Greetings! There’s no way to sugar coat it, we (the ones that are NOT in the 1%) are truly on our own but we will get through this! I have past posts where it was just chaos/during the pandemic and here’s a summary: took breaks, did programs/certifications, accepted lower wages, spent frugally, didn’t make any crazy purchases, and walked around rambling, which is my baseline… We’ve been in the trenches before but to get a better picture for over the next 4 years, I basically asked Chat GPT a loaded question about some of the crap going on… because my brain is cooked. Long story short, our current system isn’t sufficient or reliable in the foreseeable future…and I highlighted some areas in red:
Here’s a breakdown of the current (as of 2025) implications and possible outcomes in the next four years across the areas you’ve mentioned:
1. Mental Health Care Practices
- Current State: Increased public awareness and bipartisan acknowledgment of the mental health crisis (especially post-COVID) have led to more openness toward integrating mental health into primary care.
- Impact of Government Changes:
- If funding is prioritized, integrated care models (mental + physical health) will expand.
- If budget cuts target public health, community mental health centers may shrink, pushing care into already-burdened ERs and jails.
2. Telehealth
- Current State: Telehealth usage surged during the pandemic and remains critical for rural and underserved populations.
- Impact:
- Federal and state-level legislation determines reimbursement parity with in-person visits. If rolled back, many providers may abandon telehealth services.
- Cross-state licensure remains a hurdle. Uniform interstate compacts could help, but these need governmental support.
3. Psychiatric Nurse Practitioners (PMHNPs)
- Current State: They help fill the psychiatrist shortage, especially in rural areas.
- Impact:
- Scope-of-practice laws vary by state. If federal incentives support full-practice authority, PMHNPs can offer broader services.
- Resistance from physician lobbies and lack of standardized training across states may hinder growth.
4. Socioeconomic Programs
- Current State: Mental health outcomes are deeply tied to housing, food security, education, and employment.
- Impact:
- Cuts to Medicaid, SNAP, or housing support would likely worsen mental health and substance abuse crises.
- Expansion of these programs under a progressive government would improve upstream social determinants of health.
5. Insurance Coverage Problems
- Current State: Mental health parity laws exist but are poorly enforced. Many insurers still reimburse mental health at lower rates.
- Impact:
- Stronger enforcement and expansion of the Affordable Care Act (ACA) would push insurers to comply with parity laws.
- If the ACA is weakened or repealed, millions could lose mental health coverage.
6. Special Populations (e.g., veterans, minorities, incarcerated individuals)
- Current State: These groups face major disparities in access and outcomes.
- Impact:
- Programs like the VA or community mental health grants for minority populations depend heavily on federal funding.
- Criminal justice reform could shift the system away from incarceration toward treatment—but only with sustained policy support.
7. Lack of Access to Psychiatric Care
- Current State: Over 150 million Americans live in mental health provider shortage areas.
- Impact:
- Government investment in loan forgiveness, residency slots, and rural mental health incentives could slowly improve access.
- Lack of investment will worsen the bottleneck, especially for low-income patients.
8. Prognosis & Solutions for the Next 4 Years
- Prognosis:
- If mental health remains a bipartisan priority, improvements could be made in tech (telehealth), workforce expansion (PMHNPs), and funding (especially Medicaid).
- However, deep political divisions may lead to piecemeal changes rather than comprehensive reform.
- Key Solutions:
- Federal Level: Enforce mental health parity laws; expand Medicaid; fund school- and community-based mental health programs.
- State Level: Allow full-practice authority for PMHNPs; adopt telehealth compacts.
- System Level: Integrate mental and primary care; increase culturally competent care; incentivize psychiatric residencies/(many AI or computer systems still try to rely on doctors).
In Conclusion
We have to prepare that it’s going to be very little improvement if not worse for the next few years especially in psych. The focus has to be in caring for ourselves and helping others if we can. If you’re not in the capacity to add more to your plate (like ME 🙋♀️), the goal is to do LESS! not more… I’ve been cautioning people not to make crazy purchases, leave the country, get impulsive or risky, etc. in these unpredictable times unless super necessary. Instead, prioritize protecting your peace, self-care, enjoy your loved ones, and stay grounded in what you can control. Try to keep having some kind of fun.
