two women sitting on a couching talking in therapy

We Need an Annual Mental Health Checkup—Not Just an Annual Physical

We have annual physicals. We have Pap smears every three years. But what about annual mental health checks?

Most health insurances cover annual physicals as part of preventative care. Healthcare.gov defines preventative care as, “Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.” 

Blue Cross Blue Shield adds to this by saying, “This [preventative care] type of care may also help you catch health problems before they become serious.

But, if we’re only focusing on physical health and neglecting mental health, we are not truly preventing serious illness.  Let’s dive into a couple of major issues with the main source of preventative care -the annual physical- and how it can be improved with an annual mental health check.

Issue #1: Preventative healthcare isn’t fully focusing on our health.

It’s 2021, so why are we still not including mental health as part of our health and wellness? Why do we still assume health means just your physical body?

Health includes all aspects of our wellbeing and yet it doesn’t seem to be reflected in preventative healthcare. Whether you pay a high monthly premium with a large deductible or pay a low monthly premium with copays, or you have Medicare and Medicaid taxes taken from your paycheck, we’re all (in the United States) paying for healthcare. Preventative healthcare checkups are usually free under your insurance, and yet what’s the benefit if these checks aren’t checking up on all parts of our health?

The current definition for “heath” from the World Health Organization (WHO) is: “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

We can’t talk about health without including the mind and body. When we include both, we  arrive at this: physical wellness checks and mental wellness checks go hand in hand. You cannot have one without the other. 

Issue #2: Annual physicals aren’t comprehensive exams.

Fun fact: during your annual physical, you must stick to the strict protocol allowed for the visit. Meaning, you can’t ask about other issues or you’ll pay out-of-pocket. 

If you discuss any problem you’re having at your annual physical, the doctor will code your visit differently and the health insurance companies will bill you. On UnitedHealthcare’s website (a prominent health insurance company) they even offer tips for patients on how to avoid extra costs during a preventative care visit. My favorite tip: “Discussion about other issues that are not preventive (such as asking about a hurt back), may result in an additional charge for an office visit.”

If we can’t talk about physical ailments during our annual physical what, truly, is the purpose of an annual physical? What are we preventing?

Issue #3: It’s more expensive to cover an annual physical AND an annual mental health appointment.

Health insurance companies aren’t just some band of do-gooders offering the world access to healthcare; they’re businesses. Which means they are driven by profit and cost. 

Did you know the average annual physical costs $150? Imagine how much health insurance companies are making from these visits each year. (Hint: It’s a lot.) Dr. Ateev Mehrotra, a primary care physician and a professor of health policy at Harvard Medical School, told CNN Health just how much it costs.

“We estimate that it’s about $10 billion a year, which is more than how much we spend as a society on breast cancer care.”

– Dr. Mehrotra

(And these 10 billion dollars don’t include checking in on your mental health.)

The average cost of a counseling session depends on where you live, but it’s $75-$150.00 for one, 45-minute session according to GoodTherapy. Thankfully, the Affordable Care Act mandated that all health insurances have to cover mental health care. 

Covering mental health services? Great. Including mental health checkups in the annual physical? Even better.

The relationship between our physical and mental health is serious.

The Journal of Abnormal Psychology states that most people will experience some type of mental health challenge or crisis during their lifetime. Throughout the last year, we’ve all dealt with some challenge as societal norms changed, jobs were lost, and social gatherings shifted due to COVID-19. Here are a couple other examples from reputable sources on the impact of our mental health:

  • 26% of Americans ages 18 and older—about 1 in 4 adults—suffers from a diagnosable mental disorder in a given year. (Johns Hopkins Medicine)
  • During your lifetime, you’re more likely to have a mental health illness than to develop heart disease, diabetes, or any type of cancer. (Journal of Abnormal Psychology)

We can’t ignore the powerful role our mental health has on our overall wellness. What if we screened for mental health issues before they became serious? Before they impacted our physical health?

MedicalNewsToday equates the physical side effects of mental health illnesses with obesity or smoking. Our mental and physical health are linked; for better or for worse.

A study in the journal of the American Physiological Association with 15,000 adults showed some of the alarming effects that anxiety and depression have on the body.

[They] were 65 percent more likely to develop a heart condition, 64 percent more likely to have a stroke, 50 percent more likely to develop high blood pressure, and 87 percent more likely to have arthritis than people who did not have anxiety or depression.

Fact check this: look at prominent health journals and see the clinical studies and research for yourself. The physical effects of our mental health and the psychological effects of our physical health are connected. They cannot be separated—but they should BOTH be checked on.

What if we covered annual mental health exams?

During an annual physical the doctor checks your vitals to see if you have any underlying physical issues. What if a counselor checked your mental health vitals? What if they checked to see how you are processing work, family, relationships, etc.? 

I believe in the power of preventative care and I support annual physicals. But we need to do better. To truly prevent most illnesses, we need to fully care for the person and their whole health. We must treat their physical AND mental well-being. 

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