False Parity between Mental and Physical Health Care; Now Expensive Treatments Will Become a Substitute for Willpower

Article excerpt


For decades, the mental health fields have been fighting for the gold standard in coverage of mental disorders: parity with physical illnesses.

The extension of federal policy was announced by Secretary of Health and Human Services Kathleen Sebelius along with decades-long supporter Rosalynn Carter earlier this month. The new rules combine the intent of the 2008 Mental Health Parity and Addiction Equity Act with Obamacare regulations to yield virtually unlimited mental health care to anyone diagnosed with a psychiatric disorder. If mental health providers diagnose mental illness, co-payments, deductibles and lifelong coverage will be comparable to those afforded patients with diagnosed genuine medical illnesses.

The arguments against such expanded coverage have always focused on its invalidity, unintended social consequences and the costs of mental illness treatment, both drug and talk therapy.

Throughout the past half-century, there has been considerable debate over whether most mental disorders are actually physical, neurological illnesses.

While many critics of equating mental illness with physical illness were unwilling to concede that even the most extreme mental states and behaviors - such as some schizophrenias - were authentic medical illnesses, a substantial portion of the general public infers that everyday problems have the same likely neurochemical link as severe mental illness.

In addition, many people think that psychological problems of children, whether or not they are real physical diseases, are sufficiently poignant to justify being termed illnesses which deserve third-party payments. The exponential increases of diagnoses of Attention-Deficit Hyperactivity Disorder over the past several decades have thus engendered limited criticism.

While a few serious psychiatric-medical disorders (they are not called diseases in psychiatry's diagnostic manual) such as major depression may warrant lifelong coverage, many, if not most, of the hundreds of diagnoses therein surely do not. Merely disturbed patients may be diagnosed as having adjustment disorder, "social phobias" or many of the other catch-all diagnoses. Providing them lengthy and expensive attention and treatment may be a lot of things, but it is not necessary medical support. …