DOCSLIB.ORG

The Social Obligation to Reduce Stigma in Order to Increase

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Social Obligation to Reduce Stigma in Order to Increase Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Spring 2016 The oS cial Obligation to Reduce Stigma in Order to Increase Utilization of Mental Health Services Melissa Sue Berdell Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Berdell, M. (2016). The ocS ial Obligation to Reduce Stigma in Order to Increase Utilization of Mental Health Services (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/304 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. THE SOCIAL OBLIGATION TO REDUCE STIGMA IN ORDER TO INCREASE UTILIZATION OF MENTAL HEALTH SERVICES A Doctoral Project Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Healthcare Ethics By Melissa S. Berdell May 2016 Copyright by Melissa S. Berdell 2016 THE SOCIAL OBLIGATION TO REDUCE STIGMA IN ORDER TO INCREASE UTILIZATION OF MENTAL HEALTH SERVICES By Melissa S. Berdell Approved April 7, 2016 _____________________________ _______________________________ Henk ten Have, MD, PhD Gerard Magill, PhD Director, Center for Healthcare Ethics The Vernon F. Gallagher Chair Professor of Healthcare Ethics Professor of Healthcare Ethics (Dissertation Director) (Committee Member) ______________________________ ______________________________ Dr. Joris Gielen Henk ten Have, MD, PhD Assistant Professor of Healthcare Ethics Director, Center for Healthcare Ethics Center for Healthcare Ethics Professor of Healthcare Ethics (Committee Member) (Center Director) ______________________________ James Swindal, PhD Dean, McAnulty College and Graduate School of Liberal Arts iii ABSTRACT THE SOCIAL OBLIGATION TO REDUCE STIGMA IN ORDER TO INCREASE UTILIZATION OF MENTAL HEALTH SERVICES By Melissa S. Berdell May 2016 Dissertation supervised by Dr. Henk ten Have Many mental health organizations have developed campaigns that concentrate on reducing the stigma towards mental health with the intentions of increasing access and utilization for people with mental illnesses that are not receiving appropriate mental health services. The mental health campaigns predominantly focus on establishing awareness and education related to the number of people with mental illnesses and diagnoses so that people will not be ashamed or embarrassed to have mental illnesses or access mental health treatments. However, societal prejudices have caused many people diagnosed with mental illnesses to lose jobs, homes, and families; therefore, in general, people are afraid of being diagnosed as mentally ill and seeking mental health treatments. Additionally, recent national attention and media reports of tragic and senseless events caused by people diagnosed with mental illnesses intensified the societal prejudices and stigma towards people with mental illnesses, which have depicted these people as iv extremely harmful to themselves and others. Consequently, societal demands magnified the need for public changes to prevent future tragedies, which contributed to President Barack Obama proposing regulations and policy agendas aimed at reducing stigma towards mental health and increasing access and utilization of mental health services. The mental health campaign initiatives and legislative proposals are supportive to the cause by reducing prejudices and barriers for people diagnosed with mental illnesses, and hopefully, preventing future tragic events. However, the research indicated that there is another barrier to mental health services impacting the lower levels of access and utilization. v TABLE OF CONTENTS Chapter 1 – Introduction Issues Influencing Access to Mental Health Services Reducing Stigma Overview and Outline of Mental Health Services Stigma towards People Seeking Mental Health Services Chapter 2 – Overview and Outline of Mental Health Services History of Mental Health Services Importance of the Medical Model: Diagnosing and Treating Mental Health Evidence-Based Treatments Chapter 3 – Stigma towards People Seeking Mental Health Services Evidence and Demographics of Stigma Factors Magnifying Stigma towards People Seeking Mental Health Services Reduction in Utilization Chapter 4 – Reeducating and Changing Public Opinion to Reduce Stigma Methods of Change to Increase Utilization of Mental Health Services Approval of Legislation for Parity and Access to Increase Utilization Implementation of Ethical Practice and Patient Safety Standards Chapter 5 – Validation of Mental Health Awareness Campaigns and Programs Anti-Stigma Campaigns and Trainings Compounding Mental Health Campaigns to Address Stigma and Fears of Mental Health Services Mitigating Stigma and Increasing Access with Additional Mental Health Awareness Chapter 6 – Social Obligations Community Mental Health Models Prevention of Harm and Tragic Events Affordable Care Act and Justice Chapter 7 – Conclusion Summary of the Project Future Considerations Conclusion vi Chapter 1 – Introduction Issues Influencing Access to Mental Health Services Many mental health organizations have developed campaigns that concentrate on reducing the stigma towards mental health with the intentions of increasing access and utilization for people with mental illnesses that are not receiving appropriate mental health services. The mental health campaigns predominantly focus on establishing awareness and education related to the number of people with mental illnesses and diagnoses so that people will not be ashamed or embarrassed to have mental illnesses or access mental health treatments. However, societal prejudices have caused many people diagnosed with mental illnesses to lose jobs, homes, and families; therefore, in general, people are afraid of being diagnosed as mentally ill and seeking mental health treatments.1 2 Additionally, recent national attention and media reports of tragic and senseless events caused by people diagnosed with mental illnesses intensified the societal prejudices and stigma towards people with mental illnesses, which have depicted these people as extremely harmful to themselves and others3. Consequently, societal demands magnified the need for public changes to prevent future tragedies, which contributed to President Barack Obama proposing regulations and policy agendas aimed at reducing stigma towards mental health and increasing access and utilization of mental health services.4 The mental health campaign initiatives and legislative proposals are supportive to the cause by reducing prejudices and barriers for people diagnosed with mental illnesses, and hopefully, preventing future tragic events. However, the research indicated that there is another barrier to mental health services impacting the lower levels of access and utilization.5 1 Another barrier for people with mental illnesses is the stigma towards mental health professionals and treatments that is impacting utilization of services because of the people are fearful or have misconceptions of mental health services. Previously, the imperfect history of mental health services including treatments such as convulsive therapies, electro-shock therapies, lobotomies, and antipsychotic pharmaceuticals has elevated public concerns with the medical model regarding consent, safety, and confidentiality. The images of patients with mental illnesses being forced into painful and ineffective treatments at asylums have raised questions about the legitimacy of early psychiatric practices. The images of psychiatrists abusing or testing on people labeled as “mad” or “insane” became the public perception of mental health treatments and was exacerbated by the entertainment and media reproductions of these images. Diverging from the public concern and portrayals, there are movements and evidence to support that psychiatric and mental health treatments are evolving and supporting positive outcomes for the recovery6 of people with mental illnesses.7 To encourage and legitimize the mental health practices and treatments that were producing benefits and demonstrating outcomes, many of the oversight and advisory agencies, including the American Psychiatric Association, have progressed in establishing ethical practice and patient safety standards that protect people with mental illnesses.8 Even though mental health services are increasing in general, there is still a reluctance within our society for people to access mental health services. The reluctance to access mental health services has been driven by stigma and societal prejudices against people seeking treatments for mental illnesses. The prejudices and perceptions have entrenched society with stigma that people diagnosed with mental illnesses are dangerous, insane, and dependent.9 Moreover, the prejudices and perceptions have produced stigma that mental health treatments are unsafe, 2 coerced, and futile. Consequently, people with mental illnesses are avoiding the labels, such as mad or insane, and dreading the mental health treatments that are portrayed as harmful and involuntary. Therefore, the mental health campaigns must compound the awareness and education to address the stigma and fears towards both mental health illnesses and treatments in order for the culture of the society to understand the
Load more

Recommended publications
  • Department of Health and Human Services
    Vol. 81 Wednesday, No. 61 March 30, 2016 Part V Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 438, 440, 456, et al. Medicaid and Children’s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans; Final Rule VerDate Sep<11>2014 22:28 Mar 29, 2016 Jkt 238001 PO 00000 Frm 00001 Fmt 4717 Sfmt 4717 E:\FR\FM\30MRR5.SGM 30MRR5 asabaliauskas on DSK3SPTVN1PROD with RULES 18390 Federal Register / Vol. 81, No. 61 / Wednesday, March 30, 2016 / Rules and Regulations DEPARTMENT OF HEALTH AND M. Scope of Services NQTL Nonquantitative Treatment HUMAN SERVICES N. Increased Cost Exemption Limitation O. Enforcement, Managed Care Rate Setting PAHP Prepaid Ambulatory Health Plan Centers for Medicare & Medicaid and Contract Review and Approval PHS Act Public Health Service Act Services P. Applicability and Compliance PIHP Prepaid Inpatient Health Plan Q. Utilization Control SHO State Health Official R. Institutions for Mental Diseases SUD Substance Use Disorder 42 CFR Parts 438, 440, 456, and 457 S. Medicare-Medicaid Dual Eligible Treasury Department of the Treasury [CMS–2333–F] Beneficiaries IV. Summary of Changes I. Executive Summary RIN 0938–AS24 V. Collection of Information Requirements This final rule addresses the VI. Regulatory Impact Analysis application to Medicaid and the Medicaid and Children’s Health A. Statement of Need Children’s Health Insurance Program Insurance Programs; Mental Health B. Overall Impact (CHIP) of certain mental health parity Parity and Addiction Equity Act of C.
    [Show full text]
  • Will Full Benefits Parity Create Real Parity? – Congress's
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Saint Louis University School of Law Research: Scholarship Commons Saint Louis University Journal of Health Law & Policy Volume 3 Issue 2 Health Law and Bioethics: Pressing Article 7 Issues and Changing Times 2010 Will Full Benefits arityP Create Real Parity? – Congress’s Second Attempt at Ending Discrimination Against Mental Illness: The Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 Justin C. Wilson [email protected] Follow this and additional works at: https://scholarship.law.slu.edu/jhlp Part of the Health Law and Policy Commons Recommended Citation Justin C. Wilson, Will Full Benefits Parity Create Real Parity? – Congress’s Second Attempt at Ending Discrimination Against Mental Illness: The Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008, 3 St. Louis U. J. Health L. & Pol'y (2010). Available at: https://scholarship.law.slu.edu/jhlp/vol3/iss2/7 This Student Comment is brought to you for free and open access by Scholarship Commons. It has been accepted for inclusion in Saint Louis University Journal of Health Law & Policy by an authorized editor of Scholarship Commons. For more information, please contact Susie Lee. SAINT LOUIS UNIVERSITY SCHOOL OF LAW WILL FULL BENEFITS PARITY CREATE REAL PARITY? – CONGRESS’S SECOND ATTEMPT AT ENDING DISCRIMINATION AGAINST MENTAL ILLNESS: THE PAUL WELLSTONE AND PETE DOMENICI MENTAL HEALTH AND ADDICTION EQUITY ACT OF 2008 INTRODUCTION On February
    [Show full text]
  • The U.S. Mental Health Delivery System Infrastructure: a Primer
    = -*=__= *39&1=*&19-=*1.;*7>=>89*2= 3+7&897:(9:7*a==7.2*7= &2>&=:3)&7&7&2&3= 3&1>89=.3= :'1.(=*&19-= 57.1=,+`=,**3= 43,7*88.43&1= *8*&7(-=*7;.(*= 18/1**= <<<_(78_,4;= .*/-0= =*5479=+47=43,7*88 Prepared for Members and Committees of Congress -*=__=*39&1= *&19-=*1.;*7>=>89*2=3+7&897:(9:7*a==7.2*7= = :22&7>= In the past decade, four federal reports have offered insight into the nation’s mental health care system and recommended a fundamental transformation of the system. According to these reports, transformation of the mental health care system would require timely incorporation of evidence-based practices in routine practice, resolution of workforce shortage issues, removal of financial barriers, coordination of mental health care with general health and social services, and systematic measurement and improvement of the quality of care delivered. While each of these recommendations may result in some benefits, the findings suggest that a comprehensive transformation of the mental health system could be necessary to ensure the availability and accessibility of quality mental health care to all individuals who need it. In 2007 about 11% of adults (23.7 million) in the United States experienced serious psychological distress, such as anxiety and mood disorders, that resulted in functional impairment that impeded one or more major life activities. Different types of providers deliver care in a range of settings and are financed by various combinations of public and private payers. Congress has been increasingly interested in transforming the mental health system in the aftermath of tragedies involving mentally ill individuals—such as the shootings at Columbine and Virginia Tech, which led to heightened public interest in the adequacy of the mental health care system.
    [Show full text]
  • Improving Health Coverage for Mental Health and Substance Use
    IMPROVING HEALTH COVERAGE FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER PATIENTS Including Compliance with the Federal Mental Health and Substance Use Disorder Parity Provisions REPORT TO CONGRESS Secretary Thomas E. Perez U.S. Department of Labor January 2016 Table of Contents I. EXECUTIVE SUMMARY ............................................................................................................................... 1 Enforcement of MHPAEA ............................................................................................................................ 1 Regulations and Guidance .......................................................................................................................... 2 Outreach and Publications ......................................................................................................................... 2 Looking Ahead ........................................................................................................................................... 3 II. INTRODUCTION ......................................................................................................................................... 4 III. REGULATORY ACTIONS: FUTHERING PARTICIPANTS’ AND BENEFICIARIES’ RIGHTS ..................................... 9 A. The Departments Address Nonquantitative Treatment Limitations ........................................................ 9 B. The Department Addresses Scope of Services ......................................................................................
    [Show full text]
  • 2018 Pathway to Full Parity
    2018 Secretary R. Alexander Acosta U.S. Department of Labor Report to Congress [PATHWAY TO FULL PARITY] In its 2018 report to Congress, the Department of Labor outlines its current implementation and enforcement actions in furtherance of the Mental Health Parity and Addiction Equity Act. TABLE OF CONTENTS TABLE OF CONTENTS ................................................................................................................ 1 PREFACE ....................................................................................................................................... 3 I. INTRODUCTION .................................................................................................................. 4 II. EBSA’S MHPAEA PROGRAM OVERVIEW ...................................................................... 7 A. EBSA’s enforcement program ......................................................................................... 7 1. DOL MHPAEA investigations – under the hood ......................................................... 8 2. Behind the numbers – EBSA enforcement results ..................................................... 10 3. Assessing the impact of EBSA results ....................................................................... 12 4. Future enforcement efforts ......................................................................................... 14 B. MHPAEA consumer assistance, education, and outreach ............................................. 15 1. Consumer Assistance .................................................................................................
    [Show full text]
  • Institutions, Politics, and Mental Health Parity
    Society and Mental Health 2(3) 154–171 Institutions, Politics, and Ó American Sociological Association 2012 DOI: 10.1177/2156869312455436 Mental Health Parity http://smh.sagepub.com Elaine M. Hernandez1 and Christopher Uggen2 Abstract Mental health parity laws require insurers to extend comparable benefits for mental and physical health care. Proponents argue that by placing mental health services alongside physical health services, such laws can help ensure needed treatment and destigmatize mental illness. Opponents counter that such mandates are costly or unnecessary. The authors offer a sociological account of the diffusion and spatial distribution of state mental health parity laws. An event history analysis identifies four factors as especially important: diffusion of law, political ideology, the stability of mental health advocacy organizations and the relative health of state economies. Mental health parity is least likely to be established during times of high state unemployment and under the leadership of conservative state legislatures. Keywords mental health, mental health policy, mental health services Most citizens of the United States acquire health was too limited and attenuated to ensure mental care through employers. Although this employer- health parity. Following its sunset in 2005, based system has typically covered most physical Congress once again passed federal mental health illnesses, mental health services have historically parity legislation, the Mental Health Parity and been specifically excluded or minimally covered Addiction Equity Act of 2008 (effective July (Frank and McGuire 2005). Mental health parity 2010), which more forcefully prevents employers laws mandate that employers provide equal types from exempting patients with mental illness. of benefits for mental and physical illnesses Given the infrequency of federal legislation and (Mechanic and McAlpine 1999).
    [Show full text]
  • Mental Health Parity: the Ap Tient Protection and Affordable Care Act and the Parity Definition Implications Suann Kessler
    Hastings Science and Technology Law Journal Volume 6 Article 3 Number 2 Summer 2014 Summer 2014 Mental Health Parity: The aP tient Protection and Affordable Care Act and the Parity Definition Implications Suann Kessler Follow this and additional works at: https://repository.uchastings.edu/ hastings_science_technology_law_journal Part of the Science and Technology Law Commons Recommended Citation Suann Kessler, Mental Health Parity: The Patient Protection and Affordable Care Act and the Parity Definition Implications, 6 Hastings Sci. & Tech. L.J. 145 (2014). Available at: https://repository.uchastings.edu/hastings_science_technology_law_journal/vol6/iss2/3 This Note is brought to you for free and open access by the Law Journals at UC Hastings Scholarship Repository. It has been accepted for inclusion in Hastings Science and Technology Law Journal by an authorized editor of UC Hastings Scholarship Repository. For more information, please contact [email protected]. Mental Health Parity: The Patient Protection and Affordable Care Act and the Parity Definition Implications * by SUANN KESSLER Introduction ............................................................................................. 145 I. Brief History of Mental Illness ........................................................ 147 II. Before Mental Health Parity Legislation ...................................... 150 III. Mental Health Parity Legislation .................................................. 152 A. Mental Health Parity Act of 1996 .......................................
    [Show full text]
  • REFORMING STATE MENTAL HEALTH PARITY LAW Stacey A
    11 HOUS.J.HEALTH L. & POL’Y 455–504 455 Copyright © 2011 Stacey A. Tovino Houston Journal of Health Law & Policy ISSN 1534-7907 REFORMING STATE MENTAL HEALTH PARITY LAW Stacey A. Tovino, J.D., Ph.D.* INTRODUCTION This Article is the final installment in a three-part project that presents a comprehensive challenge to lingering legal distinctions between physical and mental illness in the context of health insurance. The first installment in this series narrowly inquired as to whether the postpartum mood disorders should be classified as physical or mental illnesses in a range of health law contexts.1 The second installment was broader in scope and challenged a number of federal provisions that allow publicly- and privately-funded health care programs and plans to provide mental health insurance benefits that are less comprehensive than their physical counterparts.2 The second installment also proposed comprehensive federal reforms, including the extension of federal mental health parity law to * Professor of Law, William S. Boyd School of Law, University of Nevada, Las Vegas. I thank John Valery White, Dean, William S. Boyd School of Law, for funding this research project. I also thank Jeanne Price (Director, Wiener- Rogers Law Library), Chad Schatzle (Student Services Librarian, Wiener-Rogers Law Library), and Cheryl Grames (Boyd law student) for their outstanding assistance in locating many of the sources referenced in this Article. I am grateful to the participants of the following conferences and meetings for their helpful comments and suggestions on earlier drafts of this Article: The 26th Annual Whittier Health Law Symposium sponsored by Whittier Law School, The 33rd Annual Health Law Professors Conference sponsored by the American Society for Law, Medicine & Ethics, and The 63rd Annual Meeting of the Southeastern Association for Law Schools.
    [Show full text]
  • Mental Health Parity Legislation: a Review
    Mental Health Parity Legislation: A Review Lauren O’Reilly, BS,1 Stephen McCaffrey, JD,2 Brian M. D’Onofrio, PhD1 1Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 2Mental Health America of Indiana, Indianapolis, IN Mental Health America of Indiana holds the view that all individuals and families should have access to a broad scope of medically appropriate, evidence-based interventions in the continuum of behavioral health services and supports. The Patient Protection and Affordable Care Act (PPACA) has expanded health care coverage through a combination of state-based private insurance exchanges and a Medicaid expansion in the form of the Healthy Indiana Plan (HIP). In addition, the law includes a number of reforms to curb harmful insurance company practices as well as provisions to slow the growth of health care costs and improve quality of care. ACA takes groundbreaking steps toward improving access to mental health and substance use disorder treatment services. Significantly, it includes mental health and substance use disorder services as well as rehabilitative services as components of the essential benefits package that must be offered through this federal initiative to cover the uninsured. With the enactment of the ACA, we have the ability to create a reformed health care system that provides a comprehensive, culturally and linguistically appropriate behavioral health system of services and supports. MHAI supports the State of Indiana’s HIP program in an effort to provide mental health and addiction services to the ACA Expansion population. In particular, MHAI supports the inclusion of individuals with Serious Mental Illness or chronic Substance Use Disorders with access to the “Medically Frail” exclusion, providing access to the Medicaid Rehabilitation Option.
    [Show full text]
  • Fact Sheet: Mental Health Parity Compliance in Medicaid by Elizabeth Edwards and Abbi Coursolle* Introduction Behavioral Health
    Fact Sheet: Mental Health Parity Compliance in Medicaid By Elizabeth Edwards and Abbi Coursolle* Introduction Behavioral health services are health care services that are provided for the treatment of mental health conditions and substance use disorders (SUD). Medicaid is the leading payer for mental health services in the United States and plays an important role in providing coverage and access to behavioral health services for millions of low-income individuals.1 In 2014, approximately 21.5 million people above the age of 12 had a substance use disorder in the past year and 1 in 5 adults had experienced a mental health condition in the past year.2 That year, Medicaid paid for 25% of all mental health spending and 21% of total spending on substance use disorders in the United States.3 In 2015, an estimated 9.1 million adults with Medicaid had a mental health condition and over 3 million experienced an SUD.4 Despite the prevalence of mental health conditions, there is a tendency among both private and public payers to provide more comprehensive coverage for medical and surgical benefits than for mental health benefits. Congress has passed two Acts mandating that private insurers provide coverage for mental health conditions that is on par with coverage for other health conditions.5 The parity requirements set forth in these Acts have also been extended to some public health care programs.6 This primer will describe the application and scope of these laws to Medicaid and the Children’s Health Insurance Program (CHIP), with a particular focus on recent guidance by the Centers for Medicare and Medicaid Services (CMS) concerning parity compliance.
    [Show full text]
  • How Repealing and Replacing the ACA Could Reduce Access to Mental Health and Substance Use Disorder Treatment and Parity Protections
    Support for this research was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation. How Repealing and Replacing the ACA Could Reduce Access to Mental Health and Substance Use Disorder Treatment and Parity Protections Jane B. Wishner Timely Analysis of Immediate Health Policy Issues JUNE 2017 In Brief and fully insured small group plans and including the stigma surrounding Millions of Americans gained coverage Medicaid expansion benefit plans to mental illness and the “unfair” treatment for mental health (MH) and substance include coverage for both MH and SUD limitations and financial requirements use disorder (SUD) treatment through treatment. Efforts to repeal and replace placed on mental health benefits in the expansion of Medicaid and private the ACA—such as the American Health private insurance. The commission’s insurance coverage under the Affordable Care Act (AHCA), which passed the final report stated, “Understanding that Care Act (ACA). The law also included House of Representatives on May 4, mental health is essential to overall health parity protections ensuring that MH/ 2017—could cause millions of people to is fundamental for establishing a health SUD benefits were not subject to plan lose MH/SUD coverage and the parity system that treats mental illnesses with provisions stricter than those for medical protections of the MHPAEA. the same urgency as it treats physical care (e.g., higher co-payments and illnesses.”2 lower visit limits).1 Bipartisan support Introduction for MH/SUD treatment and parity has In recent years, bipartisan support The Paul Wellstone and Pete Domenici increased since the 1990s, most recently for expanded MH/SUD treatment has Mental Health Parity and Addiction in response to the opioid epidemic.
    [Show full text]
  • The Mental Health & Substance Use Disorder Parity Task Force
    PREPARINGTHE MENTAL FOR HEALTH THE FUTURE & OFSUBSTANCE ARTIFICIAL USE INTELLIGENCE DISORDER PARITY TASK FORCE FINAL REPORT October 2016 “TO REALIZE THE PROMISE OF COVERAGE EXPANSIONS AND PARITY PROTECTIONS IN HELPING INDIVIDUALS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS, EXECUTIVE DEPARTMENTS AND AGENCIES NEED TO WORK TOGETHER TO ENSURE THAT AMERICANS ARE BENEFITING FROM THE FEDERAL PARITY PROTECTIONS THE LAW INTENDS.” -P RESIDENT BARACK OBAMA PRESIDENTIAL MEMORANDUM ESTABLISHING THE MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY TASK FORCE MARCH 29, 2016 2 Introduction Parity: Improving the Lives of People with Mental Health and Substance Use Disorders Over the past eight years, our nation has made significant progress in increasing coverage for mental health and substance use disorders (together sometimes called behavioral health disorders). In 2015 the number of Americans with health insurance coverage was at an all-time high with close to 290 million people with 1 health insurance coverage compared to 260 million in 2011. Because people with mental health and substance use disorders were among the most likely to be uninsured, a greater share of the increased access has been for these individuals. The Affordable Care Act (ACA) significantly expanded coverage of behavioral health care – mental health and substance use disorder coverage is part of the Essential Health Benefit (EHB) package, recommended preventive screenings, including for depression and alcohol misuse, are available to people with non-grandfathered coverage with no cost sharing; and, in the 31 states and the District of Columbia that have expanded Medicaid, important mental health and substance use disorder services are now available to roughly 15 million more people than before the ACA was enacted.2 Health insurance makes a big difference.
    [Show full text]