A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Children's Mental Health Campaign Questions Parity

Children's Mental Health Campaign Questions Parity

August 11, 2011

Children's Mental Health Campaign logoOn June 27, the Joint Committee on Mental Health and Substance Abuse held an Oversight Hearing on parity implementation and the causes for "boarding" mental health patients in the emergency rooms of local hospitals. The Children's Mental Health Campaign (CHMC) was called upon to talk about this problem from a children's perspective and we put together an outstanding panel of experts including Marylou Sudders from MSPCC, Matt Selig from Health Law Advocates and Kate Guinness from Children's Hospital Boston.

Senator Keenan and Rep. Malia, the Chairs of the Committee, wrote a commentary that appeared on August 4 in the Quincy Patriot Ledger about this important issue and referenced Marylou Sudders' testimony provided to the Committee during the oversight hearing:

It’s becoming clear that, despite state and federal statutes to the contrary, there remains a stark difference between how physically ill and mentally ill patients receive treatment in Massachusetts. Or as Dr. Luis Lobón, of the Cambridge Health Alliance, put it during his testimony: mental health parity does not exist in Massachusetts.

There is no one reason for this failure.

We agree with Marylou Sudders, the well-respected former Massachusetts Department of Mental Health commissioner that the boarding problem was caused by the failure of the system as a whole.

The Commonwealth does bear some responsibility, as budget cuts have forced the closure of 200 state hospital beds, which then creates backups elsewhere in the system. However, of greater concern is the apparent failure of our state’s public and private insurance plans to meet their new obligations under federal and state parity laws.

Diabetic patients aren’t kept on gurneys in hallways over a weekend because the hospital can’t get authorization for treatment from insurance companies that turn off the lights Friday at 5 p.m. And oncology units aren’t closing because they’re losing money. But these are the realities for mental health services.

Failure to properly treat mental illness comes with a staggering financial cost. As a society, we pay for it through increased demands on our police, our courts, and our jails.

Insurance companies may balk at the upfront costs, but they pay in the end, as studies have consistently shown that consumers with mental illnesses also have higher average medical costs. In addition, hospitals recover from health insurance companies the money they lose through boarding mental health patients for days at a time by shifting costs elsewhere.

Efforts are ongoing to reconstruct our state’s health care system under a global payments model. It is important that this new model also include revamping our state’s mental health system. Individuals who are suicidal, schizophrenic, psychotic, or even homicidal need and deserve proper medical treatment, just like someone suffering from a heart attack, stroke, or broken hip. We need to make mental health parity a reality.

The CMHC has also been asked to provide input to the Committee on what parity reform or improvements would entail and we will continue to work towards full parity implementation over the course of the next year. This is a very important issue for the Committee and we look forward to working together on the next stage of parity regulations.
-Erin Bradley, coordinator of the Children’s Mental Health Campaign

UPDATE: See this letter further emphasizing the issues from Sudders in the Patriot Ledger.

Comments

I fail to understand how health insurance companies are responsible for the lack of psychiatric beds in the community. I have not seen any data to suggest that insurance companies are denying coverage or imposing rules that differ from coverage of medical problems. If there was an insufficient supply of medical beds, the emergency rooms would be boarding diabetics, cardiac patients and others.

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