EXECUTIVE DIRECTOR'S COLUMN
Science and the New Parity
A major victory for mental health care was achieved in early October. As part of the financial bailout plan approved by Congress and signed by the President, the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 was signed into law.
This is a major victory for patients. It requires insurance companies to provide coverage for mental health services at the same level as that provided for medical and surgical benefits. It erases long-standing inequities in group health plans, requiring mental health benefits to be equal to (if not better than) physical health benefits. It closes loopholes in earlier laws.
This is also a major victory for providers of mental health care. Their services will now be compensated fairly, with financial requirements and treatment limitations on par with physical health services.
The new parity law also creates new opportunities and challenges at the interface of psychological science and practice. Now, more than ever, the science and practice of psychology must work together to deliver quality mental health services.
For example, it will be up to psychology to demonstrate that expansion of mental health coverage is good for patients and that it makes long-term economic sense. Evaluation research will be essential; economic outcomes will need to be established.
It will be up to psychology to demonstrate the cost effectiveness of mental health services in forms that are readily understood and appreciated. In medicine, for example, treatments are often justified in terms of number of lives saved or in dollars put back into the economy. The same can be done for mental health interventions, but which outcomes will be most persuasive? Social psychologists can help with this.
As the economic stakes grow, it will become increasingly important to expand the evidence in support of mental health interventions. Medicine has cultivated respect because treatments and interventions are continuously evaluated. Sometimes this leads to new and improved treatments; sometimes it leads to the cessation of interventions. Mental health delivery must cultivate the same respect by demonstrating responsiveness to the growing and maturing evidentiary base produced by psychological research.
Quality mental health care, just like physical health care, is supported by diagnostic tools and infrastructure. Testing and assessment become integral components in treatment. With equal coverage comes equal opportunity for psychology to renew its outstanding traditions in psychometrics, quantitative and qualitative assessment, and the use of technology to better understand cognitive, emotional, and behavioral states. Psychological science must produce cutting edge diagnostics for mental health, and psychology practitioners must be trained in their use and interpretation.
Psychological science must grow to support mental health care, just as biomedical science has grown to support physical health care. Recognizing that mental health care is just as important as physical health care must be accompanied by the acknowledgement that psychological and behavioral research is just as important as biomedical research. When that day arrives, we will have achieved true parity.