Mental Illness Is Not a Second Class Problem

The wishes and ideology of Libertarians and "social conservatives" notwithstanding, sometimes the Government must step in to right a seemingly firmly institutionalized wrong. This was demonstrated, quite clearly, during the Civil Rights Movement of the 1950s and 1960s and, more recently is evident in the move toward providing health coverage for mental illnesses.

Culturally and traditionally, mental health issues receive less attention and resources than do physical ones. This has been reinforced by both general misinformation about psychologically disabling condition as well as by insurance companies that have been slow to acknowledge and provide coverage for necessary treatment for mental illnesses. Elective ignorance, driven by either greed or fear, has also played a role.

Many people have had one form or another of health insurance for a long time. Most insurance health plans, however, have offered only minimal coverage for mental health problems or, sometimes, none at all. This decision, based largely on what for these companies are compelling economic considerations and a not insubstantial degree of medical ignorance, has resulted on many people being unable to obtain appropriate treatment for mental health conditions.

After many years of lobbying by numerous professional organizations, patients' rights advocacy groups and individual consumers, the insurance industry has finally been legislated by the Congress of the United States into providing treatment for mental illnesses to a degree which parallels the coverage their plans provide for physical problems. The key word is parity.

The Parity Movement began some years ago by particularly powerful advocacy groups promoting the inclusion of certain specific conditions/diagnoses into the list of "must be covered" conditions. Early on, these included illnesses like Eating Disorders and Schizophrenia. More recently, the conditions falling into the range of what is called an Autistic Spectrum Disorder (ASD) has become a mandated inclusion in most health insurance policies.

Quickly, treatment for all diagnosed mental health conditions will be routinely covered by insurance policies that, left to their own devices, would never have offered to cover mental illnesses.

The initial Mental Health Parity Act (MHPA) became law in 1996. This landmark legislation was championed by Senator Paul Wellstone who died in 2002.

The MHPA required that the lifetime dollar limits on coverage for mental illnesses could not be lower than those allowed for physical illnesses. With intermittent adjustments, refinements and specifics added, this law was superseded by a rider on the Troubled Asset Relief Program (TARP) that was signed into law in 2008.

While many conditions have been added to the growing list of "parity diagnoses," every mental condition is still not guaranteed to be covered. Some uncertainties and inequities remain about conditions having strong roots in physical causalities and substance induced conditions are not presently fully included with full parity benefits required. However, we are a lot closer today than we were in 1996.

There continues to be social stigmata associated with mental illness. Somehow, in general consciousness, physical illnesses are felt to be more "real" than those of a psychological nature. This profound misconception, historically reinforced by the insurance industry, has never been shared by anyone who has experienced (or has had a child or loved-one who has suffered from) an episode of serious mental illness.

While many people complain that government is too much involved in peoples' lives and that private industry will inevitably adjust and self-regulate to respond to societal need, this is a clear example of where this free-market faith has not proven to be justified.