Mental Health Deserves Equal Treatment

Although Orange and Los Angeles counties take a lot of heat for our hedonistic ways, there is one area in which we excel. It is our special concern for those persons with special needs. Hollywood, with technical help from Orange County, has awakened, enlightened and increased sensitivities to those persons who were once ignored, scorned, unfairly treated and stigmatized.

Movies like “Three Faces of Eve,” “One Flew over the Cuckoo’s Nest,” “Awakenings” and “As Good as It Gets” made us feel the terrible pain of split personality, widespread mental illness, the immense incapacitating distress of obsessive compulsive disease and the need for better medications. Who will forget Marlee Matlin in “Children of a Lesser God” as she made hearing people really hear the hearing-impaired for the very first time?

The above messages laid the groundwork for laws and accommodations for the sick, disabled and injured. We now have special appliances, computers, cars, parking places, wheelchairs, ramps, signs, seats and elevators. Researchers daily are discovering better surgical procedures, medications, devices and prosthetics, and are vigorously studying regeneration of nerve cells in the hope of new applications.

This year, California faces a new challenge, which is integrating mental health and substance abuse treatment into mainline general medical care. This issue continues to frustrate the nation, individual states, managed health care insurers, doctors and patients.

The background is that health plans offered by employers typically provide less coverage for mental health and substance abuse treatment than for medical and surgical services. States and the federal government have begun to require that mental health and/or substance abuse treatment be covered in the same way as other medical care. This concept is known as “parity.”

Last year, the Legislature passed the Mental Health Parity Bill (AB 1100), which would require health insurers to cover both physical and mental illness under the same policy. Although then-Gov. Pete Wilson vetoed the bill, Gov. Gray Davis has indicated he will sign it or a similar bill. Wilson said he rejected AB 1100 because it was too broad and, together with other mandates on health plans, too costly.

However, recent studies show that if premiums for physical and mental illness are combined and coverage provided across the board under one package by all managed care companies, it is very cost effective. A 1997 Rand study in Ohio showed that the incremental cost for combined health coverage was $1 per member per year. The National Institutes for Mental Health studies in April 1997 and April 1998 revealed that costs either very nominally increased or in some cases actually decreased.

I hope that in 1999, California will join the other 19 states that currently have parity laws.