Mental Health Parity and its Obstacles

When the mental health parity act passed in 2008, we all did a little victory dance. The new law meant improved and fairer coverage for those who use their benefits for mental and behavioral health treatments. At the American Psychological Association, we celebrated the victory, excited with what was accomplished. Parity isn’t just about money and care – it also helps eliminate the shame and stigma that many people feel when they get care for their emotional well-being.

Two years later, there are still details that need to be worked out to make parity work. That’s why I’ve been at a conference that is bringing together Accept Mental Healththe many different groups with an interest in what parity means and how it can best be put into place. At the conference are experts representing the providers of mental health care (such as psychologists), consumers who use benefits, insurance companies (payers of benefits) and employers. It’s important that these groups come together and have an open and sometimes difficult discussion because there are competing interests.

There is general consensus – the mind and body are connected and mental health and substance use disorders are illnesses. Most people do get better when helped by a mental health professional.

But there are gray areas. The implementation of the regulations governing this law has only just begun. And there remains an outdated notion that mental health care costs too much and that this perceived additional cost could be prohibitive to employers. But research on state parity laws and of the insurance plans for federal employees have shown that this isn’t the case—increased costs are minimal. In fact, the Congressional Budget Office estimated that parity would likely increase costs by just 0.04 percent. But with change, there is often some fear and pushback. Until we can all work out the details of what all those gray areas mean, there will likely be challenging times—for everyone.

What does this mean for you? Mental health parity is real. It is happening. But depending on the kind of insurance plan you have and the kind of treatment you want, you may have to jump some hurdles to get the benefitsFamily at sunset you deserve. If you talk to your primary care physician about a mental health-related concern, you may not necessarily be advised to connect with someone who can provide therapy. If you visit a therapist, you may be told you need to pay a higher co-pay than what you’d pay your primary care physician. You may be told you can only visit your therapist 20 times a year, whereas there’s no limit to how often you visit a physician. The law removes these hurdles for most patients and makes it easier for you and your family to get the treatment you need.

Check into your benefits coverage. Know what you are entitled to have. Talk to your company’s human resources office if you have questions or think you are being denied fair coverage. Call your insurance company representative. It may be uncomfortable to ask questions but you deserve equal benefits for mental health care. During my many years in clinical practice, I witnessed first hand the obstacles that were put in place to keep people from getting services in my office. I had to deal with insurance companies that wanted to limit the kind of treatment that was needed or wanted people to stop therapy before they were ready or healthy again. So don’t shy away from talking to your mental health provider or your human resources department about any concerns you have.

Mental health parity is a victory for everyone. But there is still a lot of work to do to make sure parity is implemented by insurance plans the way the law intends. We at the American Psychological Association will stay in that fight until parity really does become the law of the land!

Photos by ®oberto and Victius via Flickr

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4 Responses to “Mental Health Parity and its Obstacles”

  1. Katherine Nordal   November 6, 2010 at 6:59 pm

    We anticipate that as more companies come on line, and the dates for compliance may vary to some degree depending upon the date of their plan, that there will be more uniformity around parity issues. And remember that parity means that mental health and substance use disorder treatment decisions will have to line up with the kinds of decision rules that are used for treatment of physical disorders, so there may still be a bit of variability from company to company or plan to plan. It may be that some companies are not as much in compliance as they need to be as they work through the regulations and try to make sense of them, particularly where the non-quantitative treatment limitation rules apply. I expect that it may be rough going for some for a little while longer. Please visit our website, http://www.apa.org, for more information. Best, Katherine Nordal, Ph.D., Executive Director for Professional Practice at APA

  2. Liz O'Donnell   October 31, 2010 at 2:15 pm

    Hi, I just read your blog. I am wondering if you can help me to better understand why it is that even here in Maryland where parity was fully adopted there are still people with rather restrictive limits on how much mental health therapy they can receive. I understand what you are saying about hurdles, but I am also wondering whether or not the hurdles represent a lack of compliance with the legislation.

    Thanks for the information.

    Liz O’Donnell, MS