Contributed by: D

I’ve spent years on the frontlines of the mental health system—in inpatient psychiatric units, addiction treatment centers, and now private practice. Every day, I sit with people who are trying their best to heal. They show up to therapy, take their medications, ask for help. And every day, I watch the system make their recovery harder than it needs to be.

I’ve seen clients in crisis forced to wait three to six months for an appointment—not because providers don’t care, but because they have Medicaid, and the few clinics that accept it are booked solid. I’ve had people cancel therapy because their copay was $75 per session, even with insurance. I’ve watched families fall apart—not because they didn’t want help, but because the system made it financially and logistically impossible to get it.

I’ve tried to get elderly patients with dementia or serious mental illness into nursing homes, only to be told, “We can’t take behavior cases,” or, “We’re not set up for psych needs.” Facilities are stretched thin, underpaid, and often unwilling to accept anyone who requires more than the bare minimum of care. And when it comes to getting an accurate diagnosis, many clients hit a dead end—because insurance rarely covers psychological evaluations. Without testing, children and adults alike remain undiagnosed, misunderstood, and unsupported.

Even basic access to therapy isn’t guaranteed. Insurance companies decide whether telehealth is covered or not, often forcing people to commute long distances or miss care entirely—despite the fact that teletherapy is proven effective and often more accessible for those with disabilities, caregiving responsibilities, or limited transportation.

I’ve had to sit across from heartbroken family members and tell them their loved one had to be discharged—not because they were stable, but because insurance said they’d no longer pay. I’ve watched psychiatrists spend precious time on peer-to-peer calls, pleading with insurance reviewers for just a few more days, explaining the ongoing safety risks, the psychosis, the suicidal thoughts. And still denied. The decision wasn’t based on medical need. It was based on what the insurance company was willing to cover. And the people making that call weren’t in the room, weren’t witnessing the suffering, and wouldn’t be there to pick up the pieces after discharge.
I’ve seen treatment plans rewritten because insurance wouldn’t cover the psychiatrist’s first-choice medication—forcing us to choose what’s affordable, not necessarily what’s best.

These aren’t isolated incidents. They’re symptoms of a larger disease: a healthcare system warped by money in politics.

When Profit Sets Policy, People Lose

Behind every “we can’t afford that” excuse is a budget that somehow still includes tax breaks for billionaires, corporate subsidies, and unchecked defense spending. Meanwhile, funding for mental health services is slashed again and again.

Lobbyists from the insurance and pharmaceutical industries spend billions to influence legislation—lobbying to limit coverage, reduce public options, and privatize care. Politicians accept campaign donations from those same corporations and then act surprised when public services collapse.

The result? Care is rationed. Access is limited. And lives are lost.

This System Isn’t Broken. It’s Working As Designed.

I’ve lost count of how many times I’ve looked into a client’s eyes and had to say, “I’m sorry—there’s nothing else available.” Not because we don’t have the tools. Not because we don’t have the knowledge. But because we’ve let lobbyists and donors decide who gets help and who doesn’t.

And the truth is, my clients aren’t the problem. The system is.

Mental Health Is Political—And It’s Time to Act Like It

Every therapy session I have is shaped by what happens in Washington. By what gets funded—or defunded. By who has influence—and who doesn’t.

Mental health care shouldn’t be a luxury. It shouldn’t depend on what zip code you live in, what insurance you have, or whether your local clinic made the state budget this year.

If we want a system where healing is possible, we need a political system where people—not profits—come first.

Mental health doesn’t fail people—policy does.