Mental Health Parity Legislation Should Be Reversed Or Modified Because Questions About Mental Illness, Addiction Remain, Opinion Piece Says

Main Category: Mental Health
Also Included In: Health Insurance / Medical Insurance;  Alcohol / Addiction / Illegal Drugs
Article Date: 24 Oct 2008 - 8:00 PDT

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The parity amendment attached to the bailout of Wall Street firms that ensures coverage of treatment for mental illness and addiction should be reversed or modified because it is "likely to open up a Pandora's box for the American health care system," Jeffrey Schaler, a psychologist and professor at American University and executive editor of Current Psychology, and Richard Vatz, professor at Towson University and associate psychology editor of USA Today Magazine, write in a Baltimore Sun opinion piece. The authors write that the measure is "objectionable in so many ways" because the definition of mental illness, the question of whether psychiatric disorders are medical disorders and the nature of addiction still are under "contentious" debate. According to Vatz and Schaler, the parity amendment leaves behind "many valid objections to the whole concept of parity -- objections that have never been satisfactorily answered."

Schaler and Vatz note that the American Psychiatric Association has indicated that more than 50% of U.S. citizens are or will be mentally ill. According to the authors, such an assessment is "virtually unlimited since there is no way to accurately confirm or disconfirm" it. In addition, although supporters of the parity legislation hailed it as signaling the end of the "stigma" associated with mental illness, "they fail to consider that stigmatization is a marvelous negative reinforcer for undesired behavior, some of which is called 'mental illness.'" In addition, Schaler and Vatz state that substance use disorders are "arguably a function of behavioral choices" and because "people can clearly stop or control their addictions through an exercise of free will," they "in no way constitute diseases to which insurance should apply."

In addition, Schaler and Vatz note that mental illness is usually associated with severe conditions, such as schizophrenia, of which less than 1.5% of people labeled as mentally ill are diagnosed. According to the authors, a "more prototypical mental illness" is adjustment disorder, "a name given by psychiatrists to people who have problems in living," which is "hardly worthy of health insurance and an inducement against confronting one's problems and choices."

Schaler and Vatz conclude, "Passing a measure that is objectionable in so many ways is bad enough. Even worse is the fact that such a contentious, scientifically questionable and potentially expensive piece of legislation was passed through the back door" (Schaler/Vatz, Baltimore Sun, 10/23).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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