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Winston Churchill said, “Politics is not a game; it is an earnest business,” and finally we are getting serious about the politics of mental health care. After decades if not centuries of neglect, the bona fide health care disparity is receiving an unprecedented amount of attention. In part, this is due to the efforts to reform our nation’s health care delivery and financing systems to improve quality and rein in costs. But it represents an attitudinal change in our society toward mental illness prompted by the egregious deficiencies in our mental health care policies, sensationally and shockingly, reflected by the rising number of people with mental illness involved in civilian massacres, imprisoned by the criminal justice system, and homeless on the street. However undesirable the factors that may have occasioned it, the increased public attention to mental health care is welcome.
Most recently, we saw this reflected in the November 2013 release of the final rule for the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA), the goal of which is to improve the quality of and access to care for people with mental illness. But this goal can be achieved only if accompanied by adequate oversight and enforcement of the law among insurance companies and providers.
We must be sure health insurance plans are explicitly required to show exactly how their general medical benefits line up with their mental health benefits. Government monitors must be able to determine whether insurance plans are adhering to parity standards in all settings—from primary care offices to specialized mental health and addiction settings.
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