If you have dealt with trying to obtain treatment for a mental illness, you know that it isn't easy. The fact is that people dealing with mental illness are frequently unable to utilize insurance to get treatment. When I worked in a psychiatric/substance abuse hospital, I knew that patients were frequently discharged before their time, even when they needed further treatment to become stabilized. When I've personally desired to get assistance, I was also at the mercy of whatever provisions my insurance company was willing to make to assist me to obtain the treatment. There wasn't a small co-pay. I paid most of the cost of my visits. And when the insurance company decided that I didn't need any more help...that was it. Whatever my therapist and I thought about that. So, I am very familiar with the lack of parity between the way insurance pays for mental health services and what I was able to get for physical issues. This lack of parity probably has much to do with the way that stigma influences insurors. I wouldn't hesitate to say that the insurance industry doesn't want to deal with behavioral health because the evidence for deciding that someone might need treatment is not as clear-cut as that which is available for physical illness. Although there are more objective signs of mental illness, such as weight loss, difficulty sleeping, and isolation...much of it is subjective. Of course, if we are talking about the severely mentally ill without insurance...all bets are off. They don't get treatment at all most of the time. Unless there is some kind of free alternative in the state in which they live. And that usually requires clear suicidal ideation to get them the help.
What would parity be? If mental illness was treated in the same way that physical illness is. If treatment was seen as important because of the risks without treatment...including homelessness, criminalization of the mentally ill, and death. Before job loss, and the sometimes inevitable loss of a support system. If people with a mental illness could obtain help and proper treatment BEFORE the illness reaches crisis stage. I think many of you could identify a situation in which there wasn't parity in terms of obtaining treatment for a mental health issue. Just for the fun of it, read the requirements for obtaining assistance for mental health/behavioral problems on your current plan. Compare the benefits to those you receive for physical issues. Then factor in the incontrovertible fact that insurance isn't always helpful anyway. They try to give you the least in terms of services while charging a huge price for insurance in the first place.
The Affordable Care Act was created to deal with some of the issues that insurance companies have foisted on their consumers: Huge deductibles, expensive coverage, and disparities in payments between mental health and other benefits. In 2008, President George W. Bush signed the Mental Health Parity and Addiction Act. This act sought to deal with the lack of parity that is a feature of most insurance policies. However, few changes were actually made because the law didn't have teeth. It didn't outline requirements and consequences in the way that it was needed.
Last Friday, the Obama administration took a step towards really implementing the act. They attempted to break down the barriers that people face in obtaining mental health care. For example, the rules will ensure that the copays that people pay are not any different for obtaining mental health care as they would pay for physical health care. In addition, the numbers of visits would not be more severely restricted for mental health care. (See this article: http://pinews.co/17NlaZy) So, hopefully things will change. People will be able to use their insurance to actually get treatment. Families will have a resource to work through the problems they face with a mentally ill family member. And the one in four individuals in this country living with a diagnosable mental illness will obtain the care they need to get functional.
Of course, there are other issues to deal with. Those without the financial ability to obtain insurance still suffer disproportionately in certain parts of the country. Medicaid remains a dirty word. Eventually, we will have to deal with that. Many mentally ill people don't have access to insurance due to the fact that they are dealing with a debilitating illness. But given what we are starting to accomplish, hopefully those issues will soon be dealt with.
What would parity be? If mental illness was treated in the same way that physical illness is. If treatment was seen as important because of the risks without treatment...including homelessness, criminalization of the mentally ill, and death. Before job loss, and the sometimes inevitable loss of a support system. If people with a mental illness could obtain help and proper treatment BEFORE the illness reaches crisis stage. I think many of you could identify a situation in which there wasn't parity in terms of obtaining treatment for a mental health issue. Just for the fun of it, read the requirements for obtaining assistance for mental health/behavioral problems on your current plan. Compare the benefits to those you receive for physical issues. Then factor in the incontrovertible fact that insurance isn't always helpful anyway. They try to give you the least in terms of services while charging a huge price for insurance in the first place.
The Affordable Care Act was created to deal with some of the issues that insurance companies have foisted on their consumers: Huge deductibles, expensive coverage, and disparities in payments between mental health and other benefits. In 2008, President George W. Bush signed the Mental Health Parity and Addiction Act. This act sought to deal with the lack of parity that is a feature of most insurance policies. However, few changes were actually made because the law didn't have teeth. It didn't outline requirements and consequences in the way that it was needed.
Last Friday, the Obama administration took a step towards really implementing the act. They attempted to break down the barriers that people face in obtaining mental health care. For example, the rules will ensure that the copays that people pay are not any different for obtaining mental health care as they would pay for physical health care. In addition, the numbers of visits would not be more severely restricted for mental health care. (See this article: http://pinews.co/17NlaZy) So, hopefully things will change. People will be able to use their insurance to actually get treatment. Families will have a resource to work through the problems they face with a mentally ill family member. And the one in four individuals in this country living with a diagnosable mental illness will obtain the care they need to get functional.
Of course, there are other issues to deal with. Those without the financial ability to obtain insurance still suffer disproportionately in certain parts of the country. Medicaid remains a dirty word. Eventually, we will have to deal with that. Many mentally ill people don't have access to insurance due to the fact that they are dealing with a debilitating illness. But given what we are starting to accomplish, hopefully those issues will soon be dealt with.
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