By Michael Hill
Correspondent
If you’re seeking psychiatric care in New Jersey through a preferred provider organization or PPO, a new study says you won’t find that help as quickly as you should.
When Carolyn Beauchamp was asked if it has reached a critical stage in New Jersey, she said, “Yes, I think so. I think so.”
Beauchamp is the president and CEO of the Mental Health Association in New Jersey.
The association has just released the results of its study on access to psychiatric care. Of the 525 doctors sampled, 33 percent had incorrect information listed. Only about half were accepting new patients. And of those, 25 percent said it would take more than two months to see them.
For those seeking care, Beauchamp said, “It means for them that we are not providing care where we should. We should be looking at the front end of someone being ill. If you have a sore throat, if you have a flu, you’re going to see your doctor immediately. Not going to wait until you’re so sick you can’t get out of bed. Unfortunately in mental health, because of resources and beliefs in the past, we provide treatment at the other end of the spectrum. … So we end up with people at the deep end of the spectrum, we end up with people in jail, people who are homeless, people without hope, and people who give up hope.”
Beauchamp and others say one roadblock to access is a shortage of psychiatrists in PPOs and one senator says cost may be factor.
“When paying a doctor to acre for someone for addiction, for example, being paid $14 per visit or $8 in a group setting, that doctor can’t sustain a business on that kind of reimbursement. So what we are seeing is patients falling through the cracks,” said Sen. Joseph Vitale.
The Department of Mental Health and Addiction Services says it continues to invest heavily in the development of behavioral health community-based services and supports because we know that effective treatment can lead to sustained recovery.
A spokesman for the state Department of Banking and Insurance, which regulates the PPOs, says we’re studying their report and will seek additional information as needed.
The New Jersey Association of Health Plans, which covers some 7 million workers in New Jersey, says it learned of some of the study results last year and began right away on some solutions.
One was the new state regulation to remove doctors from subscriber directories if they weren’t seeing new patients or hadn’t submitted any claims in 12 months.
“At first blush, you have to look at this and say, ‘What’s the consumer experience?’ It does no one any good if people who need behavioral health care aren’t able to get it. Not good for them, their families, the system — the costs go up. So, it’s in everyone’s best interests to make sure that these folks get care and get care promptly,” said NJ Association of Health Plans President Ward Sanders.
The Mental Health Association in New Jersey calls its study a base — a foundation on which to build a better behavioral health care system in the state.