Monday, April 5, 2010

Movement on the mental health front

The focus lately has been on health reform. But a different law is leveling the playing field for mental health.

So much attention has been focused in recent weeks on health reform, and rightly so: It is the largest single piece of social justice legislation passed in 40 years. But another bill that has the power to do for those suffering from mental health conditions what health reform does for the uninsured launched earlier this year and now is being put in place. It is the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

Passed as part of the stimulus package of 2008, the bill seeks to end discrimination against people who need mental health and substance abuse services. Historically, access to care – meaning prohibitive costs combined with health care insurance plans that didn’t cover such services – was the main reason people who needed the help went without, according to the Substance Abuse and Mental Health Services Administration, an arm of the U.S. Department of Health and Human Services.

In the past, health care insurance plans have often treated mental health and substance abuse treatment services differently than they have other medical benefits. The new parity law ends that practice in health care insurance plans offered by employers with more than 50 employees. Under the parity law, plans that offer both physical and mental health benefits must treat them equally. That means things like co-payments, deductibles, and out-of-pocket limits must be the same for mental health and substance abuse services as they are for other medical services like surgery and doctor visits. That also means that the number of visits allowed, duration of treatment, and other treatment limitations can’t be more restrictive for mental health and substance abuse services than they are for other services.

The new law comes at a time when more attention then ever has been focused on the need for mental health care, particularly in the military. Veterans returning from Iraq and Afghanistan are being diagnosed in increasing rates with Post Traumatic Stress Disorder and other mental health conditions. Suicides among military personnel are being scrutinized, as are acts of domestic violence.

And lawmakers in some states are taking notice. Coupled with health reform, which requires all Americans to have health insurance by 2014, and the Wellstone and Domenici parity law, states’ recent actions are creating a true safety net that can significantly increase access to mental health and substance abuse services. For example, last week the Iowa House of Representatives approved a bill that requires private health care insurers to provide veterans with mental health and substance abuse coverage (the bill must pass the Iowa Senate). Also last week, Texas Gov. Rick Perry announced $1.75 million in competitive grants for mental health programming for veterans. Perry’s office said the grants are for programs that help veterans access basic treatment. The grants are also intended to expand trauma therapy services, and promote support groups.

And while they didn’t target veterans directly, Montana’s Yellowstone County Commission agreed last month to ask voters to approve a specific tax for mental health services. County officials estimate that the proposed tax would raise approximately $873,000 annually to fund mental health services designed to keep the mentally ill out of hospitals and jails.

These are excellent developments, and they will go a long way toward both increasing access to mental health and substance abuse services and reducing the stigma associated with those conditions. What do you think?

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