Although the federal mental health parity law became fully effective January 1, work remains to ensure the law works as Congress and advocates intended.
At the end of last month, the three federal departments charged with implementing the law issued interim regulations. They are thoughtful and clarify a number of key issues that will greatly help to ensure the intent of the parity law-to prohibit discriminatory treatment of mental health and substance use conditions-is fully realized and implemented.
But action in the regulatory arena is not the end of the story. We also need to inform the public about how the law works for them. A review of California's experience with that state's parity law recommended mounting a public education campaign to inform consumers about the benefits of the federal law, which they note would also help reduce stigma that deters too many from seeking treatment. One recent survey found that a large majority of workers believe their work situation would be damaged if they sought treatment for depression or drug use.
We also need to educate businesses about the benefits of mental health programs. In the current economic climate, there will be inevitable questions about cost. There shouldn't be any.
A review of the Federal Employee Health Benefit program found that when mental health and substance abuse were implemented and managed, total health care costs for most of the plans did not increase over those that did not have parity. In two states which adopted parity, health costs dropped 30 to 50 percent while the percentage of the population accessing some care increased 1 percent to 2 percent.
In fact, it has been found that limiting specialty behavioral health services increased the direct medical costs of workers and increased the number of sick days by employees with mental health and substance use conditions. Savings attributed to limiting behavioral health benefits were fully offset by increased use of other medical services and lost workdays.
In announcing the interim regulations, the Administration said the new requirements could increase premiums by four-tenths of 1 percent, or $25.6 billion over 10 years. That's not costly because we know mental health coverage and services are essential to workers' productivity, their overall health, and the economic health of a business. There s some data that integrated behavioral and general health benefits save medical costs over a two year period for persons with multiple chronic illnesses.
Business leaders increasingly understand those truths. There is a growing recognition that mental health issues are common in the workplace and that early identification, timely action and continuing treatment can address these problems effectively - increasing productivity and controlling costs.
But some still see parity as a mandate. Others have wrongly charged that it will open the floodgates to treatment of frivolous problems. In fact, our problem is getting people who need services to use them rather than controlling over utilization
Even if we didn't have a parity law, it would make sense to offer behavioral health and substance use coverage and mental health prevention and promotion in the workplace. In my next post, I'll explain the strategies that work and how we can educate businesses and leaders that they are essential investments in our human capital.
