I should also note that mental healthcare, in the past, was something insurance companies would fight their policyholders over, and many policies didn't cover it at all. The ACA and earlier legislation are responsible for increasing access to mental healthcare[1] for Americans, as they forced insurers to cover it.

So in the past, if you couldn't see a doctor, you couldn't get a schizophrenia diagnosis even if you had it.

[1] https://www.commonwealthfund.org/blog/2020/aca-10-how-has-it...