Posted by: Lisa Pampuch | April 24, 2007

Insurance parity for mental health services a must

After the horrific shootings at Virginia Tech, the talking heads, pundits and blogosphere immediately began debating the divisive issue of gun control. Some said the episode demonstrates the need for stricter gun control laws, while others said it demonstrates the opposite.

My first reaction – which intensified the more we learned about the gunman – was that the episode demonstrates flaws in our country’s mental health services.

I’ve always wondered why we treat diseases that happen to occur in the brain so differently than diseases that happen to occur anywhere else in the body. The distinction always struck me as arbitrary at best, dangerous at worst.

A patient with a chemical imbalance that leads to depression likely receives entirely different insurance coverage than a patient with a chemical imbalance that leads to hypothyroidism receives.

Why is that? I can only infer that society somehow blames people with mental illness in a way that it doesn’t blame people with most non-mental illnesses.

Clearly, that needs to change.

I suspect that creating equity in insurance coverage for diseases that are labeled “mental illness” would go a long way toward removing the stigma associated with mental illness, and thus toward improving the number of people who seek and can afford to receive treatment.

I’m not alone.

The National Alliance on Mental Illness (NAMI), which gives the United States a grade of D for its mental health infrastructure, information access, services and recovery support system, supports parity in both private and public medical insurance: “Central to an understanding that mental illnesses are both ‘blameless’ and treatable is non-discriminatory coverage for the necessary medical care for these illnesses. … Outcomes for people with untreated or under-treated illnesses are disastrous and too frequently results in death or permanent disability.”

Instead of expanding our paltry mental health services, here in Santa Clara County, we’re facing drastic cuts. The county is likely to slash $34 million in mental health services in an attempt to close a $238 million budget gap.

County officials blame unfunded federal and state mandates. “It speaks to the extent to which we don’t control our own revenue,” Budget Director Leslie Crowell told reporter Tony Burchyns recently. “We are not fully reimbursed by the state and federal governments for mandated services.”

I’m sure unfunded mandates are partly to blame. But that’s not the only place fingers need to point.

Supervisors who supported the half-cent sales tax with a not-so-secret backroom deal for half of those funds to pay for expanding BART to San Jose also shoulder their share of blame. If supervisors had asked for the quarter-cent sales tax measure they really needed and left the BART deal out of the equation, the sales tax measure would likely have passed.

Instead, the financial situation that Supervisor Don Gage, who supported the half-cent sales tax measure, predicted last June after the measure’s defeat (“There’s going to be a lot of stuff that’s going to have to disappear,” he said) has come to pass.

But it’s not all bad news. State Assembly member Jim Beall (D-San Jose), a former Santa Clara County supervisor, has introduced AB 423, a bill that requires parity in health insurance policies.

Please, write your Assembly member and state Senator to urge them to support this important legislation.

Your state representatives’ names and contact information is online at the Smart Voter web site with its Guide to Government at It provides names, addresses, phone numbers, and web site and email links.

The issue of quality, quantity and parity of our nation’s mental health services doesn’t just affect “other people.” The National Institute on Mental Health (NIMH) says that more than a quarter of all adults – 26.2 percent – experience a diagnosable mental illness each year. Six percent suffer from serious mental illnesses.

We ignore mental illness at our own physical and economic risk. NIMH summarizes a Global Burden of Disease Study like this: “… mental illness … accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers.”

Whatever the Virginia Tech tragedy demonstrates about gun laws, it clearly demonstrates the need for parity in medical coverage, for removing the stigma associated with experiencing and treating mental illness, and for improving the United States’ paltry grade of D for its mental health system.


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