It’s quite possible that most Philadelphians have not heard of CBT, or cognitive behavioral therapy, even though it’s a common mental health tool. Those living in Norway should know more about it than we do in the United States. Through the Scandinavian country’s national health-care system, people have access to empirically supported cognitive behavioral treatment, which is a form of talk therapy that focuses on breaking negative patterns of thought and action.
Philadelphia — where one in 25 residents had diagnosed depression as of 2016, according to a Blue Cross Blue Shield study — could use better mental health treatment. And the shame of it is, the city has long served in its own right as an epicenter of research and treatment. The Beck Center for Cognitive Behavior Therapy, co-founded by CBT pioneer Aaron Beck, has been located in Bala Cynwyd for nearly 25 years of pushing these treatments forward.
The problem is that those who need these services can’t always access care. When the Mental Health Parity and Addiction Equity Act took effect nearly a decade ago, it did not mandate that all employers cover mental health — just that when large companies provide those benefits, they must do so in line with medical and surgical benefits. And many affected health insurance plans have found a way to circumvent the act. Some systems used it as an excuse to lock patients into certain forms of care that saved insurance companies the most money, but did not necessarily provide the best treatment. When patients have to go outside their insurance, they face out-of-pocket costs that average $200 for specialized care, making regular sessions too big a financial burden.
This lack of access is shortsighted — not just for individual patients, but for long-term development of treatments. In Norway, the life-changing research of two psychologists who developed a four-day intensive therapy method that can reverse OCD for years has now launched a bigger project to expand the researchers' methodology and apply it to different mental health conditions. To build on their breakthrough, a foundation, a trust, a hospital, and a university will join forces to develop this project, with plans to give money toward a research center in Bergen. The result will hopefully be, in the model of the four-day method, more effective both clinically and in terms of cost.
Much of this work is buoyed by public funds that signal public support — the kind we need in Philadelphia, which has a proud tradition of revolutionary change. Our own Founding Fathers, many of whom had strong ties to this city, were people of faith who took great risks and so engineered life-affirming changes for generations to come. And our city has already led the way on major health-care issues, from opening the nation’s first hospital specifically for children, and having University of Pennsylvania hospitals be named as leaders in LGBT Health-care Equality by the Human Rights Campaign this year.
Philadelphia can show the same kind of leadership on mental health. The city already has an abundance of talent with its high concentration of medical and health professionals. The problem is that there hasn’t been the proper financial support for conditions rightly due their own medical parity. For what good is treatment if you can’t access care — and the correct kind of care, not what is most convenient for billing systems. We can start by seeking input on the best routes forward from experts like the city’s Rogers Behavioral Health, led by Martin Franklin, which last year opened its first outpatient center to treat mood disorders in the Northeast, in response to growing need.
Imagine if we could eradicate conditions that for too long have been left to languish, the incalculable human suffering that could be alleviated in many cases. That promise is a beacon of hope and joy in a holiday season known for its illuminating light. We can help shine that light on CBT and other proven approaches by advocating for mental health legislation and protections at the state and local levels. We just need the political will.
Alicia B. Grimaldi is a freelance writer and editor who previously worked as publishing director at a social science research institute.