In Brief

One of the county's largest managed-care companies has announced that mental health care is not included in its new policy that allows doctors, not plan administrators, to have the final word in patient-care decisions.

APA denounced the decision by UnitedHealth Group, saying it flies in the face of the country's desire to move toward mental health parity.

"Any policy that eliminates utilization review for medical but not behavioral health services is nothing but blatant, indefensible discrimination against people with mental health disorders," says Russ Newman, PhD, JD, APA's executive director for practice.

Other companies may follow UnitedHealth Group's lead. Aetna, one of the nation's largest health insurers, announced that it's considering a similar policy.

Despite criticism from psychologists, UnitedHealth Group officials defended their position, saying that costs would escalate if the policy was extended to mental health services because, they say, few objective tests exist to determine what type of mental health-care patients need.

"Mental health holds a lot more intangibles than medical care in determining what treatment someone needs," Saul Feldman, chief executive officer of United Behavioral Health (UBH), a UnitedHealth Group subsidiary.

But Newman argues that psychological services do provide tangible results.

"Despite what UBH would lead the public to believe, mental health treatment is no less legitimate, no less valuable and no less tangible than medical treatment," says Newman.

In fact, he says, treatment of mental health disorders today is at least as successful as treatment of general medical conditions. Major depression, for example, is treated successfully in 80 percent of patients, whereas adult onset diabetes is treated successfully by insulin therapy at a lower rate.

Yet, by continuing to require utilization review for mental health services, Newman says, UBH could challenge a doctor's treatment of depression while the parent company wouldn't challenge a doctor's treatment of diabetes.