Finally, Parity for Mental Illness

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After many legislative proposals and actions since at least 1996, the US House of Representatives finally passed a Mental Health Parity Bill. This will be good news for the 35 million Americans who experience mental illness and emotional problems, and for whom our foundation is dedicated. Please see the New York Times, March 6, 2009.

Many users of mental-health services have been frustrated because the levels of reimbursement for mental-health coverage is often less than for other medical conditions. For example, 30 sessions of individual therapy are the limit for most mental-health plans, and many people require weekly therapy sessions. (Nota: This bill does not cover businesses with fewer than 50 employees.)

The disparity is greater when looking at inpatient mental-health coverage. The limits now for mental illness are usually for 30 days of inpatient care per year. This greatly contrasts with other specialty areas, such as heart surgery or neurosurgery, wherein many more days may be needed for medical treatment and wherein cost per year may range into the hundreds of thousands of dollars.

For some, this parity of coverage may even be lifesaving. Eating disorders are frequently accompanied by high levels of depression or obsessive-compulsive disorder as well as medical concerns like electrolyte balance may be more effectively monitored in a hospital setting. Those with alcohol and substance abuse issues may also greatly benefit. Not many people may remember that there were 90-day inpatient programs for alcohol and substance abuse as recently as the 1980s. For many, this intensive program was more effective than 7-day or 30-day hospitalization, and it could be argued that a 90-day stay could be more cost-effective if it prevented the number of relapses that often accompany shorter stays. There will also be great benefit for persons with schizophrenia or severe bipolar disorder. The longer time spent in the hospital could mean a much more effective monitoring of the different dosages that may be required, and would even permit for changes in medication to be supervised in the hospital.

There continues to be debate over how much this new level of coverage will cost; but advocates predict this will be at a reasonable level.

“I have a mental illness, and I am fortunately getting the best care this country has to offer because I am a member of Congress,” stated Patrick J. Kennedy, the Democratic Congressional Representative from Rhode Island.

We hope for the day that many more of the 35 million Americans toward whom this bill is aimed will be able to convey a similar sense of gratitude.

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