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Welcome to the latest edition of Mental Health Matters. On behalf of the Section Council, a sincere thank you to all who contribute these informative articles, and special thanks to Sandra Blake for her hard work as editor. The Section Council continues to engage with various stakeholders in furtherance of its mission to engage, educate, and lead on the subject of mental health. In this spirit, I would like to share the findings of a recent report by NAMI on the subject of mental health parity titled “Out-of-Network, Out-of-Pocket, Out-of- Options: The Unfulfilled Promise of Parity.”
Despite the decision by 32 states to expand Medicaid coverage and federal mental health parity requirements, people with health insurance still struggle to find mental health providers and services in their health plan networks or in their geographic area. They incur greater out-of-pocket costs for all types of mental health care than general medical or specialty care.
Contributing to this problem is a nationwide shortage of mental health professionals. In 2012, there were 3,669 Mental Health Professional Shortage Areas containing almost 91 million people. Further, many mental health providers, particularly psychiatrists, do not accept health insurance. A recent study in JAMA found that only 55% of the nation’s psychiatrists accepted insurance compared with 88% of physicians in other medical specialties. Mental health providers cite low reimbursement rates and heavy administrative burden as reasons they do not participate in health plans. Additionally, insured individuals have difficulty finding accurate information about participating providers in their health insurance plans and insurance networks frequently fail to keep up-to-date provider directories.
To address these barriers to accessing mental health care, the report recommends that health plans:
• Maintain accurate, up-to-date directories.
• Provide easy to understand information about mental health benefits.
• Promote integration of care.
• Expand provider mental health networks.
• Cover out-of-network care to fill provider gaps.
Insurance and mental health parity is especially crucial as individuals face the impending upheaval of health care policy on both the federal and state levels. Over the rest of the bar year, Mental Health Matters will continue to highlight important issues relating to mental health.
Thank you.
Joseph T. Monahan