We Need Equal Treatment
I have a mental illness. Why do I find it so
hard to tell you this? Why are my throat constricted, my palms sweaty, and my fingers
trembling as I write this? I don't have trouble telling you my eyes are not perfect and
that I need to wear contact lenses. I don't have difficulty telling you I have arthritis
in my left knee that sometimes limits my physical activities. Why should I mind telling
you that I have something wrong with my brain and how well it works? It is because of the
shame and stigma associated with mental illness.
Why should this be so? Mental illness is common, very common. One out of ten people will
have a mental illness during their lifetime. Most people think mental illness means
someone hallucinates and is not in touch with reality, but mental illness is much broader
than that. It includes a range of illnesses from attention deficit disorder to severe
depression and anxiety disorders. Many people with mental illnesses are highly successful
and make significant contributions to society. Here are the names of a few: Mike Douglas,
Walter Cronkite, Ted Turner and Robin Williams.
People with mental illness are shamed and stigmatized. Why? . Scientists have learned more
about the brain in the past ten years, then they learned in all preceding years. This is
what they have learned. Bad parenting does not cause mental illness. It is not caused by
moral failure. Someone is not being punished with mental illness for being bad or evil. A
person does not choose to be mentally ill because he or she lacks character or moral fiber
although there continues to be the belief that a mentally ill person could be different if
he/she chose to and really tried.
Mental illness is not a choice. People do not choose to be mentally ill. It results from
something going wrong in the brain. There are other illnesses that result from things
going wrong in the brain, such as Parkinson's Disease or Alzheimer's Disease, but these
illnesses have no shame and stigma associated with them. People with these brain illnesses
get good medical care, along with society's compassion and understanding. Is it because
these illnesses of the brain have physical symptoms? Is it only the brain illnesses that
cause changes in a person's emotions, thoughts and behaviors that we stigmatize and
discriminate against? If so, what is the rational?
Mental illnesses are devastating. A recent study by the World Health Organization, in
listing the ten most debilitating illnesses, included four mental illnesses. Yet mental
illnesses can be successfully treated. Over 80% of people with bipolar disorder recover
with proper treatment. Over 80% of the people treated for severe depression recover. In
fact, rates for recovery from mental illnesses surpass the recovery or cure rates for many
Early intervention in diagnosis and treating mental illnesses is key. Mental illnesses,
when untreated, usually worsen over time. With each manic episode, the likelihood of the
episode being more severe, more protracted and more likely to recur increases. Severe
depression, left untreated, worsens, often ending in suicide. Years ago we had little
knowledge about the brain and how it functions Prior to the past thirty years, physicians
had few or no medicines to help control the symptoms of mental illness and no way
verifiable way to diagnose a particular mental illness. They usually employed a quiet
environment and talk therapies to "heal" the person with an ill brain. Today,
that is no longer the case. We have a number of medicines that adequately control the
symptoms of a whole range of mental illnesses, with more and better medicines being
developed all the time. We have MRI scans that demonstrate when something in the brain is
not functioning correctly or is not anatomically normal. With mental illness, a person
begins behaving differently. The change in behavior is caused by something wrong or
functioning wrong in the person's brain. Mental illnesses have physical causes. Mental
illnesses are physical illnesses. The only difference is that the physical illness is in
the brain, instead of some other part of the body.
Yet private medical insurance plans discriminate in the kind of medical coverage they
provide for these illnesses of the brain. Although plans may differ slightly, the
following is typical. of the coverage available for mental illnesses.
If I have something the matter with any other part of my body, from a wart to a cancer, I
can see my physician as often as I want, and have any visits covered at 80% of the cost.
If I need hospitalization, there is no limit to how long I may stay as long as the
physician says I need to be in the hospital. The hospital bill is covered in full. But for
an illness in my brain, I am allowed only twelve visits a year to a physician or other
mental health provider. These visits are covered at only 50% of the cost. If I needed more
than 12 visits in a year, I have to pay, out of pocket, in full. If I require
hospitalization, I am allowed to stay for five days, total, in any one year. If I require
extended hospitalization for my illness, again, I must pay for it myself at 100%. Many
families, even with insurance, go into debt or bankruptcy following an episode of mental
illness. I thought this is what insurance is supposed to prevent.
|Co-pay on Visits
|*The patient must pay out of pocket, at 100%, any care exceeding
these arbitrary limits on care.
Senate Bill 5425 would correct the inequities in coverage in all private group insurance
plans sold in Washington State. Mental illnesses would be covered as other illnesses are.
But won't this be costly you ask? Too costly? More than we can afford? Financial data
collected and analyzed by Price Waterhouse accountants and favorably reviewed by the
state's Department of Health indicate that the cost per enrolled member, with our current
mix of insurance plans, would increase by $1.21 to$3.47/month. If more insurance companies
switch to managed care plans, the expected cost increase would be even less.
Mental health insurance parity is an issue of fairness and justice. Why should you receive
care for your injured arm or sore little finger, while I can't receive equally good care
for my brain? Someday, something could malfunction in your brain, or your daughter's
brain, or your best friend's brain. Mental illness can occur in anyone, at any time, and
it requires adequate and appropriate care.
We need equal treatment. We need mental health insurance parity.
Click here for more information about Cynthia Hammer, MSW
Page last modified or reviewed on March 14, 2010