Mental Health Parity: A Leap Forward

Mental health parity gains ground.

By Jennifer Schramm Jan 1, 2014

November CoverMany health care plans now cover mental health disorders on terms that are on par with coverage for physical conditions. This trend took another leap forward in November 2013 with new federal rules on parity for mental health and substance abuse disorders.

Mental illnesses have long been a leading cause of disability in major industrialized countries, directly affecting the workplace through employee absence and lost productivity.

According to the World Health Organization, mental, neurological and substance abuse disorders accounted for 13 percent of the total global disease burden in 2004, the latest year for which figures are available. Depression alone was responsible for 4.3 percent of the global burden of disease. Between 2011 and 2030, the worldwide economic toll of mental illnesses is expected to be $16.3 trillion, according to a 2011 report from the World Economic Forum and the Harvard School of Public Health.

Many national health care systems around the world have already integrated mental health care into their overall health care plans. In the U.S., the approach to mental health benefits and care is evolving.

The new federal rules implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. The law requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays and deductibles) and treatment limitations (such as caps on doctor visits) applicable to benefits for mental health or substance abuse disorders are no more restrictive than limits on medical and surgical benefits. The parity law applies to self-insured and fully insured health plans sponsored by employers with more than 50 employees.

The final rules are likely to have a wide-ranging effect. They could, for example, lead more individuals to seek help early rather than wait for mental health problems to escalate. Regarding costs, many experts argue that better coverage of mental health and substance abuse disorders will save employers money in the long run because it will reduce the high cost of lost productivity, absence, serious work errors and lowered morale tied to undiagnosed and untreated mental health problems.

Whatever the effect of the new rules, mental health disorders are likely to continue to have a major influence on society and the workplace. For example, suicide rates are highest among older men. As the large Baby Boomer generation ages, the impact of depression could become even more serious. At the same time, experts in psychology report an alarming increase in personality disorders among young people; the November 2013 cover story of Counseling Today described a "heretofore unseen wave of personality disorders on campuses, in community mental health centers and even in private practice."

For many in the mental health profession, the new rules to expand access to treatment for mental health disorders do not come a moment too soon.

Jennifer Schramm is manager of the Workforce Trends program at SHRM.

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