December 20, 2013 • By: Pamela Hyde, Administrator, Substance Abuse and Mental Health Services Administration
This week a new study reported that nearly one in five American adults experienced a diagnosable mental illness in 2012. Of these tens of millions of Americans, less than half (41 percent) received any mental health services in that time.
Among the reasons for not receiving help were not being able to afford the costs and fears of what their friends and family would think. Given that half of all Americans experience mental illness at some point in time in their lives, it is very likely that we are their family or friends.
Yet, stereotypes and discrimination against people with mental illnesses persist, sometimes resulting in devastating consequences.
This year, the Administration has made clear that mental illness should no longer be treated by our communities – or covered by insurance companies – differently from other illnesses.
Recovery from mental illness and addiction – through access to medical and other treatments and supports – should be the expectation in America, not the exception. The goal of recovery includes improved health and a productive life without addiction or the disabling impacts of mental illness. It is made possible by medications, counseling, rehabilitative services, stress and relapse management, self-care and mutual aid, and other services and supports. The concept of recovery does not negate the fact that an addiction, or for some a mental illness, can be a lifelong condition to be treated and managed over time.
The Affordable Care Act and new parity protections are expanding mental and substance use disorder benefits for about 62 million Americans—making treatment more affordable and accessible.
In the past, it was legal for insurance plans to treat these behavioral health disorders differently than medical and surgical needs. Now this double standard will no longer be allowed.
Under the Affordable Care Act, uninsured Americans can shop for and enroll in health plans that meet their needs and budgets in the new Health Insurance Marketplace. Those plans must cover 10 categories of essential health benefits, including hospitalization, prescriptions, and mental illness care.
For the 85 percent of Americans who already have health insurance, the law is strengthening it with new protections and benefits. Insurers must now cover preventive services, such as screenings for depression and alcohol abuse, as well as behavior assessments for children – at no out-of-pocket cost.
The health care law allows young people to stay on their parent’s plan until age 26. Ages 16 to 25 is when mental illness is likely to emerge and is a critically important time for young adults to have health coverage. Already an estimated 3 million young adults have gained insurance because of this Affordable Care Act provision.
These changes are potentially lifesaving for people like Yashi Brown , who was diagnosed with bipolar disorder at 24. She says she now realizes she was experiencing symptoms for years before that, but she never got help. Then a concerned taxi driver called the police when he saw her on the street talking to herself in a severe manic state, after a brief disappearance from loved ones.
“Wow, there’s a name for this,” Yashi later remembers thinking. With diagnosis and treatment came hope. But she adds, “It was a double edged sword because I was ashamed. What does this mean for me, and my future?”
With strong emotional and financial support from her family, Yashi was able to reach recovery. Today, she speaks publicly around the country, using spoken poetry and prose to spread the word to hospitals, support groups, and the general public that there is hope and recovery. Her treatment is ongoing—as she notes, recovery is a journey, not a destination.
While Yashi was fortunate that she had family support, she – like so many with mental illness – wanted to be independent.
As Yashi says, “To constantly think about how you can’t afford your own care is extremely demoralizing.”
Recently, she’s decided to open up her healthcare options and begin looking for plans through a state-run Marketplace.
The Affordable Care Act and parity law are helping people like Yashi find affordable health care coverage. But we have more work to do to end other forms of discrimination–the stereotypes and negative attitudes–that still prevent people from getting help. We can move beyond the idea that mental health is just about somebody else. It affects all of us. And we all can have a role to play in making things better.
Earlier this year, President Obama called for a national dialogue on mental health to let people know it is okay to talk about mental illness and to ask for help.
The Administration launched MentalHealth.gov to help people find easy-to-understand information about the basic signs of mental health problems, how to talk about mental illness, and where to locate help. In addition, the Substance Abuse and Mental Health Services Administration supports a range of prevention, medications and medical care, and recovery support services.
We all can spread the word that treatment works and that recovery is real. Each of us also can take steps to find help for ourselves or others who need it.