State legislatures continue to work on creating greater reimbursement equality for mental health recipients

What's new with mental health parity?

Mental health parity is the term used to describe the effort to create an equal health insurance system that covers mental illness in the same way that it covers physical illnesses. Right now, people who have private health insurance who exceed their mental health coverage–which in many cases is low–must choose between paying their expenses out of pocket or applying for disability.

In 1998, four states–Delaware, Georgia, South Dakota, and Tennessee–had already passed parity legislation. Meanwhile, 13 states have parity legislation pending, and 19 states now have some degree of mental health parity.

This information is inspiring news for a lobbyist or mental health advocate, but what does it mean for the person who has a family member with mental illness? Or for the consumer? "It does provide some new options, but it is probably most meaningful for the next generation," says Susan Dore, senior legislative advisor to the National Alliance for the Mentally Ill.

"The problem with applying for disability is that you can't work, you can't go to college. You become an outsider," says Dore. "Why should someone with mental illness have to become an outsider in order to get medical coverage while someone with diabetes or leukemia would never have to, since they would be covered by their insurance?"

So far, some inroads have been made in mental health parity that help individuals and their families get better coverage. For instance in Ohio, state employees now have parity coverage. "What this means is that if you work for the state and you have a daughter with severe depression, you no longer have to worry that your daughter has to go on disability," says Dore. "And if you don't work for the state you can consider getting a government job if a family member does have a mental illness."

At this time, no state has full parity. And in many states there are loopholes, such as the parity mandate not applying to smaller companies with a limited number of employees.

However, those states that do have some sort of parity regulations are serving as great test sites, explains Dore. In North Carolina, where state employees received full parity coverage, hospitalizations for mental illness decreased by two-thirds. If people know they are covered properly, they will seek out help to avoid a crisis. And if people get treatment early, there is less chance their condition will deteriorate and they will require hospitalization. "This information will help us convince other states to follow suit," Dore says.

How can you find out how your own state stands on parity right now?

For general information, call Chris Marshall, the federal affairs representative at the national office of NAMI (1-703-516-7969). For a complete listing of federal and state parity laws, you can access www.nami.org on the Internet. If you want more specific information, contact your state office. You can usually get a copy of the law. To get more details, contact the state insurance commissioner's office.

In addition to legislation, some large companies, such as Texas Instruments and Sun Microsystems, have made great strides by offering mental health parity to employees, says Dore. She recommends asking your local NAMI chapter what companies are known to have good coverage.