U.S. Capitol

By Kristen Fritz


On Thursday, the Senate Health, Education, Labor and Pensions Committee held a hearing at the U.S. Capitol in Washington, D.C. to discuss how to improve access to mental health care insurance benefits. The meeting was in response to the recent Sandy Hook Elementary School shootings, focusing on how the United States could improve the handling of psychological problems that may lead to violence.


Pamela Hyde, the administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), noted at the hearing that “most people who are violent do not have a mental disorder, and most people with a mental disorder are not violent.” She also stated that “demographic variables such as age, gender and socioeconomic status are more reliable predictors of violence than mental illness,” according the committee website. “These facts are important, because misconceptions about mental illness can cause discrimination,” she said.


According to Hyde, patients and their families now get 69 percent of the cash used to pay for mental health care from state and federal government programs, 12 percent from their own personal resources, and 27 percent from private insurance plans. One of the major laws governing private health insurance benefits for mental health care, the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), affects insured and self-insured group health benefits. It does not require an employer to offer coverage for mental health or substance abuse disorders. The rules state that if an employer with 50 or more employees does offer mental health or substance abuse benefits, then the financial requirements and treatment limits for the behavioral health benefits can be no more restrictive than the typical requirements for benefits for other types of disorders.


Another law, the Patient Protection and Affordable Care Act of 2010 (PPACA), is set to require all non-grandfathered individual and small group plans to offer an “essential health benefits” (EHB) package that includes coverage for mental health and substance abuse disorder services starting Oct. 1. Michael Hogan, a former New York state mental health office commissioner and the chairman of the President’s New Freedom Commission on Mental Health, said improving the mental health system “must begin with a realization that we have begun to take big steps away from an approach that was both separate and unequal.” The country also needs better programs to help people who are showing signs of having psychotic disorders find and stay on effective medications, and get and keep jobs, Hogan said.