Editorial: Equal Treatment; Mental Health Parity Achieved

Last week brought genuinely good news on the health insurance front, although you certainly may be forgiven for having missed it amid all the consternation about the bungled rollout of the health benefit exchanges mandated under the Affordable Care Act.

We refer to new rules issued Friday by the Obama administration requiring that health insurers cover mental health and substance abuse treatment in the same way they do standard medical and surgical benefits. That is, co-payments, deductibles and coverage restrictions must be the same whatever the service covered.

Equality in this realm has been a long time coming. The new rules finally put into effect the Mental Health Parity and Addiction Equity Act of 2008 and will affect most Americans with insurance — an estimated 85 percent of the population — whether they receive coverage through their employers, other group plans or purchase it on the market as individuals.

Should you doubt these rules are needed, consider this. While more than 45 million adults in the United States suffered from mental illness in 2011, just over 17 million of them received treatment, according to the federal government. Some portion of these swell the ranks of the homeless and prison populations, of which the mentally ill make up a disproportionate share.

Just last week, New Hampshire Gov. Maggie Hassan announced that she was launching a review of services for the acutely mentally ill after two violent incidents at Elliot Hospital in Manchester.

In both cases, the patients involved were languishing in the hospital’s emergency department while waiting for a bed to open up at the New Hampshire state hospital, a scenario that has become distressingly common in both New Hampshire and Vermont over the past few years.

How might the new rules help? Dr. Paul Summergrad of Tufts University, president-elect of the American Psychiatric Association, outlined the following scenario for The New York Times. Up until now, when a person suffering a heart attack went to a hospital, she was routinely admitted and an electronic notice sent to her insurer; but an emergency room doctor treating a patient in the throes of an acute mental health crisis had to go through a laborious process to get prior authorization before treating him. Those days should now be ending.

If there is anything to regret in the promulgation of the parity rules, it is only the context in which they were issued. As the one-year anniversary of the Newtown school massacre approaches, the only tangible steps that have been taken to reduce mass gun violence in America are those aimed at getting mentally ill people the treatment they need and deserve.

For example, Sen. Richard Blumenthal, D-Conn., said that, “Countless Americans will be safer and healthier because these rules will enable victims of painful, debilitating and disabling mental health conditions to seek treatment before they actually commit harm to others.”

While treatment is vital, it will be too bad if in the public mind these steps forward are associated primarily with reducing violence. The vast majority of the mentally ill, of course, are not violent and are far more likely to be victims than perpetrators of violence.

Nonetheless, parity in mental health coverage is a tremendous step forward on the road to a more enlightened and just society.