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Mental health parity is a term that may be used in several different ways, but also represents a concept about how insurance companies should treat mental health benefits. Many US states have enacted parity laws, which vary tremendously, and countries with socialized medicine may also have some form of parity coverage. The basic concept of mental health parity is that most mental health conditions should not be treated by insurance companies (or government insurers) as uniquely different than any other health condition. In broadest terms this can mean that insurers, given a parity law, might have to provide mental health coverage that is equal to and not less than any coverage provided for other health conditions.
In addition to states that have parity laws, the US government has had a parity law on the books, which many considered not true equality. The 1996 Mental Health Parity Act (MHPA) is a federal law that demands insurers not provide a lower amount of dollar coverage or maximum for mental health benefits. This law did not mean that insurers had to offer mental health coverage, or that they had to provide unlimited amounts of coverage to their clients. Employers who had less than 51 employees also did not have to abide by these laws.
The MHPA was considered inadequate by many in the mental health field, by a variety of physicians, and by many who suffer from mental health conditions, since insurers could still limit the number of therapy sessions they provided to those with health coverage. In response, a number of states enacted stronger parity laws, but numerous laws were only slightly stronger and had noted loopholes. From a bipartisan perspective, both Congressional houses viewed the MHPA as inadequate, and in October 2008, they passed a stronger bill, signed into law by President Bush. The new law, more clearly defines how mental health parity is to be understood.
Under the new definition, any insurance company that offers mental health benefits must do so on an equal basis to “standard” benefits. This means insurers cannot treat most recognized disorders in the Diagnostic and Statistical Manual, as different than any other illness. Insurers may not limit the number of sessions, or offer unequal coverage for what are called “parity” conditions. Like the MHPA, employers with fewer than 51 employees do not have to offer parity coverage, and no insurer has to offer mental health coverage. Yet when they do, benefits for mental health must be treated exactly the same as benefits for physical health conditions, since mental health conditions are most often understood as having physical origin.
The discussion of mental health parity takes slightly different turns when you are working with government run health care in systems provided by countries like Canada and the UK. In Canada, people can get free mental health coverage, but they must pay for a supplemental insurance that will cover prescription drugs. Some reports in Canada state that true mental health parity cannot exist when people do not have this supplemental insurance. People with lower incomes may not be able to afford prescribed medications for mental health conditions, which can render treatment ineffective.
In the UK, people can also receive mental health treatment through government health care, and this treatment should be equal to care for physical problems, and should represent mental health parity. However, the UK has a variety of private therapists too, and many people cite the difficulty of receiving mental health treatment through the government, due to the high demand for this service. Many people opt to see a private therapist because there is less hassle involved, but those of lower socioeconomic status may not have this option. Those who rely on government provided assistance for mental health issues can wait a considerable amount of time before getting to see a public therapist, unless their condition needs immediate or emergency treatment.
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