It’s time to call for a vote on mental-health parity

It\’s time to call for a vote on mental-health parity October 7, 2006 — More than 10 years have passed since Congress passed the Mental Health Parity Act, an important step toward ending discrimination in the provision of health insurance coverage for mental illnesses.

Yet, today, many of the 44 million Americans with mental illnesses and their families still must choose between the debilitating disorders they face and the heavy financial burdens of their treatment. For one-third of those who experience mental illness, the resources to improve their mental health are out of reach.

Repeated efforts in Congress to close these loopholes have won broad bipartisan support; however, votes to expand the parity bill have been blocked. As a result, Congress has instead simply kept the 1996 law in force, through a series of one-year extensions.

Recently, the sponsors of a parity bill in the House of Representatives filed a petition to bring the bill to the floor for a vote. The National Mental Health Association encourages members of the House to support this effort.

Thirty-four states have enacted mental-health parity laws. However, many have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses.

Moreover, many employers and insurers have violated the spirit of the Mental Health Parity Act by placing other restrictions on mental-health benefits, such as limits on the number of covered outpatient office visits and number of days for inpatient care.

Mental-health parity isn’t as difficult to finance as it might seem. Actuarial firms such as the Hay Group estimate that comprehensive mental-health parity will raise costs a little more than 1 percent.

Citing a “growing body of research and actual industry experiences,” the federal government found that state parity laws have had only a small effect on premiums, due primarily to careful management of mental-health services.

Although some may think it’s a smart business decision to avoid addressing the mental-health needs of employees and clients, the truth is such policies not only deny people the medical care they need, but also increase the burden that untreated or under-treated mental illness places on the economy.

Many businesses have recognized that parity helps them to support the overall health needs of employees and, in the process, prevent the loss of productivity through sick leave.

A landmark 2005 report by the National Business Group on Health advised that parity between medical and behavioral coverage would yield significant clinical benefits without increasing overall health-care costs.

Mental illness is the leading cause of disability worldwide. Depression annually drains the U.S. economy of $44 billion in reduced productivity and missed work days.

Although depression will affect 15 percent of Americans, it is one of the easiest disorders to treat, whether through talk therapy, medication or a combination of approaches.

Without medical attention, depression can have heartbreaking consequences. Researchers estimate that 90 percent of suicides are due to depression and other mental illnesses. Suicide alone robs us of 30,000 friends, relatives and neighbors every year – a toll that outnumbers homicide deaths 5-3.

In the wake of hurricanes Katrina and Rita, the weakened mental-health system on the Gulf Coast has only compounded the desperate need for health-care services in the effected areas.

In Alabama, Mississippi and Louisiana alone, Harvard researchers estimate, 200,000 people are suffering from depression or post-traumatic stress disorder. That’s not to mention the untold cases among relocated survivors.

Unfortunately, by limiting coverage and public funding for mental-health services, we are essentially telling people that treatment for their illness ends where lack of money begins – rather than when the healing that restores them as productive members of society is complete.

By David L. Shern

Dr. David L. Shern is the new president and CEO of the National Mental Health Association ( Previously, he was professor and dean of the Louis de la Parte Florida Mental Health Institute at the University of South Florida. Contact him at NMHA, 2000 N. Beauregard St., 6th floor, Alexandria, VA 22311.

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