Amidst change, ambiguity, and uncertainty in health care, some things remain constant, and the urgent and continued need to address parity in mental health care is one of them. We are reminded that mental health is as important as physical health, and it is a non-partisan issue that requires our immediate attention, our voices, and our collective action.
In a bold step in the days following the inauguration, Patrick Kennedy and the Kennedy Forum hosted “The New Frontier on Mental Health and Addiction”, bringing together a bipartisan group of members of Congress, healthcare officials, advocates, researchers, and clinicians. Some of the speakers included U.S. Senators John McCain (R-Arizona) and Sheldon Whitehouse (D-Rhode Island), House Minority Leader Nancy Pelosi (D-California); Surgeon General Vivek Murthy, U.S. Rep Joseph Kennedy III (D-Massachusetts), and former Surgeon General David Satcher.
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The event was a call to action to push for meaningful change for the millions of Americans living with mental health conditions, substance abuse, or addiction.
“We have a divided America,” said McCain. “But this is a cause worth pursuing, a cause worth believing in. We must unite on this issue.”
Kennedy used the event to introduce a guide for the 115th Congress on mental health and addiction, a comprehensive agenda with specific, actionable recommendations to improve mental health care.
To enable the Congress to solve the parity crisis, the guide contains a series of general recommendations. Notably, the report calls for integrating records for mental health and substance use disorder treatment into electronic health record systems so that providers have the information needed to treat patients but still protect patient privacy:
While it is true that patients with behavioral health conditions can face poorer care based on their diagnoses on their electronic health records—a phenomenon known as diagnostic overshadowing—we must utilize 21st Century technology and integrate with the rest of health care if we are ultimately going to see real progress. xxiii To protect against diagnostic overshadowing, we should educate general health professionals, including administrative staff and nurses, to correct any negative and inaccurate stereotypes they may have about people with behavioral health conditions.
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The document also argues for increasing the use of medication-assisted treatment for opioid use disorders. The guide also made specific recommendations for various Congressional Committees.
The Kennedy Forum also announced the launch of a digital platform designed to allow reporting of parity violations. The data in aggregate will enable identification and disruption of barriers to access for mental health care and will serve to influence future mental health care policy decisions.
When the 2008 Mental Health Parity and Addiction Equity Act was passed, the law mandated that coverage for mental illness be equal to coverage for physical conditions. Yet nearly a decade later, we find that while there is parity in theory and parity in law, there is no parity in practice. No parity in access, no parity in quality, and no parity in the delivery of evidence-based mental health treatment. Denials of coverage remain a challenge for patients across the nation, exemplified by poignant stories told by two families who faced the challenges of denial of coverage. And stigma still acts as a critical obstacle, keeping patients from seeking and receiving the care they need.
More than 43 million Americans suffer from mental illness, accounting for nearly 1 in every 5 US adults, and over half do not receive medically necessary treatment. Murthy also reminded attendees that 20.8 million adults experience substance abuse, a number equal to the prevalence of diabetes and 1.5 times the rates of cancer in the U.S., statistics highlighted in the recently released Surgeon General’s Report on Alcohol, Drugs, and Health.
The silver lining is that we have prevention and treatment strategies that work. And for every dollar spent on treatment of mental illness, as much as $4 is saved in total health expenditures and $7 on criminal justice costs.
As the Chief Medical Officer of a national mental health care provider, I was encouraged, inspired, and uplifted by the emphasis on action. Words matter, voices matter, but actions matter more. The Kennedy Forum event highlighted the need to collect information on the gaps in parity we see today and to push Congress to act to address the gaps we face.
However, also clear was that fundamental challenges in mental health care delivery cannot be solved by bills alone; it will take a combination of activism, advocacy, outreach, and a cultural sea change to reduce stigma and fear to achieve true mental health parity. As Patrick Kennedy made clear, we can no longer afford to view and treat mental health and addiction as anything other than a medical condition.
Despite ambiguity about the Affordable Care Act and the future of healthcare in the current political environment, one truth remains certain. For the mental health movement, the time for action is now.
Correction: An earlier version of this story misstated the number of adults who experience substance abuse disorders cited in the Surgeon General’s Report on Alcohol Drugs and Health. The correct number is 20.8 million, not 28 million.
Photo: nambitomo, Getty Images
