Mental health parity bill

I haven’t posted anything on legislation that relates to mental health care so it’s about time I did.

On March 6, the House approved the Paul Wellstone Mental Health and Addiction Equity Act, a mental health parity bill that will require most medical insurance companies to provide better treatment for mental illnesses akin to what they do for physical illnesses. This is a significant move considering that insurers who cover mental health treatment can currently do one of two things: make patients pay for the bulk of the cost or place limits on treatment. The Senate also passed a similar bill in September 2007. Here’s what both pieces of legislation would do:

Both bills would outlaw health insurance practices that set lower
limits on treatment or higher co-payments for mental health services
than for other medical care.

Typical annual limits include 30 visits to a doctor or 30 days of
hospital care for treatment of a mental disorder. Such limits would no
longer be allowed if the insurer had no limits on treatment of
conditions like cancer, heart disease and diabetes.

As a result, the cost of group health insurance premiums likely will go up. However, the bills do not apply to businesses with 50 employees or less or individual insurance.

According to the NYTimes, President Bush initially endorsed mental health parity but came out opposing the current bill because it “would effectively mandate coverage of a broad range of diseases.” Technically, he’s right.

Under the bill, if an insurer chooses to provide mental health
coverage, it must “include benefits” for any mental health condition
listed in the latest edition of the Diagnostic and Statistical Manual
of Mental Disorders, published by the American Psychiatric Association.

The protections of the House bill apply to people who need treatment for alcohol and drug abuse, as well as mental illness.

Covering a broad range of conditions is a step forward, but I realize if group insurers are forced to pay for all conditions listed in the DSM, I can see why premiums would go up. It wouldn’t surprise me if costs increased significantly. No one likes to hear this but if people want better mental health coverage, they need to be willing to pay for it. For those who suffer with mental illnesses, it’s certainly worth the cost.

(By the way, only 47 Republicans joined the 221 Democrats in helping to pass the measure. It has nothing to do with the overall importance of the bill but it was a little annoyance that I had to throw in here. Grr.)

Mental health treatment for minorities substandard

Speaking of race, I stumbled upon Ephphatha, a blog from an African American woman looking to raise awareness of mental health in the African American community.

She linked to two News & Notes series on npr that focus on the lack of appropriate care to Blacks in the mental health community. This gets me thinking: If Blacks, how much more so other racial/ethnic minorities, e.g. Hispanics, Asians, Native Americans, Indians, etc. Is it really true that Caucasians a.k.a. white Americans receive better mental health treatment than other races and ethnicities?

It appears so
.

I'm officially unemployed

As of this past Monday, I currently own the title of "resident housewife." I made the big jump, at my husband's behest, and now find myself doing domestic things like housework and running errands. (I can't tell you how many times I washed dishes yesterday.) Oddly enough, I don't seem to mind except my feet hurt. I'd like a part-time job but the likelihood of obtaining a job where I wouldn't work weekends is highly unlikely. I have a friend, however, who's willing to pay me $10 an hour to help take care of her kids on Mondays, Wednesdays, and Fridays. She's currently having carpal tunnel problems so I'll likely take advantage of that offer whenever I can.

During the next coming weeks, I'm also going to try and freelance write. We'll see how that works out for me. I also wouldn't mind picking up some editing and proofreading jobs so I might have to re-interview with creative staffing services like Aquent and Boss Staffing. If anyone knows of any other creative staffing services like that in the Philadelphia area, please let me know. They specialize in placing people in "creative" jobs like editing, copy writing, proofreading, desktop publishing, web design, etc.

So that's my update. I can't promise multiple posts a day but I hope to write about mental health issues for a few publications so the potential for frequent posts and scouring other blogs for information in the next few weeks could be high. We'll see. I'm not sure about a market on writing about mental illness but it's one of the few topics I have a significant interest in.

As a result of leaving my job, the excellent medical  insurance that covered my husband and I has expired. We'll be moving to his health care insurance (which isn't awful but not as great as mine was). After a cursory search, however, we noticed that my psychiatrist isn't included under his plan. I'm reluctant to go to another doctor because I've already established a rapport with my current one. He's allowed me to have control over my own treatment and dictate the medication that I choose to use. I'm afraid another psychiatrist would try to shove Abilify down my throat if I mention passing suicidal thoughts. A few months ago, I went down to 100 mg of Lamictal in an attempt to slowly come off of it. I've been decreasing my dosages by about 25-50 mg every three months. I had a recurrence of frequent suicidal thoughts so I upped my dosage back to 150 mg. I was hoping that perhaps I had tricked myself into feeling better in conjunction with my counseling, but my suicidal thoughts have significantly decreased on the increased dose. It never ceases to scare me how much medication influences my mind.

Random news from across the board

I know I blog primarily on mental health, but I can’t help but add my 2 cents on the following:
Colts

  • Times SelectHillary Clinton and health care: The plan sounds nice and feasible, but Ms. Clinton and health insurance have been a disaster in the past. We’ll see what happens the second time around.
  • Colts and Bears face off in Super Bowl: Other than making history with two black coaches facing off in the Super Bowl, I’ve been holding out hope for Peyton Manning to lead his Colts to victory over the N.E. Patriots. The Super Bowl is definitely worth watching for me now. Oh yeah, and the Saints lost. Karma certainly sucks. (photo courtesy New York Times)
  • And I found this on NYT, but I don’t have Times Select and don’t feel like registering for a 14-day free trial (it’s just not worth it to me). If anyone’s seen the regular article or can read the reader responses, please send me some text. I’d be very much obliged.

Loose Screws Mental Health News

Liz Spikol linked to this and I can’t believe I missed it: Poorer mental health for black Caribbeans.

“The longer Caribbean immigrants who are black stay in the United States, the poorer their mental health, according to a study.

Prior research has shown that black Caribbean immigrants differ from African-Americans in various measures of physical health, but little research has been done on differences in mental health.

‘What we found was that ethnicity matters a lot in the black population in the United States for mental health risk,’ [lead author David R.] Williams said.”

This is certainly a study that should yield interesting results. As a first-generation African-American with West Indian parents, I can definitely see the higher risks of mental health problems in my own family. Not only is it an ethnic problem, but it also is rooted in genetic causes. My maternal line has no history of mental illness (the DSM threw out homosexuality a while ago), but my paternal line has many cases of mental illness – almost all of them developed after immigrating to the U.S. From what I understand, my grandmother suffered from some kind of mental illness and out of her eight children, three of them developed mental illness, including my father.

I’m mainly interested to see what kind of effect this could have on first-, second-, and third-generation blacks of Caribbean ancestry and what correlations result from immigrant relatives who developed mental illnesses in the U.S.

Before leaving office, Gov. George Pataki signed a bill into law that requires commercial insurance policies to pay for mental health care just like care for physical illnesses. (Pataki has been slightly redeemed in the sight of a former New Yorker who suffered under his reign.)  Since this is news from Dec. 23, you might have to pay $4.99 to read the article, but as of Jan. 9, the article is still available for free. Read a few excerpts below:

“Most commercial policies already cover mental health treatment, which the governor said had helped allay his concerns about cost, and so do government programs like Medicare and Medicaid.

Business organizations – whose members pay for most health insurance – and insurance companies generally oppose these kinds of mandates. But they did not work against the mental health bill this year, after small employers were exempted and after coverage that would have mandated treatment for alcohol and drug addiction was taken out of the bill.

An employer with fewer than 50 workers could opt out, but the insurer would be required to offer a policy that covered mental illness. The law pledges that the state will develop a method to help small businesses pay for that coverage if they choose to buy it.

There were at least 17 other states that mandated some kind of mental health coverage, but not full parity with other health benefits.”

I'm glad that the state has offered to help small businesses pay for mental health coverage if employers choose to provide it. It would be difficult for a small business to pay for health insurance – let alone mental health! – for 50 employees or less. However, it's an important investment in employees that small businesses and large corporations can't afford to overlook.

As for treatment for substance abuse, the state is doing a major disservice to employees who struggle with these issues. More employees are likely to suffer from some kind of substance abuse problem and the lack of coverage for treatment is a step backwards. During my mental health treatment, I've noticed that mental health problems sometimes accompany substance abuse. If a patient can't obtain substance abuse coverage, then the entire problem isn't solved. I can only hope that an amendment mandating substance abuse coverage is added to the bill in the future.

The American Foundation for Suicide Prevention provides their take on the bill:

"The law requires insurance companies to cover 30 inpatient and 20 outpatient days of treatment for mental illness. Companies must fully cover "biologically-based mental illnesses" including major depression, obsessive compulsive disorder, anorexia and binge eating. Timothy's Law would also require coverage for children with attention deficit disorder, disruptive behavior disorders or disorders that include suicidal symptoms. The measure is expected to increase premiums about 3 percent and no more than 10 percent, while providing a much wider array of mental health services.

Timothy's Law took effect on New Year's Day and will last for three years. The Legislature will make a decision about continuing the law in 2009. New York is the 38th state to enact mental health parity."