From the CEO
It was a year ago that I had the privilege to participate in the White House's National Conference on Mental Health. Leaders representing government, education, health, community groups and patients came together to discuss collaborative efforts to increase awareness about mental health and eliminate the stigma associated with seeking help. President Barack Obama and Vice President Joseph Biden were there to launch this National Dialogue on Mental Health.
Despite the increased national attention on mental health and access to services, it turns out that most Americans are still not aware of the Mental Health Parity and Addiction Equity Act signed into law in 2008. A recent APA survey revealed that only 4 percent of Americans are aware of the law. More than one in four Americans (27 percent) have received treatment from a mental health professional. Yet, few people know that health insurers that provide coverage for mental and behavioral health and substance-use disorders must make that coverage at least equal with physical health (see page 16 for a full report on the survey).
While the APA survey found that 61 percent of adults reported that they have adequate mental health coverage, many report details of their insurance coverage that seem at odds with provisions of the parity law. Only slightly more than one half of people polled (56 percent) said that their current health insurance covers their visits to a psychologist or other mental health professional. Almost three in 10 (29 percent) survey respondents said their insurance has different co-pays or other limits for mental health care.
Just as stigma is a barrier to seeking help, so is lack of awareness and lack of enforcement of the mental health parity law. Many psychologists around the country contact APA to share reports of patients experiencing problems accessing psychological services, such as visit limitations and denial of care. For example, our members complain that they are subjected to reviews in which insurance companies pressure them to reduce or terminate care for patients with chronic mental health needs. Certainly, insurers do not apply pressure to patients with chronic medical conditions, such as diabetes or heart disease.
APA and the APA Practice Organization (APAPO) actively monitor how insurers are implementing the mental health parity law. In 2013 and 2014, APAPO submitted letters to the three federal agencies overseeing parity implementation, the Departments of Health and Human Services, Labor and Treasury, addressing concerns related to the parity law and advocating for adequate enforcement of the law. APAPO has also filed a number of federal and state complaints about insurance practices that it believes violate the parity law.
Mental health advocates and lawmakers worked for a comprehensive parity law for more than 10 years. Both the APA and APAPO were instrumental in the shaping and passage of parity legislation. But, having a law is still not enough. We have a lot more work ahead of us to ensure that the parity law is appropriately enforced and Americans are aware of their right to mental health coverage on par with their physical health coverage.
APA members can help by notifying the Practice Directorate's Legal and Regulatory Affairs Office when you or your patients may be experiencing parity violations by an insurer. And, you can help educate the public. APA offers free resources, including a consumer guide and a new informative video to educate the public about their mental health coverage. The materials are available on the Psychology Help Center for distribution to your patients and people in your communities. The video about the mental health parity law builds upon APA's psychotherapy awareness video series. APA members can also link to the parity video and consumer guide from their websites.
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