The Assumptive Worlds of Psychopathy IX: The World of Aspirations
It is at this point that Rosmarin gets down to the “nitty-gritty”. Like most of the successfully advocates of the fourth assumptive world of mental health, Rosmarin makes the convincing case that prevention saves money.
I am not a politician, and I don’t work for a health insurance company, but from my vantage point, it seems that annual psychotherapy well visits could yield substantial cost savings in addition to their health benefits·. The World Health Organization recommends early cancer screening not just because it’s humane and kind to save lives but because it cuts treatment costs. Routine screening for heart disease is even more financially beneficial, saving approximately $3,500 per patient and more for high-risk people. . . .
If people don’t fall off the cliff then we don’t have to pay for either treatment or amelioration (reducing the long-term damage). Rosmarin brings out his calculator:
Adding all those costs up, I estimate that if every American had an annual psychotherapy well visit at a cost of $90 per session, the program would pay for itself if it alleviated only 5 percent of the direct costs of medical illness in this country. And that’s even without factoring in the gains in productivity and reduced use of the medical system that could result. When President Joe Biden proposes enhancements to Obamacare, psychotherapy well visits should be an option for employers and states to include.
Rosmarin now makes an important point that moves his analysis past medicine and economics to the social-psychological context within which people live when anxious and in need of support:
Beyond the economic and health benefits, psychotherapy well visits would help put an end to mental health stigma. Historically, mental distress has been a mark of disgrace and source of shame. For this reason, fewer than half of people with a diagnosable mental disorder receive professional help. Routine visits to a psychotherapist would normalize mental health care.
He closes his essay with a turn to the established argument among mental health advocate for screening. Rosmarin draws the usual parallel between mental health treatment and other forms of health-related treatment (teeth and mind). He suggests that members of our society are open to discussions about mental health—at least if psychopathy is considered an “Illness”:
I am not the first to advocate for annual mental health screenings. It has been suggested, for example, that primary care providers screen for depression during annual physical exams. But our society’s unprecedented openness to discussing mental health underscores the need for something more. Perhaps preventive psychotherapeutic care is finally within reach. ·