One of the biggest obstacles people face when trying to deal with their mental health problems is stigma.
There is still a lot of shame attached to needing help with one’s mental health, which is absurd. It would be ridiculous and insensitive to tell someone with a broken ankle that their injury is a shameful sign of weakness, and that they should just keep quiet and not seek medical help. But our society often delivers that message of shame to people who are in pain because of psychological conditions such as depression. So a lot of people with mental health problems just suck it up and let their pain go untreated, which is as futile as letting a broken ankle go untreated. Without attention, it will only get worse.
Insurance companies have often cashed in on the perpetuation of this stigma by not taking mental health needs as seriously as physical health needs. For a long time, activists have sounded the alarm about the unfairness of insurance policies that don’t cover mental health treatment at all—or much less generously than physical health treatments.
In response, in 2008 the U.S. Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA), which mandates health insurance plans that cover mental health or substance use disorder treatments to cover those benefits in parity with medical and surgical benefits, without imposing greater restrictions. Earlier this month, the U.S. Departments of Health and Human Services, Labor, and the Treasury issued final rules to implement that law, in addition to other regulations that were issued in 2013.
To me, the newsworthiness of this is that it was even necessary to take such action. A fact sheet put out by the agencies announcing the action said: “The United States of America continues to experience a mental health and substance use disorder crisis. In the almost sixteen years since the enactment of MHPAEA, disparities in coverage between mental health and substance use disorder benefits and medical/surgical benefits have persisted and grown.”
A press release from these agencies says that issuing the rules will help in “achieving the full promise” of that law.
Even when federal legislation is needed to address a problem, as is certainly the case here, I don’t expect that legislation alone to magically solve the problem overnight. Legislation is often a catalyst for cultural change—and cultures can take a long time to change. But it has been a long time since 2008. You would think that, at the very least, we wouldn’t have to argue about the need for fair mental health coverage.
It just goes to show how tenaciously stubborn stigma can be in its perseverance. You can’t just leave it for dead. Sometimes you have to drive a stake through its heart.