Join Us in the Fight to Save Access to Mental Health Treatment: Act Now by Telling Congress You Care!

elderly_handsThe Centers for Medicare and Medicaid Services (CMS) wants to significantly limit access to antidepressant and immunosupressant medication for people subscribing to Medicare Part D. Read today’s post to learn why you should be concerned, and what you can do to support the mental health community by raising our voices in Washington.

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would remove antidepressants and immunosupressants from the protected class status under Medicare Part D and is considering removing antipsychotics from the same status the following year. If CMS adopts its proposal, it would reduce patient access to and the availability of mental health treatment.

Since it went into effect in 2006, Medicare Part D’s protected class structure ensures patients with mental health conditions have access to all or substantially all of the most appropriate medications, protecting them from “fail-first”1 experiences or other appeals processes. In many cases, delays caused by these processes can result in inadequate treatment and potentially tragic outcomes.

We need to ensure that all mental health patients have access to all the medications that they need. It is clear that CMS’ rule will signal a step in the wrong direction and the consequences will be detrimental. According to the World Health Organization, depression is currently the leading cause of disability worldwide. By 2030, it will be the leading global burden of disease.2 In the United States alone, the total direct and indirect cost associated with depression exceeds $83 billion annually.3

Ultimately if CMS’ rule is approved, there will be severe human, economic and societal consequences for not only mental health patients, but for all Americans. We must take action now.

Here’s How You Can Take Action Today

Now, more than ever, the mental health community of patients, families, friends and others need to join together to tell CMS and the Administration how big of a mistake implementing this rule will be for all Americans. Below you’ll find several ways in which you can make your voice heard during CMS’ open comment period, ending March 7, to protect antidepressants, immunosupressants and antipsychotics within Medicare Part D. The clock is ticking!

  1. Make Your Voice Heard by writing to your Member of Congress. Use the sample email letter to inform your member of Congress that the implementation of this proposed rule is a big mistake. Be sure to share any personal experiences and how this rule will impact you or a loved one.
  2. Share your personal stories: The Care For Your Mind blog is interested in your personal stories to help share the extent of the issue and how it will impact you or a loved one. While this rule is expected to decrease patient costs for medications, members of the mental health community understand the treatment for our conditions is far from one size fits all. Below are a few questions that may help you shape and share your story:

    a. What will happen if you lose access to your medications?
    b. Have you had a negative experience with “fail-first” experiences?
    c. How will the new rule impact you, your parents, other family members or friends?

    We encourage you to submit your personal story here for publication on our website. And in the meantime, join our conversation online by contributing to this blog below. Your voice counts and the time to speak up is now!

  3. Share this information with others:  Knowledge is power. The more people know about the proposed rule’s real life consequences, the more we can make our voices heard. Share this post and relevant information with your friends and family, on your social media accounts, through email and word of mouth offline.Together, we can send a powerful message and help ensure that patients have access to the medications they need and deserve.

At Care For Your Mind, we understand that your personal experience and ideas can help build a mental health care system that works.


1 Fail first refers to the practice of forcing doctors to prescribe the least costly drug in any class to patients first, even if the physician wants to begin treatment with a different medication.

2 World Health Organization. http://www.who.int/mediacentre/factsheets/fs369/en/

3 Greenberg, et al.(2003).The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry, 64, pp. 1465-1475

18 comments
edwartfruitman
edwartfruitman

Anything that relates to brain and has a disorder in functionality, that would cost more on repair. It's is recognized fact. The upcoming technologies in the department of mental health care & treatment would be far advanced than what we have for now. Techniques for depression treatment such as TMS Therapy are already out of reach of the most people and not many people can afford them. That's where the congress should bring such reforms that all advanced methods can come into reach of the most depressed part of American population.

AniGonzalez
AniGonzalez

Me without meds is me with 7 suicide attempts, maybe an 8th that will be final.  Me without meds is me overthinking every detail in my life and becoming so anxious I can barely concentrate on anything. Me without meds is me having 5 car crashes due to manic euphoria.  Me without meds is me making my mother suffer because I become so irritable that Im unable to be around people. Me without meds is the reason I had to quit my full time job even with excellent performance because the stress was making me look from the top of the parking garage to the street everyday thinking what would happen if I jumped. I can be out in the world without meds, I'm not a danger to others ( unless I drive when manic) but Im a mess, I have tried to finish University countless times with no success due to my inability to stay in one faculty, everytimes I was depressed I was a zombie in classes and maybe didn't go, then I was manic and I could conquer the world and would like something new to learn and changed still managed to stay with a 3.50 GPA now in my medicated attempt I have 3.70 GPA and Im not planning to change. I have to admit I do not love meds, but I need them to be fully functional and to actually be part of a working society. 

Marcia Taylor
Marcia Taylor

Mental illness takes a huge toll on every aspect of peoples' lives and thus affects society as a whole. When it's not treated; it affects society in a very negative way, so please keep access to mental healthcare services available to all.

Michele Rodriguez
Michele Rodriguez

Dear CMS,

"Fail First" = "Suicide First" or "Death First" for many people suffering from mental illness without the proper medication and therapy. Why does our society continue to treat brain illnesses differently than physical illnesses? A person with a heart condition cannot survive without the proper heart medication. The same is true for a person with a brain condition. Improperly treated heart illnesses cause heart attacks; improperly treated brain illnesses cause brain attacks. Unfortunately, these brain attacks which momentarily impair the brain's ability to function correctly (i.e., think) oftentimes result in impulsive suicide attempts, or impulsive rage-filled actions causing physical assault or death to other members of our society. It is apparent from the proposed rule that there is a severe lack of knowledge and understanding for those that suffer from mental illness. That being said, is an innocent bystander's life worth the savings yielded from removing coverage of medications which could prevent brain attacks of the mentally ill? This proposed rule also affects those that do NOT suffer from mental illness.

Rev. Daniel Wright
Rev. Daniel Wright

I am very concerned about the possible increase in the suicidal rate if medications are restricted under medical part D. I have written my congress representatives and have asked them for their support. Thank you for your hard work.

Elise Herner
Elise Herner

Please ....understand that removing antidepressants and antipsychotic medications from coverage and enforcing a fail first law/ protocol is not only irresponsible and heartless legislation. It will be immeasurably costly and toxic to our society. Mental health sciences and Heath care are incredibly difficult and tricky...when one of my children became ill out of the blue at 16 years of age with OCD and depression, he fell into a whirlwind of illness and treatment that lasted for months ...actually a few years. When the right drugs finally took effect, my child was able to succeed in college(making the Dean's list several semesters while running his bachelor's in business administration, adhere to his probation and refrain from substance use, etc. Please tell me how forcing a patient to u se the wrong drugs can benefit our society...prevent suicides, careless driving, crimes, ....the list is exhaustive and endless. Even when a patient has the best insurance and health care, as we did at the rime, his recovery took nearly three long years. During this time, we witnessed the deaths of three of his peers with similar diagnosis ....all three took their lives.this country really needs to get their priorities straight and consider....do we really want to act penny wise and pound foolish....when it comes to mental health care costs...? Truly upfront spending will result in less havoc to society, less jail time and court time, fewer unnecessary deaths and so much more. Resist this ignorance!

Monica Wood
Monica Wood

Whenever I get Medicare, I hope I will have access to these medications.

Tom Roberts
Tom Roberts

I have been treated successfully since my diagnosis of Bipolar Disorder in 1993. I am on medicare now and this proposal scares me and I am afraid for others. I am a survivor of two suicides in my family. My brother and later my sister killed themselves instead of getting help out of fear of stigma. How can I tell others there is relief with medication if this rule goes into effect?

Tim Grabowski
Tim Grabowski

There is a stigmatic predgudice of people suffering with a no fault brain disease. Please have the Government raise fund to help people suffering with a brain disease and disability.

Kimberly Allen
Kimberly Allen

As an Administrator in a 90-day chemical dependency treatment center, we saw the impact of senior citizens who are on a "fail first" requirement on psychotropics. On most occasions, we opted to go with our Medical Director's prescription so we could protect our patients and provide proper care, while paying the difference that we needed to pay so appropriate meds could be used, or the family had to shoulder the additional cost-sharing. Overall, this costs families in dollars and cents, and facilities and patients in time. The resulting anguish of ensuing depression, the potential of chemical dependency relapse and the exclusion of certain medications is inexcusable. When people are compelled to "fail", that is exactly how they feel; like failures to themselves, to their families and to society, which can reduce quality of life, and potentially have more devastating results, including suicide. Though generic meds have their place, they must be utilized in an appropriate sense, by way of good diagnosis and through Plan D. Limiting access of good medicines to subscribers who already carry a part of the cost of medications and treatment is in no way appropriate, humane, or cost-effective.

Nancy Smothermon
Nancy Smothermon

To save access to the proper doctor prescribed medications under Medicare part d and Medicaid. Please understand the seriousness and potential damages that will surely occur under this kind of change. It will like setting the treatment of mental illness back by 100 years or more. In thiday and age we need to be striving to help as many individuals suffering from mental illness to lead healthier, efficient, and productive lives not falling back to ancient and failed methods. It is ignorant to think that mentall illness is any less a fatal and damaging disease than say diabetes or cancers or heart conditions. WISE UP DO RIGHT BY US! Don't let us down now when our nation is just now coming to understand mentall illness. Let's continue in our movement forward. Having the right medications for my personal battle with mental illness has made the whole difference in my being alive and able to write to you now, finish raising my children in a healthy and safe environment, and work as a productive member of society. Not to mention all the brilliant minds who suffer from some form of mental illness that May lost in vain. Please sincerely consider my heartfelt plea.

Susan Haslam
Susan Haslam

I think back to the days of the Reagan regime and remember what a nightmare it was when he cut funding for the mentally ill. It is almost guaranteed to contribute to a sharp increase in homelessness and crime.

CFYM
CFYM

Thank you for sharing with our readers the pathway to recovery and that it is not a "one-size fits all" treatment plan. DBSA advocates for the right of people with mental health conditions to choose their own paths to mental, emotional and physical health. We encourage you to contact your representative via the sample letter in this post. In future posts we will share more ways you can make your voice heard to the Centers for Medicare and Medicaid Services and ask them to rescind this regulation.

Liz Felt
Liz Felt

Dear CMS,

I am writing to ask you to keep all psychiatric medications available to all benefiting from Medicare Part D.

This issue is extremely important to me as I was diagnosed with paranoid schizophrenia 16 years ago. I recently left full time employment due to a severe onset of mental illness due to a antipsychotic no longer working for me. Scrambling to find a new medication that would be effective, I endured a serious list of side effects, including Cervical Dystonia now permanent, in an attempt to find an effective medication. My Dystonia is not only incredibly painful but will also require costly life long treatment. Due to the Dystonia, I am extremely limited by my choice of antipsychotic medications I can tolerate. I eventually had to leave employment due to my illness that was exacerbated by the Dystonia.

I am now eligible for Medicare in February 2015. I am switching medications once again and hopeful this one will work. My health and return to employment depend on being able to find the ONE medication that works.

Having all antipsychotics available so that my mental illness can be effectively treated without worsinging the Dystonia is crucial for me.

Please consider my personal story when considering why all it important for consumers to have access to all available psychiatric medications.

Thank you.

Toni J. SIlvey
Toni J. SIlvey

It is discrimination and genocide of the worst kind. I propose a class action. If they discontinue my medication, then who is next? Cancer patients? Diabetics? AIDS patients? Yes, I will be writing some letters, we all should. This needs to be heard!

Lisa Marino
Lisa Marino

There should be care, 100% coverage, and concern for mental health patients. Not limitations and political b.s.

P. J. terHorst
P. J. terHorst

We need more help, understanding, financial assistance, living places, and care.

SunWillShine
SunWillShine

Thank goodness you're paying attention to this issue. I never would've heard about it otherwise.

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  1. […] the leading cause of disability worldwide. By 2030, it will be the leading global burden of disease.2 In the United States alone, the total direct and indirect cost associated with depression exceeds […]