Is there parity in mental health or are we still dealing with a paucity?

With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental health benefits be no lower than the dollar limits for medical and surgical benefits offered by insurers. But what has this really done for patients seeking mental health care?

I work in both the inpatient and outpatient setting in rural Mississippi. My perspective is unique because I see both Medicare patients and privately insured patients. I can honestly say that although the Parity Act guidelines are awash with great intentions, the enforcement has been abysmal.

As the medical director of an inpatient geriatric unit where we only take Medicare, both Humana and Windsor not only make getting a patient admitted difficult, but make getting days approved for full, effective treatment is virtually impossible. I have to speak, or should I say plead, with a physician who is miles away on a phone, who has never evaluated nor met the patient so that he or she can determine whether the days will be approved. I plea. I yell. I cry.

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