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Mental Health Month: Insurers taking advantage of loopholes in mental health parity law, say advocates

05-02-18 Category: Mental disorders

Mental Health Month: Insurers taking advantage of loopholes in mental health parity law, say advocates

“My insurance company said my 16-year-old daughter’s mental condition had improved when it had actually worsened. They mentioned it wasn’t necessary medically for my daughter to visit her psychiatrist twice each week,” said 54-year-old Duncan Caber (name changed) of Chicago. In the past, Caber’s teenage daughter was admitted to the hospital twice with chronic bipolar disorder. Lack of treatment triggered a new series of suicidal tendencies, forcing her to get hospitalized again in the next six months in a $350 per day facility.

Caroline Adams (name changed) of Philadelphia has a substance use disorder (SUD), in addition to borderline personality disorder. She would consult her therapist each week and had a co-payment of $30 per session. But two years ago, her therapist hiked his consultancy fees to $45 per session and stopped accepting her insurance. “I feel helpless, I can’t afford an out-of-budget psychiatrist,” says 41-year-old Adams.

“My insurer is ready to pay my primary care physician for a 10-minute appointment for common flu. But it will never let me have an hour-long session with my psychiatrist,” lamented 45-year-old Diana Parker (name changed) of Miami. Parker has battled several depressive episodes in the past, and is now heavily in alcohol. She feels her struggles with depression have pushed her toward alcohol. She attended a few treatment sessions with her psychiatrist, but couldn’t complete the entire course of cognitive behavioral therapy. The reason: her therapist has stopped accepting insurance, and others charge a bomb.

Like Caber, Adams, and Parker, mental health advocates believe there are many victims of lax enforcement of laws under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. The MHPAEA seeks to prevent insurance plans from imposing stringent coverage limits for mental health and substance abuse treatment compared to physical health conditions.

In 2016, the then President Barack Obama had announced the formation of a new task force on mental health parity to prevent discrimination in the system, and the creation of a new government website to address citizens’ grievances surrounding parity. However, an average American continues to be uninformed about the law or how to file a complaint in the case of an adversity. Nevertheless, the lax enforcement of Mental Health Parity law continues to endanger many patients in the country. A 2015 survey conducted by the National Alliance on Mental Illness (NAMI) revealed several patients were denied coverage because the treatment was deemed “not medically required” for their mental condition as opposed to other medical conditions. So far, states like New York and California have shown some seriousness to investigate matters involving non-compliance with the law.

Sadly, even as the nation has raged a war against the ongoing opioid crisis, many insurers continue to restrict treatment through several strategies that are tougher to monitor, say experts and attorneys. Mental health advocates view the denial of services to patients on grounds like lack of coverage or pre-authorization requirements as potential violations of the law. On the other hand, insurers don’t agree that mental health and addiction get less consideration in health plans.

Seeking treatment for mental disorders

According to the 2016 National Survey on Drug Use and Health (NSDUH), there were nearly 45 million people aged 18 years or older in the country with any mental illness (AMI) in the previous year. To raise awareness about the need of sound mental health, and fighting the stigma surrounding psychiatric conditions, Mental Health Month is observed every year in May. During all awareness events to be held in May 2018, the NAMI will promote the theme of “CureStigma” to advocate for policies that support afflicted individuals and their families.

Fortunately, most of the mental disorders are treatable with timely professional help. If you or your loved one is battling any mental ailment that needs medical intervention, contact Sovereign Health to avail the latest treatment options at its residential mental health treatment centers. Call our 24/7 helpline or chat online with our counselor for more information about our evidence-based residential mental health treatment programs.

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