I didn't blame it all on the system, I just pointed out that it contributes. (Also, the "system" is really just shorthand for a bunch of people not doing the right thing.)

I take mental health statistics with the same huge grain of salt I take crime statistics. Why? Because almost no one is in jail for the crime they actually committed--most people take a plea and a conviction of a lesser crime in exchange for leniency.

It's a similar deal in mental health, unfortunately, though for different reasons. A lot of therapists "upcode" or "downcode". They "upcode"--provide a more severe diagnosis than is actually warranted--in order to get paid by insurance companies or government programs or whoever happens to be signing the check for a particular client. They "downcode"--provide a less severe diagnosis than is actually warranted--if they think the real diagnosis would create problems for the client (i.e. problems at work, social stigma, etc.) So a lot of folks are never given their real diagnosis at all. (Or they are given one diagnosis, and the govt/agency/HMO is given another.)

Here's another example:
Jane Doe is seeking treatment for a phobia--specifically, a fear of heights. This is a huge deal for Jane because her job is now requiring her to fly on a semi-regular basis. She's a single mom without a lot of money, and she needs her job to make ends meet. She's seeing a therapist for this phobia and planning to use her HMO to pay for services since she can't afford treatment out-of-pocket.

Here's the catch: Her HMO doesn't pay for the treatment of specific phobia. What can the therapist do in this situation? He can "upcode" Jane to something like Generalized Axiety Disorder on the paperwork and actually treat her for the phobia. Or he can be honest with the insurance company and not treat Jane at all. (Which could very well result in Jane getting no treatment and losing her job.) Either way, someone is going to question his integrity or accuse him of not putting the client's welfare first.

(PS - I realize there are other options here. The therapist could take the work pro bono, but many therapist are not in a financial position to do that. Also, he could refer Jane to a low/no-cost clinic--but those clinics tend to have long waiting lists and it's probable that Jane would lose her job before she actually got any treatment.)

It's not always as simple as it might seem at first.