Equal Health Insurance Benefits Is the Law, But Are the States Enforcing It?

Tim Clement Photo

Tim Clement, Policy Director, ParityTrack

For most of the history of modern American health care, mental health treatment was not covered by insurance the same way other medical treatment was covered. Insurance plans often implemented arbitrary and restrictive annual and lifetime limits on inpatient days and outpatient visits. Copayments and coinsurance rates were often far higher than they were for other medical care. Separate and more expensive deductibles for mental health care were the norm.

Thankfully, the Mental Health Parity and Addiction Equity Act of 2008 (the Federal Parity Law) made this form of separate and unequal insurance coverage illegal. The Federal Parity Law prohibits insurance plans from imposing treatment limitations and financial requirements that are more restrictive for mental health and substance use disorder treatment than those used for the treatment of other medical conditions.

The good news is that health insurance coverage that discriminates against people with behavioral health conditions is now against the law. The bad news is that nearly a decade after President George W. Bush signed this landmark piece of legislation into law, insurance coverage for treatment of mental illness and addiction still is not on par with insurance coverage of other medical conditions.

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Shared Decision Making – with Families – Yields Better Treatment Outcomes

Alison Heru

Alison M. Heru, M.D.
Professor of Psychiatry, University of Colorado Denver

In the NES Program at University of Colorado Health, a six-month program combining neurology and psychiatry treatment for non-epileptic or non-electrical seizures, psychiatrist Dr. Alison Heru makes shared decision making an integral part of practice.

In my experience, shared decision making yields the best results in treatment. When patients feel like they have participated in choosing the treatment and are able to ask questions and weigh alternatives, they are more likely to feel they have selected the treatment that is the best for them and have a stronger stake in the outcome.

At the NES program (addressing non-electrical seizures), there’s not clear evidence for which treatment approach will be best for each patient. It’s my role, then, to make sure we make the correct diagnosis, provide information about the treatment modalities available, and decide together with the patient (and the patient’s family, unless not available) on the treatment plan. I won’t tell the patient what to do or to force a choice on them, but I will offer my opinion.

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How Can Parents Help in Shared Decision Making?

Doctor consults with family

Families for Depression Awareness for Care for Your Mind

Your teenager has been diagnosed with a mood disorder and the clinician is talking with her or him about treatment. What is your role as a parent in the shared decision making model? How can you participate?

At Families for Depression Awareness, we believe that parents can play an essential role in recognizing and addressing mood disorders in their children. When you’re worried about a teen in your life, you might need to take crucial actions in a crisis situation, convince a reluctant teen to go to a mental health provider, or be supportive in finding and accessing mental health care.

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How Peer Specialists Enhance Shared Decision Making

Tom Lane

Tom Lane, Certified Recovery Support Specialist

Much has been written about patient-centered care. Proof that this model is gaining acceptance is the evolution to shared decision making (SDM). The National Learning Consortium defines SDM as a “process in which clinicians and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.”

In a recent CFYM post John Williams, M.D., writes that there are several tools that clinicians can use to step through the shared decision making process. Dr. Williams opines that when there are many different treatment options, SDM takes on added importance. As a result, a major step in the SDM process must be for clinicians to understand the desired outcomes of their patients.

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