The Silver Lining

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No matter what your view is on the economic bailout plan that passed Congress in October 2008, the silver lining is the Mental Health Parity Bill attached to the bailout. More than 113 million people who currently have mental illness will benefit from this new legislation. Mental Health America, a nonprofit advocacy group, has estimated that 67% of adults and 80% of children requiring mental health services do not receive help, in large part because of discriminatory insurance practices. The Mental Health Parity Bill is a landmark, requiring employers to provide mental health insurance benefits comparable to their medical coverage. Although employers with 50 workers or less are exempt, this legislation still represents major progress in our country's recognition of mental health and illness and the potential for treatment. Thousands of citizens will be better served, and importantly, although the new legislation is not perfect and may lead to increases in insurance premiums, it is a giant step forward. In short, the legislation makes it illegal for health insurance companies to discriminate against patients who have psychological or behavioral disorders, outpatients.

Included in the new legislation is the stipulation that Insurance plans would be barred from setting higher copayments or deductibles for mental health or substance abuse treatment than for medical care. Other important components are that lower benefit limits for mental health treatment would be illegal, along with caps on the number of outpatient therapy sessions or inpatient treatment days. In addition, employees would have to be covered for out-of-network mental health care if their plan includes out-of-network medical coverage. The law requires the U.S. Department of Labor to report to Congress every 2 years on how group health plans are complying with the law.

As mental health professionals we all have known the inequities in the treatment of mental illness and the continued discrimination and negative attitudes that have been part of the United States and global culture. Further, there is sufficient research linking mental health and physical symptoms and strongly supporting the value of early intervention in mental illness.

Many of you have no doubt lobbied for this legislation, perhaps for years, on behalf of patients, professionals, and society. Although we may not be celebrating the economic downturn in our society and the blatant abuses by financial managers and executives that led to the bailout plan, it is important to rejoice about the add-on regarding mental health. There may be downsides to the financial bailout, but mental health parity is essential. We have taken a giant step forward to toward this goal.