Stephensville, MI – When 16-year-old Johnathan Benz-Bushling attempted suicide in February, his parents immediately sought intensive mental health care for him. But despite urgent medical recommendations, their insurance provider denied coverage for Johnathan’s residential treatment, citing it as “not medically necessary.”
This heartbreaking case sheds light on the widespread challenges families face in securing adequate mental health support amid complex and costly insurance processes. The Benz-Bushlings’ experience highlights how insurance denials can jeopardize vulnerable patients’ recovery and strain family resources.
A Dire Need for Residential Mental Health Care
Following Johnathan’s suicide attempt, local doctors at Forest View Hospital, a pediatric behavioral health facility in Grand Rapids, strongly recommended residential mental health treatment, emphasizing that Johnathan was “too unstable to function outside of hospital” and that his needs “cannot be expected to be met in a lower level of care.” The family quickly secured a placement for Johnathan at Newport Academy in Washington, a specialized residential treatment center.
Nick and Misty Benz-Bushling prioritized their son’s well-being over logistics and cost. Nick remarked, “I’m just trying to make sure that he’s getting the help that he needs… Let’s get him somebody that can help him through these hard times, because we’re not it.”
The Crushing Blow of Insurance Denial
Only five days into Johnathan’s treatment, the family received a devastating letter from their insurance company denying coverage. The insurer classified the care as “not medically necessary” and suggested that treatment could be provided at a “less restrictive level of care”—a conclusion starkly opposed to medical evaluations.
This denial set off a grueling battle, imposing severe financial and emotional hardship on the Benz-Bushlings. Misty quit her job to provide full-time support, Nick sold rare Stephen King memorabilia to cover costs, and the couple cut back drastically on expenses for their three other children, including making their eldest switch to virtual college education.
“If my son comes home now, he will end his life, and the blood will be on your hands,” Misty Benz-Bushling said to an insurance care coordinator during a tense phone exchange.
The Larger Crisis: Mental Health Care Access and Costs
The Benz-Bushlings are far from alone. Nearly 60 million adults in the U.S. live with mental health conditions, yet only about 50% receive treatment. Among children, 20 million have been diagnosed with mental health disorders, a number that continues to rise.
In 2019, mental health treatment costs in the U.S. soared to $106.5 billion, with private insurance covering roughly a third. Pediatric mental health conditions accounted for $59 billion in household spending in 2021, making up nearly half of all pediatric medical costs.
Residential treatment centers for minors are both rare and costly, with a 2024 study noting typical monthly fees exceeding $26,000. Dr. Robert Trestman, chair of the American Psychiatric Association’s Council on Healthcare Systems and Financing, described how financial incentives urge insurers to minimize covered care levels.
“Because of the financial incentives, it’s become painful, and it’s at every level. The system itself is broken badly,” Dr. Trestman said.
Years of Struggle and a Determined Appeal
Johnathan’s mental health challenges began to surface in 2022, with worsening depression and a growing addiction to marijuana and other substances. To protect him, the family relocated from Virginia to Michigan, hoping for a fresh start. Despite prior treatments—including therapy, outpatient programs, and a previous residential stay—Johnathan’s condition deteriorated leading up to his suicide attempt.
The Benz-Bushlings compiled a comprehensive 270-page appeal to challenge the insurance denial, detailing their son’s sustained struggles and clinical evidence supporting intensive care. Despite their efforts, the financial toll remained heavy, prompting them to seek legal recourse with a potential lawsuit against their employer’s insurance provider, American Electric Power.
After multiple contacts from NBC News and legal pressure, the family and American Electric Power quietly settled the dispute under confidential terms. A company spokesperson nevertheless emphasized that “AEP offers benefit plans that include access to a broad range of healthcare, including mental health services,” clarifying the company’s limited role in treatment decisions.
A Hard-Earned Hope and a Call for Change
Today, Johnathan’s health shows signs of improvement. He secured a summer job at a local hardware store and spends time fishing with friends — milestones that mean a great deal to the Benz-Bushlings. Reflecting on their journey, Johnathan expressed gratitude despite the hardships:
“I was upset that they had to, but I was also really grateful,” he said of his parents paying out of pocket for his care.
Yet the family remains angered by the insurance denial that forced them into such sacrifices. They have taken extra precautions at home, installing locks to secure medications and alcohol, underscoring ongoing risks.
Nick Benz-Bushling hopes their story might spur change:
“Maybe insurance companies will see this and say, ‘Oh, these are real people out there. It’s not just a stack of paper.’”
For those needing help, resources like the Suicide and Crisis Lifeline (call 988), the National Suicide Prevention Lifeline (800-273-8255), and the Substance Abuse and Mental Health Services Administration helpline (1-800-662-HELP) offer vital support.
Learn more about the challenges of mental health treatment access and insurance coverage at NBC News.
