Mental Health Parity January 24, 2011
Posted by alana in Activism, Economy, Health Care.4 comments
I just happened to come across a headline stating “Few Americans Aware of Law Broadening Access to Mental Health Treatment,” and I must confess that I was among the unaware. The article states that, “In a survey recently conducted by the American Psychological Association (APA), 87 percent of Americans said they had not heard of the Mental Health Parity and Addiction Equity Act of 2008, a federal law now in effect for people who have health insurance through a group or employer plan.” The focus is on raising awareness of mental health benefits, which I am all for! But I think what is missing from the “raising consciousness” perspective is an acknowledgment of what parity actually means. It’s not a synonym for equality in the way that we as socialists would use the word equality, meaning “available to everyone.” It is very clear what it actually means from the way it is described by The United States Department of Labor fact sheet for the 1996 Mental Health Parity Act, which preceded the 2008 Parity Law. In fine print at the top of the page, it says,
“The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.”
So, “equal” mental health care means health care that is “no more restrictive” than your regular medical health care. You’ll be forgiven for not bouncing up and down for joy at the thought if, like most Americans, “unrestrictive” or even “adequate” are not words you would use to describe your health coverage.
Right now health care reform is being leveraged as an election campaign issue, and it’s a debate that is framed in very narrow terms that are dictated by conservatives. As Democratic and Republican politicians essentially argue about what is best for the insurance business — requiring people to buy insurance, or keeping “big government” out of it and letting the free market decide who gets health care and for how much — the actual health care needs of ordinary Americans (and their mass support for at least a public option, if not universal health care) are completely marginalized. In this context, the Mental Health Parity Law requiring that mental health care be as accessible as medical health care does not come close to ensuring that people receive the care they need, even if they are aware of the law. (more…)
Toxic Politics vs Mental Health in Arizona January 17, 2011
Posted by alana in Health Care, Mental Illness, Violence.5 comments
A few people have suggested to me that I write about the Arizona shooter who took aim at US Rep Gabrielle Giffords and killed six people on January 8, perhaps as part of a discussion about alienation. The reason I haven’t wanted to do that is because, from a political perspective, I find it so frustrating and hypocritical for the mainstream media to discuss this case as a “mental health issue.”
There is no doubt in my my mind that the shooter, Jared Lee Lougher, is a sick man. And I would be the first to argue that putting more resources into mental health services would reduce crime substantially, both in terms of prevention and rehabilitation. And I wouldn’t argue with the recent spate of articles decrying the stigma against mental illness that prevents the mentally ill from seeking help, and pointing out that adequate mental help is not available to most people in this country anyway. All of those things are true. But in this case, the media rhetoric focusing on the Arizona shooting as an indictment of the mental health system in America serves a hypocritical purpose, and that is to shift the blame away from the unabashed incitements to violence coming from right-wing celebrities like Sarah Palin and Tea Party candidates like Jesse Kelly, who invited his constituents to come and shoot an automatic rifle with him while he was running against Giffords, saying “Help remove Gabrielle Giffords from office. Shoot a fully automatic M16 with Jesse Kelly.” In her insightful article about the politics of hate that created the context for this shooting, Nicole Colson writes: “The shooting in Arizona has demonstrated in the most shocking way how easily the hate-filled rhetoric of supposedly respectable politicians can spill over into violence. Whether it’s the wave of Islamophobia that leads to the stabbing of a New York City cab driver, or a political assault on immigrant rights that turns into actual anti-immigrant violence, or an anti-abortion climate in which doctors can be assassinated as they attend church services, none of these acts occur in a vacuum.” Focusing on Jared Lee Lougher as an individual with specific mental health issues is a way of pretending that this tragedy did happen in a vacuum, allowing the powerful people who build their careers on spreading hate to continue to incite violence without being held accountable. (more…)
Informed Decisions and Women’s Health November 12, 2010
Posted by alana in Depression, Education, Health Care, Mental Illness, Women.1 comment so far
A functioning democracy relies on an educated and informed public who will make reasonable decisions. Not many people would argue with this statement, but at the same time there is widespread belief that people are too stupid to make decisions for themselves so we’d really better let the experts handle things. This is true of politics and economics, which most people have been convinced they know too little about to have an opinion on (even though I would argue that the majority of people have a far better sense of what justice is, and the difference between right and wrong, than anyone in the Justice Department). One field that is generally thought to be the exclusive terrain of experts and never meant to be democratic is medicine – it goes without saying that a doctor who has had years of training will know best what is good for our bodies. Ironically, nobody can actually know what is happening with our bodies better than we can ourselves. I’m not arguing that personal self-knowledge about one’s own body and extensive medical knowledge are congruent – just that more knowledge is better, and an educated patient will be better able to convey what is wrong with them and to participate in a discussion about possible treatments. In mental health care, it almost seems like people believe the opposite principle – that psychiatry is like a magic trick, and if you know too much about the inner workings, then the magic won’t work for you. So, when it comes to our health care – and especially our mental health care – we are expected to be passive recipients of treatment rather than active participants. This is a problem because I believe that a contributing factor to most people’s depression is that they have no control over their own lives – they feel uninformed and helpless to change most things, from political and economic concerns to their jobs and family, to their own physical and mental health. Education is a process of learning that there are geniuses and experts who know what’s right, and if you just do what you’re told then you’ll be alright. Because none of us can know everything about everything, it is necessary to outsource most knowledge to professionals who concentrate on one particular specialization. But this obscures the fact that we can all know enough about most subjects to be able to make informed decisions, and that when we know about more than just one specialized field we are better able to make connections and have a holistic view of how seemingly disparate parts are actually interconnected (like the mind and the physical body, or politics and economics).
The idea of informed decision-making is especially relevant to women’s health, because culturally we are expected to simply endure particular symptoms as a matter of course because they are part of what it means to be a woman. A certain amount of misery just goes with the territory. Even doctors will tell us that a degree of pain, both physical and emotional, is normal and expected. Rather than having a scientific explanation for premenstrual or menopausal symptoms that would allow us to move away from a fatalistic view of suffering, we curse our ill fortune at having been born female. (more…)
