Loose Screws Mental Health News

In the wake of the Newtown, CT shooting, NRA chief executive Wayne LaPierre called for a national registry of those who are mentally ill. According to the Washington Post, the federal government does not possess the constitutional authority “to require state agencies to report data.” All the federal government can do is either offer or withhold funding, as it did in the wake of the 2007 Virginia Tech Shooting when it provided additional funding for state governments that shared 90 percent of their mental health records. But it seems that 38 states already maintain an active database that “require or authorize the use of” mental health records during gun background checks. And the Gun Control Act of 1968 does not allow sales of firearms to people who have been institutionalized or considered to be mentally “defective.”

For the purpose of firearms sales, I support the idea of maintaining a database of people who have been institutionalized. This could prevent a person from being a harm to himself or to others. I speak as a person who has been institutionalized for being a harm to herself more than once. If I’d had access to a firearm, I wouldn’t be here right now. There may be many others who are in the same boat.


The New York Times reported on mental health coverage through insurance. In any given year, 26 percent of adults have a mental disorder, and 6 percent of adults have a mental illness that prevents them from functioning, according to the NIMH. In addition, 21 percent of teenagers between the ages of 13 and 18 undergo a “severe emotional disturbance.” But it seems as though 85 percent of employers offer some kind of mental health coverage through insurance, and 84 percent of employers with more than 500 employees allowed access to in-network and out-of-network mental health treatment. Beginning in 2014, insurance plans will be required to cover mental health disorders as part of President Obama’s Affordable Care Act.

The New York Times notes that many psychiatrists, however, don’t accept insurance:

Plenty of psychiatrists in private practice accept no insurance at all, though it is not clear how many; their professional organizations claim to have no recent or decent data on the percentage of people in private practice who take cash on the barrelhead, write people a receipt and send them off to their insurance company to request out-of-network reimbursement if they have any at all.

My psychiatrist does not accept insurance. He writes me a receipt, and I am to seek out-of-network reimbursement, a claim that has been repeatedly rejected by my insurance. The NYT is right on the money in this instance. But I am happy with my psychiatrist and would rather pay out of pocket for him without reimbursement than to find another psychiatrist who is in network.


According to the San Francisco Chronicle, California is ahead of every other state in covering mental health services with public money. But as always, there are critics who say California does not go far enough, even though in 2004, California voters approved Proposition 63 that funnels $1 billion annually for mental health services by taxing the state’s highest earners. But funding is being cut, not just in California but also nationally, according to NAMI.

Overall, California cut $768 million from its state mental health services outlay during the past three fiscal years, according to a November 2011 report from the National Alliance on Mental Illness. California’s 21 percent reduction in mental health funding over that period is the seventh-highest among all states.

Nationally, states cut more than $1.6 billion in general funds from their state mental health agency budgets for mental health services since 2009, according to the 2011 report by the National Alliance on Mental Illness.

I’m not sure what can be done to stop funding cuts of mental health services when state budgets are slashing services across the board.


And finally, according to NY1 News, New York City Mayor Bloomberg has announced an initiative to get mentally ill people out of jail and into treatment facilities. The mayor’s office estimates that 36 percent of inmates suffer from some kind of mental disorder. The city initiative will attempt to “reduce incarceration rates, improve jail safety, and lower crime.”

Advertisements

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."