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mental health

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Maggie Hermann

on 18 November 2013

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Transcript of mental health

Mental Health Policy

Why Should We Care?
1 in 5 Americans suffers from mental illness.
Results from the 2010 National Survey on Drug Use and Health: Mental Health Findings
45.9 million adult Americans aged 18 or older, or 20 percent of this age group, experienced mental illness in the past year.
11.4 million adults (5 percent of the adult population) suffered from serious mental illness in the past year.
The report indicates that about 4 in 10 people experiencing any mental illness in the past year (39.2 percent) received mental health services during that period
8.7 million American adults had serious thoughts of suicide in the past year - among them 2.5 million made suicide plans and 1.1 million attempted suicide
Stigmatization of Mental Illness
Violence
Incompetence
Blame
are three commonly held stereotypes about people with mental illness
People who show symptoms and signs of mental illness are more likely to be arrested by the police and tend to spend more time incarcerated than those without mental illness.
Oppression Psychology
Research shows that people with mental illness often internalize stigmatizing ideas that are widely endorsed within society and believe that they are less valued because of their psychiatric disorder
Historical Context
Before the 1800s, mentally ill people were cared for at home or in almshouses.
Dorothea Dix
1992
Senators Domenici and Danforth authored the nation's first bill targeting mental health parity.
Original Intent:
Treatment of severe mental illness should be provided in a manner that... 1. is not more restrictive than coverage provided for other major physical illnesses

2. provides adequate financial protection to the person requiring medical treatment

3. is consistent with effective and common methods of controlling health care costs of other major physical illnesses
The bill never proceeded to hearing
1996
Mental Health Parity Act
pushed by Senetors Domenici and Wellstone
Stripped of any substance by the time it made it out of legislation
The legislation required plans to “equalize aggregate lifetime and annual dollar limits for mental health benefits with comparable limits imposed on medical and surgical benefits.”
2008
Mental Health Parity and Addiction Equity Act
Not a mental health care mandate
Does not apply to small employers covering fewer than 50 persons
Does not mandate mental health care coverage where there isn't already
Who Is Eligible?
Diagnose with DSM - but does not delegate treatment
Every state is different - set their own policy
Federal Minimum Standards

MPHAEA 2008: Insurers developed their own definitions for "mental necessity"
-Insurers must now provide this criteria if requested
-decide what which conditions they will and will not cover
Community Mental Health Act of 1963
Deinstitutionalization


Flaws
Solutions

Include mental health mandates in insurance policy
Treat mental healthcare the same way as any other care (mental health parity act)
Address the quality of care issue through increased availability of services and mental health training for healthcare professionals
Public education plan to increase understanding of mental illness in the general population
Emphasis on the need to seek help and treatment
Reduction of stigma and stereotypes
The Mental Health Parity Act
"Group health plans with mental health coverage offer that coverage without the imposition of discriminatory financial requirements or discriminatory treatment limitations."
"Financial Requirements" include deductibles,
co-payments, coinsurance, and out of pocket expenses.
Forces insurance companies to publish their definition of "mental necessity"
Insurance companies had been able to decide which conditions they will and will not cover, which is still allowed under the Mental Health Parity and Addiction Equity Act. However, the definitions can no longer remain private.
Kennedy proposed the closing of state psychiatric hospitals and the opening of federally funded community mental health centers to provide psychiatric services.
Mentally ill individuals who are not being treated are responsible for approximately 1,400 homicides each year. (10 percent of the nation's total.

1.
2.
The law allows insurers to provide parity coverage within the context of managed care, which could cause stricter management of mental health benefits (such as the requiring of referrals)
Does not address quality
of care issues
Quality of Care
Hard to distinguish parity between mental health care and physical health care.
3.
Does not address the needs of the uninsured.
4.
5.
Conditions in asylums worsened during the Great Depression and World War II
Health plans are not required to provide coverage for mental health
Early 1800s
--small privately funded hospitals
--state asylums
Mid 1800s
Federal government to provide for institutions
Instead, more state hospitals
End of 1800s
emergence of public health
prevention and early intervention
Funding left to local government
Depletion of quality
1946 National Mental Health Act

1949 National Institute of Mental Health
Federal Legislation
Increase Education and Awareness
Questions for Discussion
What do you think of when you hear the term "mentally ill"?
Where do you see prejudice towards those with mental illness in our society?
Do you think it is possible to regulate parity with mental and physical health?
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