‘Mental illness is a disease, just like diabetes or multiple sclerosis, except the organ it attacks is the brain.’ We’ve heard this statement before; it’s an oft-used one in attempts to shift public perception with regard to the origins of mental illness. To me, it sounds like a no-brainer (pun intended), but in some arenas, the struggle to translate this into a practical reality rages on.
A new mental health parity class-action lawsuit was filed last month in New York against group insurance provider UnitedHealth. The suit’s most recent litigant joined after UnitedHealth decided to limit therapy sessions for his bi-polar son. Under 2008’s federal Wellstone law (it’s full name is The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act – P.L. 110-343), group insurance plans must provide the same coverage for mental illnesses and substance abuse disorders as they do for other health issues.
In the story, written by Jim Spencer of the Minnesota StarTribune, it’s reported that “mental health parity suits have been filed before… But they are usually individual claims based on state laws.” This most recent case is the first on a class-action level, and the first to point to the relatively-new federal parity law to support its argument.
This case also draws on passages from 2010’s Affordable Healthcare Act (AHA). The AHA states that mental health coverage is an essential benefit, but more importantly, it includes small employers and individual plans in the text (both were left out of the Wellstone law). The U.S. Department of Heath and Human Services estimates that 2.3 million Americans who are insured through the individual market will gain mental health coverage at parity with medical and surgical benefits because of the AHA.
As a self-employed purchaser of individual medical insurance, a consumer of mental health services and an occasional user of the expression, “Well, duh,” I am excitedly anticipating the day in 2014 when the U.S. mental health parity law goes into effect across the board to include all shapes and forms of insurance plans and providers. ‘Small business is the growth engine of America’ is another statement we often hear in this country, and yet with the way the laws have been up until now, the entrepreneurial are the ones who are getting hosed.
Have you had any experience with caps on mental health insurance coverage? Or with differences in coverage from one plan to another?
This blog post came at the right time since we don’t know who was behind the Boston Marathon bombings. We’ve already seen several U.S. mass shootings and bombings by individuals suffering from mental illness. We discuss gun control, but too many ignore the importance and need of health insurances and institutions for the mentally ill. I, as well as you, look forward to the mental health parity law going into effect. Thanks for posting.
Thank you for your comment, Denise. I agree, Boston could be a result of terrorism or it could be someone with a mental illness, and there have been enough tragedies due to the latter recently that it shines a light on the struggling state of mental health care in this country. Gun control is only half of the conversation. And you’re spot on when you mention institutions. The movement to deinstitutionalize in the 1950s swung so far in one direction that it has left us without an adequate number of ‘beds’ for longer term in-patient care.
This is an important post. I, like Denise, have felt that health insurance and institutions for the mentally ill are critical for the well-being not only of the individuals suffering from such illnesses, but for the well-being of our society as well. I hope the Plaintiffs win the class-action lawsuit–what an important precedent that would set.
It’s like the Hubert Humphrey quote says, “The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.”
Thanks for writing this. I am a New Yorker, a mental health practitioner, and an insurance panelist and I’m embarrassed that I did not know!
There’s so much news and information out there, and so distilling it has become the challenge of the 21st century. I’m just glad you found the post helpful!
I remember the worst years when my mom might be hospitalized twice in one year, but she never stayed there as long as would have been needed to get her to a more balanced place because the insurance always ran out and then she would come home. And my dad’s insurance from the mine was pretty good, though not good enough to provide proper coverage for mental illness.
Argh. That’s the kind of stuff that gets me. There shouldn’t have to be those kinds of health trade-offs.
My experience with mental health and insurance is that in a lot of instances, insurance has little to no experience or possibly patience with patients requiring mental health coverage. After my son died, my depressive state was at its absolute worst. I finally decided to get help, found a therapist and ended up getting the run around and had to change therapists a few sessions in because of how the mental health aspect of my husband’s insurance was mismanaged. For somebody who was reluctant in doing basically anything at that stage, it was so frustrating to fight for my own mental healthcare.
Excellent post and informative, as per your usual Laura.
Tylia, you’ve pointed out one of the regretful by-products, and that is that no one should have to deal with the extra strain of worrying about whether their insurance will see them through when all of the focus just needs to be on getting better. Thank you for sharing your experience.
Hi Laura,
I’m basically an optimist. In terms of the overarching picture I see things as improving. That doesn’t mean that I’m blind to tons of incompetent and maddening practices that desperately need fixing.
But here’s a big improvement:
I share something with you Laura — my mother was mentally ill. There was such a stigma about mental illness, (or anything that didn’t fit the cookie-cutter picture of how a person should lead their life in the 50’s), that the situation kept getting swept under the rug.
I’m 60 now, so my perspective is one of looking back at all the drama and craziness. I see a world now where mental illness is being dealt with much better. People get help in the form of school interventions, therapies, and medication that not only helps them but all of their families as well.
Class-action law suits are a form of the people talking. And that’s what will change the future of health care. Thanks for your post and to start this discussion.
Regards,
~Josie
I think the current discussion around mental illness bears some similarity to that of gay rights in that society is demanding equality. Nobody should be treated like a second-class citizen, and I agree with you, there are a lot of things that can be seen as really encouraging. I was speaking in a high school classroom a couple of weeks ago about my own struggles growing up with a mentally-ill parent — and the horrible isolation of the experience — and a young woman (who I later found out had just left her home to go live with a brother for the same reason) was brought to tears. But at the end of the class, she stayed behind and went to her teacher to talk about it. I was so heartened to see that, and I just wanted to hug the teacher for making herself accessible. I like to think that’s another one of the shifts from the 1950s and 60s to today. Thank you for reading and for sharing your story, Josie.
🙂
Laura, I found out recently that all the various phobias I have are considered forms of mental illness. I never thought of myself that way. I thought everyone had phobias and just covered them up. Discovering that I had a form of mental illness made me more sensitive to those who struggle with much worse.
That’s very interesting, Cindy. It got me reading up on phobias, because I wasn’t clear on the guidelines for diagnosis. I’m sorry to hear you’ve had to deal with them, but the silver lining is, as you said, the compassion that grows out of it. Saying it builds character is too trite, but I think it does give a lot of depth to a person. Wishing you the best, xo.