Is mental health treatment reserved only for privileged people in Taiwan? The question made the news again following a violent incident in Pingtung County last month, while calls to expand coverage for counseling made headway with a forum last week held by the National Health Insurance Administration (NHIA).
The problem is long-standing — people seeking psychological counseling in Taiwan either have to pay steep prices out of pocket or wait for months to receive affordable services.
A petition to have counseling services covered by the National Health Insurance (NHI) system was launched in May and gathered more than 5,000 signatures, leading to the forum that included signatories and experts.
The NHIA said the government has established 385 community mental health centers across the nation since 2015 that provide free or low-cost services to more than 20,000 people annually.
However, an expert at the forum said few people have been using the service, with some psychologists not seeing a single patient during their shifts. Some of these centers are doing well, while others appear to be understaffed and can only accept suicidal people or those with mental disorders, a participant at the forum said.
While the centers were not the main topic of discussion, the issue needs serious consideration, lest it become another well-intentioned venture that turns into a waste of public funds. The services are already in place and if they are utilized fully, they can help alleviate resource shortages and reduce waiting times.
While more advertising and education could help, the real problem is the stigmatization of mental illness, which dissuades people from seeking help, especially at community clinics where they might run into people they know.
Lawyer Lu Chiu-yuan (呂秋遠) yesterday wrote that someone had sought him out for legal advice on how to prevent a mental health clinic from being set up in their community, which is disheartening.
The clinics are not enough to serve the roughly 2 million people who sought help last year, a number that would increase.
Getting people the help they need as soon and as consistently as possible is crucial, and people should not be only talking about this when violent incidents happen. That only helps reinforce the stigma that all mental health patients are dangerous.
Several experts at the forum agreed that the NHI should cover mental health services, noting that increased accessibility would allow people to get preventive help before their symptoms possibly worsen and they become a danger to society.
However, psychiatrist Kuo Hsi-ching (郭錫卿) said that psychological issues are different from serious mental disorders, with the latter already covered by the NHI. He equated the situation to “having high blood pressure, a precursor to a disease, but not yet a medical condition.”
However, people should seek help when their problems are still manageable, as that ultimately saves costs for themselves and the public health system in the long run.
Furthermore, letting mental health issues go unchecked is different from having high blood pressure, as the former could put other people at risk.
The government should provide incentives for hospitals and psychologists to make mental health treatment more accessible. There are many details that need to be worked out, but expanding NHI coverage of mental health treatment is a worthy goal.
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