Although psychological and addictive disorders have come to be recognized as common and treatable conditions within the medical profession and even among the general population, the United States health care system is still lagging behind. Insurance companies do not provide equal coverage for mental health services, and most Americans lack access to even basic mental health care. The goal of interest groups campaigning for better mental health coverage has been to achieve “mental health parity,” meaning that mental health services would be covered at the same level as general medical services and surgical procedures.
The first major victory is this campaign came in 1996, when Congress passed a law mandating equal annual and lifetime dollar limits for mental health benefits. A more recent piece of legislation has extended this parity in benefits to co-payments, deductibles, out-of-pocket limits, and caps on the number of inpatient or outpatient visits. The passage of this law is being hailed as a tremendous success by advocacy groups. However, the law has problematic limitations that may actually serve to increase systemic barriers to mental health treatment, particularly among the working poor and the lower middle class.
In this analysis we will examine the consequences of the present mental health parity law, and the structural barriers that continue to limit access to mental health services. We will examine the consequences of these limitations, both for the affected individuals and for the society as a whole. Finally, we will propose changes to the current policies which could remedy the problems we outline.