Unlike a broken bone or cancer, mental illness isn’t easily diagnosed by a blood test or an X-ray. So when it comes to approving — or denying — costly, ongoing treatment, insurance companies have found it ripe territory to cut costs. The results of those decisions don’t discriminate by age, insurance status or race. Those with serious needs often are told to go without, even when the stakes are life or death.
Like many news organizations, ProPublica’s examinations of health insurance in recent years mostly focused on how companies deny physical care. But our reporting revealed that barriers to mental health care are often more pervasive and hidden — a consequence of the stigma that behavioral conditions carry. Our reporters deftly recognized that insurers’ longstanding neglect of mental health care represented a hidden crisis that deserved attention and exposure.
When ProPublica began investigating mental health care access, with the publication of a callout requesting reader stories, the reporters were inundated with tips, even receiving dozens each day. The crowdsourcing process ensured that the reporting was authentic and community-driven, identifying persistent and ongoing insurance dilemmas.
The reporters followed up and interviewed hundreds of the patients, providers and industry insiders who reached out, many of whom described a mental health care system that had been captured by profit-seeking insurance companies. People in pain were paying the price.
Reporters covered the issue from multiple perspectives. They provided unprecedented reporting into insurers confidential playbooks, taking readers inside the draconian policies that led to coverage denials. After reviewing thousands of pages of court records, reporters explained in clear and precise language how and why judges had found that these companies had violated federal law —and how little consequence they faced for doing so. They cut through the convoluted nature of insurance barriers with poignant stories, including that of a 15-year-old girl whose treatment was denied despite such severe anorexia that she wore her 8-year-old sister’s jeans, and a man who struggled to find mental health care covered by his insurance, which ultimately led to his tragic death.
And they masterfully wove together the experiences of hundreds of psychologists, psychiatrists and therapists to explain to readers how insurance companies squeeze providers out of insurance networks, leading to restricted, delayed and denied treatment.
Their resulting series, “America’s Mental Barrier,” is one of the first nationwide examinations of how insurance companies interfere with access to necessary mental health care.
