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Seeking solutions for mental healthcare coverage in the U.S.

The status of mental healthcare coverage has been discussed among lawmakers and advocacy groups for many years. While instances of untreated mental illness leading to tragic consequences have appeared before the public’s eyes several times in past decade, the Sandy Hook Elementary School travesty two weeks ago was a wakeup call of sorts to many. Making mental health resources, treatment and counseling affordable for Americans – especially government workers – needs to happen now.

Where coverage stands
Many federal and state lawmakers are pointing to the Mental Health Parity of 1996 and Addiction Equity Act of 2008, which require group health plans to ensure financial requirements and treatment limitations for mental health and substance abuse disorders. The acts call for conditions to be no more restrictive than those provided for other medical and surgical benefits.

Because of these advances, roughly 68 million Americans will have access to mental health and addiction treatment, states former representatives Patrick Kennedy from Rhode Island and Jim Ram of Minnesota in an opinion piece for Politico.

“Furthermore, these services, which have been misunderstood and marginalized for so long, will finally be fully integrated as part of a comprehensive approach to healthcare,” they explain.

Neglected mental illness disturbs employee focus and motivation, which severely impacts work output and quality. These untreated disorders and conditions cost the country $105 billion in lost productivity every year, reports USA Today.

The Scope of Mental Illness
The foreseeable coverage numbers seem reassuring, considering more than one-quarter of adults in the United States experiences a mental disorder and roughly 22 percent of those cases are deemed “severe,” according to the National Institute of Mental Health. That means nearly 6 percent of the country’s adult population experience severe mental illness. The institute found in 2005, only 36 percent were receiving mental healthcare treatment, while only 12 percent of people with disorders were covered.

Another more recent survey of employers, including government agencies, reveals a stark contrast in numbers. The Society for Human Resource Management’s “2012 Employee Benefits Research Report” found 85 percent of U.S. employees receive mental healthcare benefits.

Looking ahead: The example of Missouri
State and regional employers are still addressing mandated changes in their healthcare provisions for teachers, firefighters, law enforcement professionals and other public workers. Lawmakers are grappling to find a balance between expanding coverage and keeping costs down.

The Missouri Department of Mental Health (DMH) recently released its goals for the next five years. “Strategic Directions: 2013-2018” explains how it aims to improve medical and behavioral services, put a greater focus on preventative measures, strengthen employment opportunities for residents facing mental health disorders and boost trauma-informed care.

While these goals seem promising, Missouri currently only has seven state-operated psychiatric facilities for adults. In addition, the state’s mental healthcare provisions received a national grade of C by the National Alliance on Mental Illness.

Consider medical homes to cut costs and widen coverage
While Missouri is behind B-level states Massachusetts and Connecticut, it has experienced positive results from one type of mental health services. Health homes for patients with chronic conditions currently serve 36,000 high cost insurance recipients, according to the DMH report.

“Preliminary data regarding health outcomes and cost savings are positive,” it states.

Medical homes and wellness clinics continue to grow in popularity throughout the country. In these facilities, physician teams provide comprehensive and continuous care to a group of people, strengthening doctor-patient relationships.

A study by the Group Health Cooperative found transferring employee care to medical homes can reduce emergency visits 29 percent and drop hospitalization rates by 11 percent, reports Healthcare Finance News. Incorporating mental health provisions into medical home systems and wellness clinics may just be the right prescription for governments trying to increase coverage with limited funds.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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