“I Need My Nerve Pill.” – Psychotropic Medication and Access to Mental Health Care in TN

Mental health care has changed drastically over the course of the last 50 years. What was once a fairly misunderstood and costly service is now much more common and affordable.

In fact, it is not uncommon at all to report to a family care provider certain mental problems are occurring in hopes of receiving help. Often, resulting in a new trial prescription to alleviate common mental symptoms of anxiety or depression.

For many Tennesseans, it is much easier to seek a prescription instead of traditional therapy. Perhaps something traumatic has just occurred: a loss, unemployment, divorce, or any other event that takes some time to adjust to and overcome. In the end, the person seeking help just wants to feel better; to live a more fulfilling life. Often, psychotropic medications such as anti-depressants, among others, are prescribed to alleviate symptoms in order to find some type of balance.

This is a common practice in the United States and abroad. However, according to research conducted by Marissa D. King, PhD, of Yale University in 2013, a large regional cluster in the South centered on Tennessee uses an estimated 40% more psychotropic medications than the rest of the country. This statistic alone can tell us a great deal about the current state of mental health care in TN and the Southeastern United States.

It should be noted that there is absolutely nothing wrong with taking medication for mental illness. In fact, many mental health illnesses require medication management and long-term oversight from a provider such as a psychiatrist or psychiatric nurse practitioner. The topic of responsibility comes into play when the provider and consumer are being discussed. One has to wonder, how many of these consumers are also seeking therapy for their mental health? Further, do consumers of mental health services understand how to receive help beyond medication? If not, are providers giving consumers enough resources or information? It seems as though more people are only taking medication for their mental health instead of seeking some type of therapy in conjunction with medication. One may wonder, ‘is this a cultural phenomenon?’ Or, is it possible to look into other factors creating this large difference in psychotropic medication usage in the South versus the rest of the US.

Data released from Mental Health America displays national access to care statistics published late 2016 and early 2017. Interestingly, as of 2017, Tennessee ranks 46th nationally in regards to access to mental health care. This is alarming considering data released in 2011 show Tennessee as ranking 37th nationally 2. In a 3-year time period, Tennessee fell from 37th to 48th 2: currently showing a modest improvement overall since 2014. However, these are not the only statistics worthy of acknowledging. Tennessee ranked 50th nationwide for adults with a mental illness who are uninsured at a rate of 23.6%2 . Turning to the mental health workforce availability, it is reported for every 780 people needing mental health care there is 1 provider in TN; ranking the state nationally at 44th.

Now, reflecting on the study published by Yale University concerning the South and psychotropic medication use, it becomes much clearer what types of obstacles inhibit the ability of seeking of mental health care beyond medication or any care at all. It should be stressed to those with mental health concerns that a family care provider is not trained to give therapy, nor does a prescription guarantee success or relief.

Consumers of mental health services and candidates deserve to know what other services may be available in addition to medication and to what extent the cost may be. With the large percentage of people in TN who lack insurance, it is difficult to receive any type of consistent treatment. Utilization of resources such as peer support centers may provide a hope for those who are rendered unable to find mental health care. Providers of mental health services should attempt to locate a readily available list of resources for those they serve. Through iBHealthlist.com this can be accomplished. It is set to launch this Spring along with its TeleHealth services. More to report in the near future concerning mental health care in TN.*


1. https://insights.som.yale.edu/insights/study-maps-mental-health-medication-use-in-the-us

2. http://www.mentalhealthamerica.net/issues/mental-health-america-access-care-data