March 19, 2007

Kennedy V. Kennedy On Mental Health Parity

There are two mental health parity bills before Congress. One is authored by Sen. Ted Kennedy, the other by his son, Rep. Patrick Kennedy. The basic difference between the two bills is that Patrick's would cover alcohol and substance abuse treatment while his father's would not. You can read the New York Times article and decide which you prefer.

As much as I think mental health care and treatment is a disaster on every level, I fully support parity legislation. If someone wants to follow society's push to medicalize mood and feeling and behavior, then I don't think they should receive lesser coverage than for other physical ailments. Mental health care is already unfair enough without adding an inequitable financial burden to patients.

That said, I find it amusing that the article omits an reference to Patrick Kennedy having bipolar disorder or his Ambien-induced driving adventure last year. The article also ignores Ted Kennedy's alcohol-induced auto accident--you know, the one that killed an aide in the 1960s--much less his long history of alcoholism. The article also ignores that Ted's sister, Rose, was mentally ill herself and had a botched lobotomy which left her institutionalized for much of her life. She died in 2005.

Leaving out such context is, well, very interesting. But, then, the rich are very different from you and me.

Posted by Philip Dawdy at March 19, 2007 12:25 AM
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Comments

I'm sure you're being ironic, since it's apparent the rich are not at all different from you and me, being equally subject to the prevalence of mental illness. OK, there's one difference - they are unlikely to end up homeless* or dependent due to inability to pay for adequate treatment or inability to work. I too support these important bills.

May I request that we not qualify mental illness by comparing it to the metric of "other _physical_ ailments"? The main objection that insurance companies have had is that many symptoms of mental illnesses are self-reported and not 'physical' in nature (even as the mountain of biological data piles up). The obvious counterargument to this is, so is pain, and that is covered. Of course, the true issue is that parity would cost money.

*[20-25% of the homeless have a serious mental illness, vs. 4% of the general population.- http://www.nrchmi.samhsa.gov/facts/facts_question_3.asp]

Posted by: Keith at March 19, 2007 01:55 AM

I don't know...parity scares me. What happens if there's parity? If the beds in the psych hospital aren't full and they know that patient has insurance and the hospital needs the funds, then what's the incentive to release that patient? I work in a regular hospital, and there's often a scramble to fill the beds because empty beds equal no $$. I just think it's going to encourage psychiatrists to keep patients longer than necessary. I hope I'm wrong.

Posted by: anon at March 19, 2007 06:42 AM

There is just one reason not to have parity legislation.
Mental illness is decided by the( a single) psychiatrists beleifs, not xrays, blood tests or brain scan.

Psychiatry jails their patients, you can call it hospitalization, but it is jail.

When parity happens, many law abiding individual's will lose their freedom due to the beleifs of a single person.

Only criminals should lose their liberty.

Posted by: Mark at March 19, 2007 07:13 AM

Here's the deal folks:

Insurance Parity will not land a person in an empty psych ward bed.

You have basic rights and laws to protect you from being held in a psych ward if you are not ill, and even get a free attorney to make sure that does not happen if you DO get involuntarily committed.

IF a person, like my daughter, who suffered the merry-go-round of misdiagnosis of Childhood Bipolar Disorder; needs to go to one more stay at a psych ward: she can't. Unless I have a credit card, or cash, she won't land in a private hospital; or even a medical hospital's psych ward. Been there done that. Money talks, and maybe no one understands this; for not having experienced it.

Lifetime INSURANCE CAP RAN OUT in inpatient psych hospital days.

She can go have her Chiari malformation MRI'd. She can have her Chiari Malformation of the brain operated on. With insurance coverage.

BUT if she has a psychotic-event; she will reside on the non-insured floor of the County hospital. Oh wait, that already happened for 4.5 months last April through July of 2006.

Parity means to be equal.

Anyone who does not want their mental illness to be paid for by insurance companies to be equal; MUST have a boatload of money to afford to pay for the psych appts., medications, and possible hospitalizations, for their entire lifetime.

There are life-time caps placed on inpatient stays for mental health hospital beds. I think that right there is a discriminatory action by insurance companys.

Good old Teddy; he has received countless letters written by me since 1999.

My daughter's 7th grade math teacher wrote one to him on her behalf; asking for parity.(2001)

That is the year I nearly went bankrupt from paying private hospital bills with savings that was set aside for my kids' college.

Now 2 of my kids are on FAFSA (Government)loans to pay for college; and that teacher?

He wrote the letter when he saw me working 2 jobs and taking care of my daughter who at the time was on a Zoloft withdrawal.

When she had meltdowns at school, and I would have to pick her up; she went to work with me washing the elementary school lunchroom dishes.

Mental illness; if this is going to be classified as a real medical condition, better the hell get equal coverage from my insurance company.

I've been waiting too long for parity to pass.

I bet it still doesn't.

Posted by: Stephany at March 19, 2007 09:09 AM

@ Stephany RE:"you have basic rights and laws to protect you"
Sorry only sane people are eligible. Once you are deemed mentally ill by a psychiatrist you will be lucky to have any rights.

Past Examples are
Rosenhan experiment
http://en.wikipedia.org/wiki/Rosenhan_experiment

ECT
Paul Henri Thomas
http://www.oikos.org/denfeb06.htm

rodney yoder
http://www.raids.org/killer4.htm

http://louisianastatehospitals.com/N1I19.html
"..they crashed thru the back door to take me away. I asked them if I had any "rights" and they laughed saying "No, man - none at all - you see rights are for people who are being arrested but you are being committed."

Posted by: Mark at March 19, 2007 01:19 PM

Well Mark, then tell me why my daughter was shuffled to mental health court once a week for 4 months; had a court-appointed mental health attorney; and due to being a legal adult--that attorney never was obligated to tell me a damn thing.
The one civil liberty right she had removed, [besides her dignity]is the right to own a firearm.

Due to being ITA (involutary treatment act)she had to give up, [if she had one]her gun, or permit to own a gun.

I suppose that removal of her rights to own a hand-gun for protection is for the protection of society from an innocent young woman who now has a background of psychiatric hospitalizations that will most likely prevent her from finding a job, or prevent idle gossip from neighbors.

I don't need to google any examples; I live with one.

I also wonder why gun ownership is removed from a person as a result of an ITA; yet the person still has access to kitchen cutlery and their fists.

Posted by: Stephany at March 19, 2007 02:12 PM

One more thing re: jail comparison to psych wards. I totally agree. I find most of the psych wards (state and county)to feel like jail.
I often heard many inpatients ask (and so did my daughter)"Why have I been arrested? why am I here? have I committed a crime?

One staff said this:

"The only crime you have committed is being mentally ill." [!!!]

My daughter still has nightmares and often asks me if she "has a police record"; due to police presence in psych wards; and security guards checking her in at the State Hospital; and due to the police presence/metal detectors in mental health court: and mostly because she WAS IN COURT.

It has taken me months, and months, to tell her she did nothing wrong, and there is mental health court "for a reason".[and make it sound like it was protecting her civil liberties!]

I hated that place. The patients are treated like criminals there. It feels like court, because it IS court. Those are some of the most regretted days in my life.

Monday morning court dates for 4 months.

Posted by: Stephany at March 19, 2007 02:21 PM

I forgot the most important outrage of all:

My daughter's inpatient psych doc at a private hospital discharged her when her "Lifetime cap" of insurance days ran out.

His discharge plan for admit:

"Return as an ITA; that way I can keep her here longer."

At that point I did not know what an ITA was. I took her to the ER as he instructed (this was her first ITA, as a voluntary patient seeking care).
In was in that ER that my ignorance regarding the system was proven: I had no idea [Sept.1, 2005]mental health court existed.
It was the ambulance crew who told me this:
"We see this all of the time at[that hospital].That doctor uses ITA status to admit teens for lengthy hospital stays."

I was to find out later, through a self-imposed detective-journalist mind-set of research; that this hospital in fact gets kick-backs from the state in payment; and foster kids are the high percentage rate of teens admitted.[$$$]

So yeah, @Mark.
You are right. That psychiatrist removed my daughter's Civil Liberties; as well as other teens, and still does today.

This is a twisted system. I wonder if any of the Kennedy's really do give a shit.

Posted by: Stephany at March 19, 2007 03:49 PM

I'm from a state that's near the bottom when it comes to spending on mental health care. I also happened to be one of the more fortunate folks in that I had health insurance so my 3 stints inpatient were in private psych hospitals. Having experienced what I experienced, I can't blame health insurance companies for not wanting to cover it. It was a complete joke. How much do you bill an insurance company for a scattergories game and call it "recreational therapy?" Once insurance discounted it my 1/2 a game of scattergories (1/2 a game because the psychiatrist came before it was finished) was >$80. Group therapy, if you could call it that, was run by a couple of young women with a high school diploma (no credentials whatsoever). We sat in a group and they asked us, "If you were an animal in a circus what kind of animal would you be?" I mean, come on, insurance should cover this bullshit? If we're talking coverage of a therapy appointment by a licensed professional, okay I will go for that. But the bullshit that goes on these psych hospitals I can't blame them for not wanting to cover it. I can't believe they cover what they do cover.

Posted by: Lisa at March 19, 2007 07:30 PM

I guess I should clarify...
I'm not opposed to medication nor to therapy for those that want/need it. If parity means that people can access treatment, then okay by me. Mental health care in my state is such a mess, I don't know what the answer is really. Who knows...maybe more funds would allow psych hospitals in my state to actually hire people with some creditials. One could hope.

Posted by: Lisa at March 19, 2007 08:12 PM

@Lisa
Who is opposed to medication for those that want/need it?
Who decides that they want and need it?

Posted by: Mark at March 20, 2007 09:35 AM

Lisa,
Here's an example of what you speak about:

Western State Hospital hires staff (that are the predominant caregivers of the patients 24/7)with 2 requirements:
1. High School Diploma
2. 3 weeks of training (which is basic restrain holding techniques to use in case of violence)

They get paid, [last year's stats, per a staff] $9.00 an hour.

NO games there;(Scattegories, etc.).
Staff, on their own dime, would often bring in games and one staff brought in his personal X-Box for the patients.
I would stop at the local Dollar store daily and bring in puzzles, and magazines,etc.

Over a year's time following my daughter from hosp to hosp I bet I have purchased over a dozen chess sets and checkers games.

I've since returned to most of those places and donated games/magazines/DVD's.

High-end hospitals, with private donations funding them have the most qualified and highly paid staff.

Also, this transcends hospitals. I have a 20 year old. She and her friends are all signed on with the State of Washington as respite providers. The state pays out about the 9.00 an hour range for that as well.

I do agree, that sitting and coloring, bead bracelet making, etc. is degrading.

I could go on and on about this, and it appears I have already; so enough said on that.

This lack of insurance though, is WHY I am doing everything in my power (like running down roads) to keep my daughter from entering the legal system that includes bad ass psych wards.

Posted by: Stephany at March 20, 2007 10:33 AM

Mark, I was just clarifying my own position - not wanting to sound like I am opposed to mental health care because I'm not.

Stephany, I hear what you're saying. If parity means that people could more easily access outpatient treatment (and avoid some of the inpatient "treatment" disasters I experienced) then that certainly seems like money well spent. As bad as it was for me as a patient, I can't imagine how scary it is for a child. Your child is lucky to have a mom like you.

Posted by: Lisa at March 20, 2007 01:59 PM

Lisa,
Thank you.
-Stephany

Posted by: Stephany at March 23, 2007 01:02 AM

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