I envision Utah as a model for other regions confronting the growing global mental health crisis.
While numerous factors contribute to the rising prevalence of mental health conditions, the most immediate challenge for providers is ensuring that patients can access treatment. This is where we need to create new avenues to accessing care and adopt upstream strategies to address one of the greatest barriers: cost. Through innovative and collaborative efforts, we can unlock timely treatment opportunities for those who need it most.
The cost of delayed access to care
Delays in accessing mental health care carry significant consequences — not just for individuals, but also for their families and the broader economy.
Although stigma and lack of insurance are often cited as barriers, one of the most pressing issues lies in the limitations of insurance coverage itself. For example, despite Utah having the highest rate of employer-sponsored health insurance in the country, nearly 41% of adults still report experiencing anxiety or depression. This paradox stems from restrictive insurance policies that fail to provide adequate support.
Patients often face the requirement to exhaust conventional treatments before being eligible for more effective, personalized options. In our clinic, we frequently see cases where a patient must fail four different medications before being approved for Deep Transcranial Magnetic Stimulation (Deep TMS). The newest medical literature recommends TMS earlier in the treatment algorithm, typically after two trials of antidepressants. I highlight this treatment specifically because Deep TMS has demonstrated clinical success in addressing treatment-resistant depression and is a highly personalized treatment best used in conjunction with therapy and medications. During this prolonged period of trial and error, there is also a significant risk of patients discontinuing treatment, mistakenly believing that no solution will work for them.
Even with insurance, high out-of-pocket costs can cause patients to delay appointments or skip medication, undermining care effectiveness. For some, the financial strain prevents them from seeking treatment altogether, impacting not only the individual but also their loved ones, creating a cycle of untreated mental health issues across generations.
What often goes unnoticed is the economic toll of these delays. Between 2017 and 2023, employee leaves of absence for mental health reasons surged by an extraordinary 300%, highlighting how limited access to care ripples beyond the individual to affect the broader workforce and economy.
Breaking down barriers to care
Organizations like the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA) work tirelessly to fill the gaps in mental health care while systemic change is in progress. As the saying goes, “It takes a village.” In Utah, we sought to create an expedited path to treatment by building “Healing for Heroes,” a nonprofit program that subsidizes treatment costs for veterans, first responders, as well as for their families, all while advocating for more patient-focused insurance policies. Change takes time, and for many patients, time is a luxury they cannot afford. Too often, we’ve seen treatment denied because patients aren’t deemed “depressed enough” by insurance standards, yet as I sit across from them, I see them suffering to the point of suicidal ideation.
Organizations like ours can provide temporary solutions, but the ultimate goal is to remove these barriers altogether. Achieving this requires upstream thinking and a significant shift in insurance policy frameworks — changes that will take time, which is why stopgap measures are essential as we work toward a better future.
This new mindset starts with acknowledging that the current medical model used by insurance providers does not align with the reality of mental health conditions. Depression, for instance, is a leading cause of disability, yet is often treated as a condition manageable with just a few office visits.
Moreover, many people seeking mental health treatment have endured years of trauma or long-standing illness. By investing in early interventions for children and families, we can reduce the incidence of future mental health crises. Supporting school-based programs, family-focused initiatives and poverty reduction measures can help tackle root causes and build lasting mental health resilience.
The path to better mental health care in Utah and beyond involves bridging current gaps while striving for lasting change. By fostering collaboration, challenging outdated models and investing in early intervention, we can create a system where timely, accessible and patient-centered care becomes the standard. The time to act is now.
Improving mental health care in Utah requires bridging existing gaps through targeted action. I call on our community to urge policymakers to subsidize costly treatments and enhance school-based mental health programs for lasting support. Expanding telehealth access is also vital for reaching more individuals. Supporting local nonprofits already aiding the underserved can help build a united front for change. With these steps, Utah can lead by making mental health care a right, not a privilege.
(Antenna Group) Alex Mageno, MD, is a psychiatrist with Meadowbrook Counseling and the medical director for Whole Mind.
Alex Mageno, MD, is a psychiatrist with Meadowbrook Counseling and the medical director for Whole Mind.
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