Let’s not allow the national debate over health care reform distract us entirely from the very impressive and clear victory that mental health advocates won recently in North Carolina and elsewhere.  It’s called Mental Health Parity.   One may like or dislike the ObamaCare plan, but it would take a truly self-interested employers trade association to object to the idea behind mental health parity: mental health illnesses are real ailments and it’s not proper to discriminate against those who suffer from them.

Parity is pretty simple.  It says that employers and health plans can’t subject people with mental illnesses to more stringent coverage limits than those imposed on people with other ailments.    It makes it easier for people to access the mental health care they need and it’s less likely that their insurance benefits will run out in the middle of their treatment.  Peoples’ annual mental health insurance benefits used to run out quickly because of the insurance company cost-saving mechanism called, “the visit limit.”  In the old days [i.e. last year], it was typical for insurance companies to cut off payment for treatment after a person had seen their psychiatrist and/or psychologist or psychotherapist twenty times.   For people being treated by both a psychiatrist and a psychologist or psychotherapist [the most effective way to treat many mental illnesses according to a large body of clinical evidence], this often meant running out of benefits within three months or so assuming a normal treatment regimen.   Since having no insurance benefits is an absolute bar to receiving treatment for many people, psychiatrists were being placed in the awkward and dangerous position of not being able to complete treatment with seriously ill clients.  For the patients, it goes without saying that this was not a clinically acceptable situation.

When Parity is in full effect in North Carolina,  most people with nine so-called biologically based mental health diagnoses will have unlimited mental health treatment visits available to them.  These diagnoses are: (1) Bipolar Disorder, (2) Major Depressive Disorder, (3) Obsessive Compulsive Disorder, (4) Paranoid and Other Psychotic Disorder, (5) Schizoaffective Disorder, (6) Schizophrenia, (7) Post-Traumatic Stress Disorder, (8) Anorexia Nervosa, (9) Bulimia.

These Parity laws will also make it easier for people with other illnesses to escape discrimination at the hands of employers and insurers – at least by requiring that insurers cover mental health illnesses other than the ones listed above for at least thirty visits per year.

There has been some grumbling from business groups, sure, but less than we might have expected.  Even Blue Cross Blue Shield of North Carolina said that Parity would only raise its costs by one half of one percent – and it could even save the system money if projected preventative care gains are realized.

Parity is a good thing for mentally ill people on the face of it.   So hurray and congratulations to the committed people who fought for the passage of mental health parity legislation, some of whom fought for decades!   Hats off to you!