The U.S. government has enacted a set of final federal rules aimed at ensuring that people with mental health conditions receive similar insurance coverage for needed care as they would for physical health conditions. This represents a step forward in acknowledging the importance of mental health and in terms of supporting treatment options.
Researchers from University of Michigan and Michigan Medicine have been considering the changes and exploring how they may affect individuals, families, insurers and the health care system.
Many have found the process of identifying and paying for mental health treatment more taxing than with any other health care need. Within the market-centric U.S. healthcare system, for many people mental health support has been unattainable.
A national shortage of mental health care providers and a rise in diagnosis of mental health conditions exacerbates the issue.
According to Briana Mezuk, professor of epidemiology and co-director for the Center for Social Epidemiology and Population Health at the School of Public Health, the new federal rules build on much-needed implementation of core provisions in the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.
Mezuk has used her training and research explore the various ways that mental and physical health intersect throughout life. She is particular keen on those aspects of the new measures that are intended to prevent health insurers from limiting or denying patients seeking mental health care.
“Leaders in the field have argued that there is no health without mental health, and the Wellstone Act seeks to ensure that mental health care is given equal footing to medical care. This is an important milestone in addressing the substantial mental health needs of Americans.”
Despite the best of intentions there are resource implications, which Mezuk draws out: “It is critical to understand that even with these regulations, the mental health care needs of Americans will not be met by specialists alone—there are simply not enough psychologists, psychiatrists and social workers, particularly in rural and underserved areas, to meet this need.”
This places the responsibilities for addressing mental health issues back with local doctors: “Instead, the vast majority of mental health care in the U.S. will continue to be provided by general practitioners. To support these general practitioners, who often lack training in psychosocial interventions, it is essential that health care systems and payers embrace coordinated team-based care models.”
Outlining this approach, Mezuk explains: “Team-based care—which typically involves a general practitioner, nurse and a mental health specialist working together to support the patient—not only generates better clinical outcomes for patients with co-occurring mental and physical health problems, it is also cost-effective for managing such complex health needs. Payers and health care systems need to invest in these types of structural and personnel solutions to complex patient care to genuinely embody the spirit of the Wellstone Act.”
