Circa 2006
PARITY FOR MENTAL HEALTH—NOW
Dear ABILITY Readers,
Last spring, I joined with fellow senators Ted Kennedy (D-MA), Pete Domenici (R-NM) and Gordon Smith (R-OR) to inaugurate the Senate Caucus on Mental Health Reform. For me, as a long-time advocate for people with disabilities, forming this working group was a logical—in fact, urgent—step forward. After all, depression is the number one cause of disability in the United States, and mental illnesses account for four of the 10 leading causes of disability for persons aged five and older.
Untreated mental illness has catastrophic consequences for our society, leading to chronic illness, suicide, substance abuse, unemployment and incarceration. Some 30,000 Americans die by suicide each year. More than half of all prison and jail inmates have a mental health problem. This is an incredible waste—and a largely unnecessary waste—because up to 90 percent of all mental illnesses are treatable by therapy and medications.
It is time to confront our national neglect of mental health. Before his tragic death four years ago, Sen. Paul Wellstone (D-MN) led the way by sponsoring the Mental Health Parity Act. His bill aimed to dramatically increase access to mental health services by ending the absurd practice of treating mental and physical illnesses as two different entities under health insurance. The good news is that his bill, now named the Wellstone Mental Health Equitable Treatment Act in his honor, is still very much alive in Congress. And it is more urgent than ever.
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Opponents of mental health parity claim it would drive up the cost of health care. However, earlier this year, the New England Journal of Medicine debunked this myth when it published the results of a study evaluating the Federal Employees Health Benefit Program, which has provided insurance parity since 2001. Researchers found that when the care was managed (as most health care services are these days), the cost of coverage for mental health problems attributable to parity did not increase and the quality of overall care remained constant. Significantly, the Wellstone Mental Health Equitable Treatment Act is modeled after the mental health benefits provisions in the Federal Employees Health Benefits Program.
Previous high-quality studies have found similar results, and the cost studies that have not have almost universally been flawed by failing to calculate and quantify the benefits and savings that result from parity. When employers offer insurance incorporating mental health parity, they experience offsetting benefits of increased productivity, reduced sick leave and lower disability costs. Indeed, a true, comprehensive assessment of the costs of parity must take account of the costs of not providing parity—including the economic costs in the workplace, costs to taxpayers from burdenshifting to public systems (the public mental health system, prisons and jails, care of homeless persons, etc.) and the cost of increased emergency room visits.
Add it all up, and the cost of failing to treat people with mental illnesses is at least $79 billion annually in the U.S. By contrast, one study showed that when workers experiencing depression received treatment, medical costs declined by $882 per employee per year, and the average absenteeism dropped by nine days per year.
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But the best news is not quantifiable in dollar terms. When people with mental illness can recover, they are able to reclaim their lives, reconnect with their friends and loved ones and become productive, self-supporting citizens.
Senator Wellstone once said, “Politics is about what we create by what we do, what we hope for and what we dare to imagine.” For those of us who had the privilege of serving with Paul, his spirit is still with us; he still calls us to conscience. We know it is time to end the discriminatory practice of treating mental and physical illnesses differently under insurance. It is time to do away with barriers to mental health treatment and coverage. It is time for mental health parity.
The Wellstone Mental Health Equitable Treatment Act must be a top priority in the new 110th Congress. With bipartisan support—and with letters and phone calls to members of Congress from people like you—we can and will pass this vitally important legislation.
Sincerely,
Senator Tom Harkin
