Coalition for Fairness in Mental Illness

 Talking Points on Mental Health Parity

• Clinical social workers are one of the four core mental health provider groups as identified by the Substance Abuse and Mental Health Services Administration, with the others being psychiatrists, psychologists, and clinical psychiatric nurse specialists. Of those four core practitioner groups, clinical social workers comprise the largest group of mental health practitioners nationwide, roughly 60%.
• According to the National Institute of Mental Health (NIMH), 1 in 5 Americans suffer from a diagnosable, treatable mental disorder in a given year-- namely 44.3 million but only 1/3, 14.6 million, receive treatment in any given year.
• Mental illness has a significant fiscal impact as 4 of the 10 leading causes of disability in the U.S. and other developed countries are mental disorders, namely: major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder.
• As the Mental Health Parity Act of 1996 was authorized only for five years, it expired on September 30, 2001. It is imperative that Congress address this issue before the end of the First Session of the 107^th Congress.
• NASW strongly supports passage of either S. 543, the Mental Health Equitable Treatment Act of 2001, or H.R. 162, the Mental Health and Substance Abuse Parity Amendments of 2001. Why?
• Parity is Economically Prudent. When illness goes untreated, costs escalate. NIMH has calculated the annual cost of untreated mental illness to be over $300 billion per year in the U.S. Productivity losses due to missed days of work and premature death account for almost 1/2 at $150 billion, health care costs total $70 billion, and societal costs (increased use of the criminal justice system and welfare benefits) are $80 billion.
• Parity is Affordable. Research and actual experience has shown contrary to popular belief, mental health parity does not cause an exponential increase in either premiums or costs. The National Mental Health Advisory Council reported to Congress that total health insurance premium costs would only rise by 1.4% if mental health parity was established. For example, North Carolina implemented mental health parity in 1992 for its state employee health care plan. In FY1996, the percentage of mental health payments as a part of total health care plan expenditures dropped from 6.4% to 3.4% and simultaneously there was a 64% decrease in the number of hospital days paid by the plan due to mental illness.
• Mental Illness Parity is Beneficial for Business. Delta Air Lines testified last year before Congress "that in the last decade we have introduced and implemented generous mental health and substance abuse benefits for our employees and their families, not in response to legislative mandate, but because it improves our corporate 'bottom line'." A 1999 story in the Wall Street Journal reported that a four-year study of the subject at McDonnell Douglas found a "four-to-one return on investment after considering medical claims, absenteeism, and turnover" for mental health parity. The Kennecott Copper Company discovered that when a mental health counseling benefit was provided to employees, its hospital, surgical, and medical costs decreased 48.9%

Disaster-Related Mental Health Talking Points

• According to a recent poll sponsored by the Pew Charitable Trust after the events of September 11, 2001:
  • 71% of Americans surveyed have felt depressed;
  • nearly 50% have had difficulty focusing;
  • 1 in 3 have had trouble sleeping; and
  • 1/5 or 20% of all Americans know someone who was killed, injured, or is still missing, or have friends or relatives who are directly affected.
• Clinical social workers comprise 40% of the American Red Cross Disaster Mental Health Service professional volunteers and constitute 60% of the four core mental health providers nationwide
• Dr. Spencer Eth, Medical Director for Behavioral Health, at Saint Vincent Catholic Medical Center, which was the closest medical facility to the World Trade Center, testified before the Senate Health, Education, Labor and Pensions Committee on September 26, 2001 that his facility alone provided mental health counseling to over 7,000 people since September 11^th. In the same time frame, over 10,000 people have called Saint Vincent's mental health toll-free hotline that was established in the wake of the disaster.
• Dr. Eth also testified that he "fears that we have just scratched the surface of the need for mental health care . . . . Though many, if not most, will cope successfully with the horror and stress . . . some will develop psychiatric symptoms, which could worsen over time. We know from study of prior disasters that the incidence of post-traumatic stress disorder, depression, and substance abuse has already increased in the New York City area . . . . "
• Another witness at the same Senate hearing, Dr. Carol S. North, stated: [p]sychiatric illnesses that develop after disasters are imminently treatable with medications and psychotherapy, and those at risk can be identified early and encouraged to seek treatment. Mental health programs should begin as soon as possible and continue into the unforeseen future."
• At risk populations include, but are not limited to: survivors; loved ones of those killed, missing, or injured; fire department personnel; law enforcement personnel; emergency medical personnel; volunteer rescue workers; military personnel; mortuary services and funeral home personnel; media personnel; relief agency personnel; children; the elderly; the disabled; those Americans currently receiving mental health treatment; and those Americans directly affected by previous disasters, terrorist attacks, or combat experience.
• Dr. North reiterated in her testimony that mental health "disorders often become chronic, and therefore mental health services must remain in place to manage the long-term consequences and serve the many who do not seek treatment right away. Applying emergency emotional first aid in the short run only to abandon people in their long term need is shortsighted."
• NASW stresses that emotional health is just as important as physical health. Inadequate recognition that appropriate mental health treatments are as necessary as appropriate medical or surgical treatments, hurts Americans in the long run.
• NASW also holds that it is important for government and business decision-makers to support satisfactory access to mental health services to meet the increased need, since the current mental health care supply and its financing problems cannot.