When Wealth Is a Source of Mental Illness

But first, read the story of 10 cool working-class ladies from Mumbai, India who, with no filmmaking experience and just 5 smartphones between them, created a documentary narrating their lives. The driving theme of the entire experience, their coach, the filmmaker Shilpi Gulati told NPR, is that even in their busy lives and in the face of so much prejudice, these women could take time for themselves, build friendships and show that “having fun is not frivolous. That being mast [carefree] and claiming joy is cool. It is a radical act of resistance against oppressive structures.”

The hidden cost of extreme wealth, according to one Harvard psychologist

Money is a powerful tool that can resolve a host of problems, including mental health struggles related to food, housing or economic instability. It can even create opportunities for creativity and exploration. But according to psychologist David H. Rosmarin, an associate professor at Harvard who has provided years of bespoke mental health services to the ultrawealthy, for many, money is also an unexpected source of mental distress. Among the uber-rich, he writes in Time, loneliness, family conflict and emotional disconnection hide behind the veneer of car services and comfort. Extreme wealth reshapes relationships by removing the everyday frictions — compromise, accountability, negotiation and shared sacrifice — that often strengthen connections. Rosmarin says that money can make relationships far more transactional and driven by expectations and control.

As examples, he offers two stories: One describes parents tossing more than $1 million at their son’s gambling losses over the course of a year, driving him further into addiction and ultimately family estrangement. The other tells of a young college student from a “prominent family” who was pushed to avoid treatment for serious depression rather than disappoint her parents, who often reminded her of the financial investment they’d made in her future. She spiraled into self-harm before finally getting help, fearful that revealing her struggles was antithetical to her parents’ demands for achievement and success.

In each case, the bigger issue was neither the young man’s gambling losses nor the young woman’s depression. Rather, the problem was their parents’ idea that money alone could make difficult problems disappear. Parents with less resources would have no choice but to quickly confront the painful realities their children were facing, Rosmarin writes, while these pairs expected their money to make the problems disappear. Such dynamics ripple beyond personal relationships, too, since many wealthy individuals hold outsized influence over companies, philanthropy and other institutions, effectively shaping communities affecting thousands and sometimes millions of people. Even with all of that, connection can’t be purchased.

Real connection requires emotional vulnerability, including honesty, accountability, forgiveness and sacrifice, Rosmarin writes. It bodes better for our physical health too, according to the nearly 80-year Harvard Study of Adult Development, which finds that strong social bonds predict long, happy lives better than intelligence, genetics or money. The Centers for Disease Control and Prevention and the World Health Organization reinforce those conclusions,, arguing that loneliness raises the risk of cardiovascular disease, stroke, depression and early death by roughly 30%.

As former U.S. Surgeon General Vivek Murthy put it in his farewell letter, human connection isn’t a luxury, it’s a fundamental requirement for wellbeing. Money can buy a lot — but not the hard, human work that real relationships require.

She finally found a treatment that worked. Her insurer still won’t pay for it.

After seven years of treatment and multiple suicide attempts, Rachel Levasseur finally found a residential program that worked. But now her insurer, CareFirst BlueCross BlueShield, can’t decide if the treatment for obsessive compulsive disorder (OCD) is worth the money, a baffling and devastating blow for her entire family. As the family told NBC News, Levasseur’s case is just one of many examples showcasing the difficulty in securing quality, relevant and effective mental health care that is covered by insurance, particularly for complex cases.

Levasseur, 24, lives with a complex form of obsessive compulsive disorder which creates the conviction that she is a danger to others and contributes to an extreme fear of germs and illness. Her OCD is further compounded by autism spectrum disorder, which makes her black-and-white thinking harder to disrupt and irrational thoughts more challenging to recognize. Throughout the years, her condition grew so grave that her parents arranged to have her under their direct supervision nearly every moment.

“We basically took shifts where I would watch her through the day,” Levasseur’s father Larry said. “I’m a little bit heavier of a sleeper than Kandy [Levassseur’s mother], so she would take the night and we would have to check on her every few minutes to make sure she was OK and alive.”

Things changed last year when Levasseur’s parents reached out to a therapist at Sheppard Pratt, a Maryland psychiatric hospital whose self-pay, residential program, The Retreat, connects patients to a personalized care team of psychiatrists and therapists among other specialists. “When I got to The Retreat, it was different, because no one was giving up on me,” Levasseur said. “It just felt like much more of a place where people were very focused on me getting better, and I had a lot more of individualized support.” A year in, Levasseur’s wellness soared. She ceased all suicide attempts and became increasingly social, even willing to join a friend for dinner or a concert. 

Though CareFirst covered just $521 of the out-of-network program’s staggering $3,000 daily price tag, her parents decided to pursue it anyhow, citing phone conversations with CareFirst representatives who told them their daughter was likely eligible for a “single case agreement.” If the patient can prove the care isn’t available to them anywhere else, CareFirst will allow patients to apply in-network benefits to an out-of-network provider. 

There’s no better evidence than what’s right in front of them, Levasseur’s parents say. While other treatments addressed certain aspects of Levasseur’s mental health issues, the Sheppard Pratt program was the only one to target them collectively. “I truly believe that if Rachel wouldn’t have gone to The Retreat this last year, she would not be alive today,” Levasseur’s mother said. For now, though, CareFirst will not pay more than the fraction that it has.

Determined to keep their daughter in the treatment that’s saving her life, Levasseur’s parents have drained their retirement savings, taken out a second mortgage on their home, and now hold a hospital bill topping $1.3 million. Due to the outstanding debt, Levasseur has been removed from Sheppard Pratt’s specialized program and into its in-network general inpatient unit, where her mental health has noticeably deteriorated. This, despite an email last month from hospital vice president Bryan Mroz, stating that Sheppard Pratt “would be willing to enter into a single case agreement to address the current outstanding balance.”

“It’s just confusing how insurance can’t recognize that I am getting better finally,” Levasseur said. “They’re just focused on the money instead of my life.” More than that, she adds, CareFirst actually covering the program would cost less for everyone in the long run, including the insurance company, because she could simply get better and stop being in treatment.