Posing a Challenge: The True Cost of Mental Healthcare

Ann Kendall avatar

by Ann Kendall |

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Stories from the Road, Ann Kendall

Many years ago, while working in the association management world, I had a director who challenged his managers (including me) to calculate the “true” cost of every program we proposed. My director’s challenge was not merely a budgetary task; it was an exercise in extreme critical thinking that moved us to consider each request and activity broadly.

Our reasoning needed to include the hard, fixed costs of administration and the opportunity costs of our choices. Until we understood this concept of true cost, we were simply throwing money and hours at problems to see what would stick.

What was the point of this examination? Impact. We could never understand our actual — or lack of — impact until we understood all the ramifications of cost.

During May, as messages about mental health awareness fill my inbox, I’ve spent a fair amount of time thinking about the true cost of mental healthcare access for our hemophilia community, and I’ve got my own challenge to issue.

The need for mental health services for people living with hemophilia and their caregivers has been well-documented by scientific literature, news outlets, and national organizations. This need mirrors that of our larger society. Children, teens, and adults struggle not only with mental health conditions, but also with getting access to providers.

The true cost of mental health services breaks down into three areas: financial, opportunity, and access.

The most obvious expenses of mental health services include co-pays and health plan deductibles. Depending on your plan and coverage, this can be a significant financial burden. Regardless of coverage, everyone I know in our hemophilia community consistently has financial concerns, and every co-pay is a blow to the wallet. Our family always meets our out-of-pocket maximum, and sometimes we face necessary choices of what to do first and when. With mental health, this is a dicey calculation.

Opportunity costs abound when it comes to mental health appointments, from lost wages to childcare expenses. I scanned our current health plan last week and found only a handful of providers who work partial hours on the weekend or after 6 p.m. and are located within a 20-mile radius of my home.

An appointment with a practitioner that accepts my insurance carries a $50 co-pay. I’ll have to take two hours off work to reach and attend the appointment, resulting in less pay. Even if I get a weekend appointment, I’ll have to pay for two hours of childcare in a major metropolitan area. A quick calculation brings the cost of each visit to $130 or more. Knowing this number causes me to pause. This is well beyond my plan’s co-pay requirement, and now I’m faced with yet another healthcare choice.

Once we’ve muscled through the outright financial and opportunity costs, we come up against the obstacle of access. PBS recently highlighted this issue: Even if we have insurance and the finances to cover care, where do we find a provider? A shortage of professionals, narrow health insurance networks, and waiting lists for appointments add up to a triad of access issues, further raising the true cost of care.

The most frightening aspect of access issues when it comes to mental health services is timing. In treating bleeds, timing can make all the difference in the outcome. Not receiving care can lead to dire consequences. It’s the same with mental health issues.

We’re talking more about mental health as a community and as a country, but talking about care and paying for the true cost of care are two entirely different things.

My challenge to our community and our leaders is this: It is not enough to encourage people to seek mental healthcare; we must find a way to cover the true cost. Financial, opportunity, and access costs must be addressed if we are to have a community that thrives, both physically and mentally.

The ultimate true cost of mental healthcare is no care at all.


Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to hemophilia.


Shellye avatar


Thank you, Ann, for bringing attention to this critical component of comprehensive care. All the challenges you mention can create barriers of access to this needed resource.


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