- Mental health parity reflects equality in how mental health and physical health conditions are treated.
- Federal laws have been passed that require mental health parity.
- States are typically responsible for a large portion of the enforcement of mental health parity laws, and they do not do so equally.
By Samantha Patton, Ph.D., on behalf of the Atlanta Behavioral Health Advocates
Parity is a synonym for equality. Mental health parity reflects equality in how mental health and physical health conditions are treated. In 2008, the Mental Health Parity and Addiction Equity Act was passed. This federal law prevented group health insurance plans that cover mental health services from limiting mental health and substance use disorder benefits while maintaining more favorable medical/surgical benefits. It is important to mention that an estimated 55.3 percent of Americans will have some diagnosable mental health disorder in their lifetime (Kessler et al., 2007), and the COVID-19 pandemic has only exacerbated this issue (Czeisler et al., 2020).
The Mental Health Parity and Addiction Equity Act was amended in 2010 by the Patient Protection and Affordable Care Act to include individual health insurance and to require the inclusion of mental health and substance use disorder services as an essential benefit in nongrandfathered plans. Simply put, mental health concerns (e.g., depression, anxiety, alcohol use disorder) should be covered (e.g., copay, treatment coverage, the number of visits you are allowed) by insurance plans in the same way that physical health concerns are covered.
State Laws Differ
While this legislation exists at the federal level, states are typically responsible for a large portion of the enforcement of these laws. As one might expect, enforcement and monitoring differs from state to state. Parity-related legislation in each state can be found by visiting https://www.paritytrack.org/reports/. Because of these between-state differences, it continues to be difficult for some individuals to obtain the beneficial treatment and services that they need and deserve. Common violations of this legislation can include a separate deductible for mental health services, needing permission from an insurer to continue mental health treatment, being charged more for medications that treat mental health concerns, and insurers refusing to pay for residential treatment, out-of-state or -region treatment, or another mental health treatment that your provider recommends (The Kennedy Forum, 2022).
Know Your Rights
So, what can be done? Educate yourself on your rights as a consumer, and, if applicable, the rights of your patients. If you or someone you know has received a restriction or denial in mental health care that likely violates the federal parity law, an appeal can be filed at www.parityregistry.org. Follow parity legislation as it is being developed in your state and talk with your representatives about it. When approximately half of the population will struggle with a diagnosable mental health disorder in their lifetime, treatment should be covered. You can be a part of making sure that happens.
Czeisler, M.E., Lane, R.I., Petrosky, E., Wiley, J.F., Christensen, A., Njai, R., Weaver, M.D., Robbins, R., Facer-Childs, E.R., Barger, L.K., Czeiler, C.A., Howard, M.E., & Rajaratnam, S.M.W. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic – United States, June 24-30, 2020. MMWR Morbidity and Mortality Weekly Report 69, 1049–1057. http://dx.doi.org/10.15585/mmwr.mm6932a1
Kessler, R.C., Angermeyer, M., Anthony, J.C., De Graaf, R., Demyttenaere, K., Gasquet, I., De Girolamo, G., Gluzman, S., Gureje, O., Haro, J.M., Kawakami, N., Karam, A., Levinson, D., Mora, M.E.M., Browne, M.A.O., Posada-Villa, J., Stein, D.J., Tsang, C.H.A., Aguilar-Gaxiola, S., . . . Ustun, T.B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):168–176.
The Kennedy Forum (2022, January 31). Common Violations. https://www.paritytrack.org/common-violations/