The mental health toll of the abortion ruling

July 7, 2022

By Courtney Wise

Good morning, MindSite News readers. In this issue, you’ll find journalist and author Laura Fraser’s chronicle of the fear, panic, desperation and other mental health issues afflicting people seeking abortion in the wake of the Supreme Court ruling that overturned Roe vs. Wade. Our news section roundup also looks at the threat to patient confidentiality that has surfaced after the decision.

In other news: more on “phantom” mental health providers in insurance networks, processing moral injury and the stigma of mental illness among Vietnamese exoeriencing homelessness in Los Angeles’ Little Saigon neighorhood. Plus, the mental health rollercoaster of professional cricket players.

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The mental health consequences of abortion denials

Hours after the Supreme Court’s Dobbs decision overruled women’s civil rights to abortion, clinics began turning away patients who were seeking the procedure. The overall effect of the ban on her clients is fear, said Rebecca Jones, a licensed counselor in San Antonio. “It’s terror of being oppressed and marginalized. It’s hopelessness, helplessness, and despair.” Our MindSite News original looks at the issues faced by women in Texas and Ohio — where the state just denied an abortion to a 10-year-old rape victim — and how providers are responding.

New study highlights “phantom” mental health providers in insurance networks

A new Health Affairs study from researchers at Oregon Health & Science University confirms a national problem: Nearly 60 percent of in-network mental health providers listed in Oregon Medicaid directories don’t actually see patients. Coming at a time when more and more people are seeking professional mental health support, researchers are sounding the alarm. 

“If this represents the state of provider directories more broadly, that’s a huge concern for patients,” lead author and OHSU School of Medicine professor Jane M. Zhu said in a press release issued by the school. “If the majority of providers are not actually accessible, it leads to delays and interruptions in care and treatment that people need.” It’s a particular problem for Medicaid enrollees, who are more likely to have severe and persistent mental disorders, along with social and physical health challenges that make access to care much harder, Zhu and her team found.

Noting that almost half of Medicaid recipients with serious mental illness report having unmet medical needs, Zhu said, “At least on paper, an insurance plan can point to provider directories and say, ‘See, we have all these providers who are part of our contracted network,’” Zhu said. “But if these directories don’t reflect the providers who are truly seeing patients, then what good are they?”

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Mental health parity law now in effect in Georgia

Health insurers in Georgia must cover mental health treatment at the same level that they cover physical health care, due to a new law that took effect July 1. “Mental health matters and is just as important as your physical health,” Kim Jones, executive director of the Georgia chapter of the National Alliance on Mental Illness, told the Rome News-Tribune.

For example, Jones said, health insurers who already offer out-of-network coverage for urgent physical care will be required to cover urgent mental health and substance abuse treatment as well. The new law also creates a multi-agency team for children in need of emergency support and will fund co-responder efforts that send mental health professionals and law enforcement officers in pairs to respond to mental health crises.

Later in the year, the state plans to receive proposals from the community about outpatient treatment and will select five to fund as pilot programs.

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Will patient confidentiality protections be eroded by Roe v. Wade’s reversal?

As outrage over the Supreme Court decision continues to build, the Seattle Times spoke with legal and mental health experts struggling to understand how SCOTUS’s ruling on Roe v Wade will impact care for people seeking abortions in another state.

Though psychologists and other medical professionals are bound by patient privacy laws in Washington – meaning clinical notes and patients’ records should mostly remain confidential and protected from state authorities –  federal law offers fewer protections from a court order for patient records. For that reason, some states are moving to pass laws that prevent in-state government and health providers from participating in out-of-state investigations. 

In other cases, mental health providers are considering changing how they take notes or even renaming their practice to protect their livelihoods and those of their patients. “Will it be safer to do life coaching versus therapy because it’s unregulated?” asked Lesli Desai, a Seattle-based clinical social worker. “How do we ethically and morally continue to serve in ways that we believe are important and that we value, but also protect our licenses and protect our clients from prosecution?”

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Processing moral injury

If you’re experiencing mental distress based on recent events, ranging in decisions from SCOTUS to the horrifying mass shootings on July 4th, you’re not alone. While some of us may be experiencing vicarious trauma, Arianna Galligher, a social worker and trauma expert, told WBNS-Columbus that most of us are probably experiencing moral injury. “Moral injury is when we’re faced with reconciling differences between what’s happening in the world, and what our values and our morals tell us should be happening,” she said. 

In times like these, experts say it’s important to acknowledge your emotions, recognize that feelings of fury, grief, and uncertainty are normal; and reach out to a counselor for help.“This is a time when it’s important to get as informed as you can, to get as active as you can in [the] kind of the rules that govern our world,” Gallagher added. “There is hope, it’s just not immediate gratification.”

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In other news…

The Los Angeles Times published an inside look at a segment of the unhoused community in the city’s Little Saigon neighborhood. Comprised of Vietnamese immigrants and second-generation Vietnamese Americans, those interviewed are largely from households rooted in family, career achievement and a strong work ethic, and they feel great shame for being homeless.  Their experiences highlight the persistent stigma of mental health in some communities:  Citing mental health struggles as a primary reason for losing employment and stable housing, most are reluctant to contact their families. However, Ngoc Khanh Banh of Southland Integrated Services is reaching out to offer food and mental health services, and the district is considering teaming up with others to provide housing.

Disability claims are on a sharp rise in the UK, largely due to the nation’s mental health epidemic. “If this trend continues — or is even hastened by the pandemic — it will add further pressure to disability benefit spending,” research economist Heidi Karjalainen told Bloomberg News. The UK’s Institute for Fiscal Studies reported that the rise in disability benefit claims over the past 20 years – roughly 80 percent of the increase, in fact – can be attributed to those with psychiatric conditions such as mental health and learning difficulties.

Professional cricket players experience “a mental health rollercoaster” during the course of their careers, according to a recent study from researchers at Loughborough University. Researchers said that while cricket provides many nourishing and energizing opportunities for positive mental health, its players’ short-term contracts and job insecurity contribute to negative mental health, according to the BBC News.

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If you or someone you know is in crisis or experiencing suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255. Or contact the Crisis Text Line by texting HOME to 741741. En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889. Services are free and available 24/7.

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