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By Jeffrey A. Lieberman, MD, Special to Everyday Health where the original blog post resides (see below for a direct link)
People with mental illness, including addiction, have long suffered and fought hard for treatment coverage equal to that for medical and surgical care. If you or someone close to you is in need of care for a mental illness, including substance abuse, the Affordable Care Act will finally provide important protections and benefits.
For the first time ever, under Obamacare, millions of Americans will have access to psychiatric and mental health care.
So what does this really mean in terms of treatment coverage for you, your family member, or friend who needs care for a mental illness or addiction?
Core Coverage for Mental Illness
- mental health and substance abuse treatment
- prescription drugs
- rehabilitative and habilitative treatment. Habilitative treatment serves patients with developmental, cognitive, and mental health conditions by helping them learn and keep life skills and functions needed on a daily basis.
- wellness and prevention services
While the core benefit categories are required, the specific care within these categories will differ from state to state. For example, coverage for mental health and addiction treatment other than inpatient or outpatient care, such as crisis services or mental health screening in primary care, will vary depending on where you live. Also, different plans may cover different medications within particular categories or classes of drugs.
Pre-Existing Mental Illness Coverage
A key element of this new law is that patients with mental illnesses and addictions can no longer be denied benefits or have insurance coverage dropped because of a pre-existing mental health issue. In addition, the law prohibits lifetime and annual dollar limits.
Mental Health Services Covered at Parity
The ACA, in combination with the final rule released only last month for the 2008 Mental Health Parity and Addiction Equity Act, are meant to provide equal treatment.
Starting January 1, all new plans, including individual and small group plans and plans offered on the Health Insurance Marketplace, must offer coverage for mental health and substance abuse on par with other types of medical and surgical care.
But even with these broad categories of coverage, plans will vary significantly in specifics, so you should look closely at your plan for exceptions, limitations, and other restrictions, such as visit limitations, out-of-network coverage, or coverage exclusion of specific diagnoses. MORE HERE
Illness that is of a chronic nature has a huge impact on individuals separately, as well as within the context of family systems. Health care systems, being “systems”, have an inability to care for patients on an individual basis. While systems managed health care, impersonal by nature is promoted as cost effective, it increases costs in the long run by not holistically treating the client. Impersonal health care adds to the disassociation patients often experience; for the ill body/mind and subsequent new family/life dynamic, the medical profession, and the possibilities of wellness.
In 1990 I worked with Bear, a 38 year old womyn who had a late stage mastectomy. She was dealing with issues of an altered body, of thoughts of death, her children being motherless, things left undone. During a 10 day group movement based expressive arts residential retreat, she took the opportunity to explore some of these issues. One of her expressions was in the form of a healing ritual. Most of the group stood on one side of a pond, singing the gospel hymn, “Wade on the water”. On the other side, Bear was carried down to the waters edge, wrapped in a blanket, and left there, standing, still wrapped. She slowly undid the blanket and waded into the water, slowly swimming to the other side, where, like a chorus of angels we waited, still singing.
Bear engaged in a method of emotional healing that falls, far, from the “systems” method of health care. Her methodology embraced her needs, hopes and fears in a manner that can only be facilitated in an open, accepting, creative and supportive atmosphere. The waves that she stirred that day in the pond are still going, still rippling outwards, deeply and profoundly on all those who witnessed her wade in the water.
Interesting BBC World Service documentary on mental health featuring stories from around the globe.The Truth About Mental Health
Mad or Sad Duration:29 minutes First broadcast:Friday 31 May 2013
From time to time we all find ourselves in some kind of emotional turmoil. But when do everyday anxieties or unusual thoughts tip over into a mental health problem? And who decides what’s normal, and whether a treatment that works in one country will work elsewhere?
Last October in a village outside of Bangalore, Keshava was dramatically rescued from ten years of being bricked into a room, in his own home. As police knocked down the walls, the young man in his thirties emerged, dishevelled and naked. He’d been locked in a tiny room, without doors or daylight, and was fed through a window. Keshava had become increasingly unwell in his twenties. Unable to cope with his increasingly violent outbursts, or get him the help he needed, his family gradually walled him in.
Stories of mental illness like this are happening all around the world, and in this opening programme Claudia Hammond explores how mental illnesses are treated in different parts of the world. Do we all experience similar conditions and respond to the same treatments? Or are our beliefs about our minds so tightly bound to the culture in which we live, that local solutions provide the best chance of recovery? Claudia visits Cultural Psychiatrist, Dr Micol Ascoli, at Newham’s Centre for Mental Health, who believes that service users’ own cultural interpretations of mental illness are crucial to their recovery.
Children and War Duration: 29 minutes First broadcast: Friday 07 June 2013
It’s a common misconception that children, unlike adults, are so resilient that they can bounce back from the emotional and psychological impact of war and conflict. The evidence contradicts this and world experts in the field warn that, while some children do recover fully from exposure to the horrors of war, others experience long-term mental health problems.
As the war and fighting in Syria continues to claim more lives and destroy many others, Claudia Hammond reports from Jordan on how this latest conflict is exposing yet another generation to the traumatic impact of violence, killing and loss. She investigates what actually helps to alleviate the suffering of these children and prevent a life-time of recurring emotional distress.
From the Al Zatari refugee camp in the north of Jordan she hears about the scale of the challenge facing international organisations like Save the Children. And she meets a group of Syrian mental health professionals from the Arab Foundation for Care of Victims of War and Torture who, as refugees themselves, are running a mass outreach programme, developed by some of the world’s leaders in child trauma at the Children and War Foundation, to teach as many Syrian children as possible, psychological techniques and coping strategies.
Four Walls Duration: 29 minutes First broadcast: Friday 14 June 2013
Solitary confinement is a form of torture that undermines identity and mental health. In “The Truth About Mental Health – Four Walls” Claudia Hammond talks to ex political prisoners about their experiences and how they dealt with living in such inhumane conditions. Advice too from Professor Craig Heaney who works with prisoners in Supermax prisons in the United States of America and psychiatrist Professor David Alexander who has worked with many hostages.
Healing Norway Duration: 29 minutes First broadcast: Friday 21 June 2013
July 22, 2011 has been described as the day Norway cried. After detonating a car bomb in Oslo, killing eight and injuring many more, Anders Breivik took a ferry to the island of Utoya. There, dressed as a policeman, he began a murderous spree, hunting down and indiscriminately shooting young people on the island who were attending a youth camp. Seventy seven people were killed in total, many of them teenagers, and hundreds injured.
This was the worst mass murder in Norwegian post-war history and the whole country was in shock. But Norway used this national tragedy to pioneer new ways of caring for their citizens. Claudia Hammond reports on the ground-breaking new ways Norway has been road testing to deliver psychological and mental health support to those who survived, and to those who lost relatives and friends.
Treatment Gap Duration: 29 minutes First broadcast: Friday 28 June 2013
If you have a mental health problem, where you live in the world makes a big difference to the care you receive. In many lower and middle income countries, three-quarters of people with mental health problems don’t have access to mainstream mental health services. Even in wealthier, developed countries, the figure is close to 50%.
Claudia Hammond investigates some of the alternatives that occupy this ‘treatment gap’.
Psychiatrist Dr Monique Mutheru is one of just 25 psychiatrists in Kenya. In the absence of services to meet the mental health needs of Kenyans, traditional healers and witchdoctors play a crucial role in diagnosing and treating them. Claudia examines a programme which brings health workers and traditional healers together. It provides training for traditional healers to refer their severely ill patients to the clinic and avoid harmful practices that some healers carry out, such as lobotomy and bloodletting.
Even in developed countries like the United Kingdom, where mental health services are freely available, some people with mental health problems feel that the treatments do not help. The Hearing Voices Network provides support to ‘voice hearers’, through support groups, helping them to manage and engage with the voices that trouble them.
Hikikomori Duration:29 minutes First broadcast: Friday 05 July 2013
In Japan hundreds of thousands of young people withdraw from society for years or even decades. They are known as hikikomori and Claudia Hammond travels to Tokyo to discover more about this mysterious condition and why it is so prevalent in Japan.