I outline three main barriers to finding adequate mental health assistance below—insurance coverage, costs, and the lack of therapists focusing on young adult needs—but, I offer some suggestions for how to make it all work for you.

Insurance Coverage

Finding a therapist that fits your needs is tough. It took me about 20 emails and calls to find a therapist in DC and then another 20 emails and calls to find a therapist when I moved to Boston. I wouldn’t call myself picky, but the biggest problem was finding a therapist who took my health insurance. Many therapists would prefer to set up a private practice and get paid more; who could blame them? But this isn’t something new. Kaiser Health has noted a growing disconnect between mental health specialists and the health insurance industry since the end of the Second World War! A 2014 study said that only 55.3% of psychiatrists accepted insurance.

Costs

With so many therapists and psychiatrists not accepting insurance, I started asking their fees to see if I could simply pay out of pocket. For those who didn’t take my health insurance, they were charging between $125 to $175 per session. If I were to go weekly that could cost me up to $8,400 for the year! After enough calls, I finally found a therapist that fit my needs and accepted my insurance, but that isn’t the reality for so many young adults. 38% of young adults (18-24) work in the gig economy (e.g., Uber or Grubhub), which rarely provides health insurance. Many more might be in unpaid internships, in school full-time, working part-time, or have other barriers to insurance. With health insurance largely dependent on your employment, many young adults simply cannot afford adequate mental health treatment.

Specializing in Young Adult Needs

As a teenager, I used to hate going to therapy because all they wanted to talk about was my mom’s diagnosis of Huntington’s Disease rather than my needs. It was because I was just trying to find someone who took my health insurance and was available during the same time I was. I realized I was looking at it the wrong way and should have been looking for someone who had a background in working with young adults dealing with anxiety. It’s increasingly more difficult to find therapists who can understand my needs as a young adult, my anxiety, and the stress that comes from having a rare disease.

What to do about it

So how do we fix this issue? It starts by investing in programs and services around psychological, social, and emotional well-being of young adults. We need to make sure they are able to afford the high prices of seeing a psychiatrist because as of right now, we are only helping the older and wealthier people of America. This continues disadvantaging people already marginalized by healthcare and society at large: youth, young adults, and racial/ethnic minorities.

It took me longer than anticipated to find the right therapist. At one point, I thought about giving up because I never thought I would find someone. And now that I found a therapist, I am nervous that if anything happens to my health insurance or if I move, I will have to start the dreadful process over again. Lucky for me, I found a therapist. But there are many young adults who may not be as lucky as I am to afford a therapist who fits their needs. We need to figure out how to improve this, otherwise we are letting down young adults who actually need mental health support.

Some tips young adults can do now

Here’s a good plan for finding your therapist:

  • Think about and write down what you need. Do you feel you could use more support on coming to terms with your own rare or chronic disease? Perhaps how to handle the increased family stress because one of your loved ones’ health is failing? You may just have a lot of stress and anxiety from the stress of everything and want to learn strategies to cope.
  • If you are having trouble thinking about what you need, perhaps start with reflecting on what prompted you to think about going to therapy in the first place.
  • If you have insurance, go to your insurance’s “Find a Provider” page. Search for therapists in your area and that list a specialty that fits what you need: “Family stress,” “life changes,” “youth and young adults,” “general anxiety,” “etc.” If you are still having trouble finding a therapist, call up your health insurance company and ask them for help finding a therapist (that’s what I did after realizing the “Find a Provider” page was outdated).
    • If the above two options still do not work, then try searching on Psychology Today
  • Email or call (whichever you prefer) the therapists that jump out to you. Be open with what you want and ask the therapists if that’s an area they can help with. If not, ask for a referral. Think of it as an interview to make sure it’s the right fit on your end.

If you do not have insurance or cannot otherwise afford a therapist, here are some resources that I came across that could temporarily help when trying to find a therapist who fits your needs.

  • Dr. Fran Walfish, a psychotherapist, suggests contacting your local Psychoanalytic Training Institute to see if there is an affordable psychologist in your area.
  • Many qualified training hospitals have a department of psychiatry and outpatient psychology program that offers reasonably priced psychotherapy.
  • A nonprofit by the name of Open Path Psychotherapy Collective helps match middle and lower-income people (and families) with affordable mental health services and education[1]

Let’s start discussing how we can implement affordable mental health services for young adults in America. If you expect us (as young adults and consumers) to participate in mental health services, then make sure our voices are heard at the table.


[1] Please note these are suggested resources and are in no mean endorsements. Please make sure to further look into this to see whether or not they are a good fit for you.

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