Institute on Psychiatric Services Update

APA’s 2013 Conference

The 2013 Institute on Psychiatric Services is underway now (October 10-13) in Philadelphia. The conference theme is “Transforming Psychiatric Practice, Reforming Health Care Delivery,” and the conference is featuring two special events. Thanks to the support of the American Psychiatric Foundation, former Rep. Patrick Kennedy, a strong advocate for improved access to mental health services as part of health care reform, has joined APA President Jeffrey Lieberman, M.D., for a session in the “Conversations” format, discussing changes in psychiatric practice, stigma, and the need for increased advocacy to improve access to psychiatric treatment. Dr. Lieberman is also chairing a special symposium on the role of psychiatrists in the transformed health care system with esteemed colleagues Ellen Katz, Ann Sullivan, and Grant Mitchell.

Kennedy Says This is a Critical Time for Parity

Kennedy and Lieberman spoke before a packed hall, and the former congressman, who was instrumental in the landmark 2008 parity bill, discussed his own journey toward understanding the importance of equal treatment for mental illness and substance abuse. He recounted his mother’s struggle with alcoholism and his problems with addiction, as well as his Aunt Rosemary’s intellectual disability, saying that within his own family mental illness and substance abuse were “the elephant in the living room that no one talked about.” He recounted parking his car three blocks away from his psychiatrist’s office to avoid being recognized during his political career.Yet, ironically, Kennedy found himself, along with his late father, Sen. Edward Kennedy, championing the 2008 federal parity law.

Kennedy emphasized that now—with a “final rule” from the government that will provide a regulatory framework for implementing the 2008 law expected very soon—is a decisive moment. He said transparency in the way insurance companies make medical-necessity decisions will be crucial to ensuring the full implementation of parity.

“The exciting thing for all of you is that with health care reform, we are rewriting the rules. Organizations like APA need to be even more aggressive than ever before, because we are at a formative point….This is the moment in history when we really have the opportunity to change the landscape.”

What is Parity?

“Parity” refers to fair and equal coverage of mental health and substance use disorders. In states with comprehensive parity laws, plans subject to state law must provide coverage for a broad range of mental health and substance use disorders in a manner that is equitable with coverage for other health conditions. Parity leads to complex legal issues and about half of all covered Americans are enrolled in large self-insured health insurance plans that are subject to federal, not state, law.

NAMI’s Position on Parity

NAMI supports full parity in both private (individual and employer-based) and public (Medicare, Medicaid, and other government-sponsored) insurance coverage for mental illnesses. Central to an understanding that mental illnesses are both “blameless” and treatable is non-discriminatory coverage for the necessary medical care for these illnesses. One key to unlocking the prisons of these illnesses is research, and research is driven by funding.

The discrimination in access to care is evidenced by limited coverage, punitive co-pays, and restricted access to hospitalization during acute episodes and what one would logically conclude would occur for other untreated or under-treated serious illnesses. That is to say: the outcomes for people with untreated or under-treated illnesses are disastrous and too frequently results in death or permanent disability. To that effect NAMI has been actively pursuing non-discrimination clauses in both federal and state insurance laws.

For more information about parity, visit NAMI’s Parity Policy Web Page.


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