Mental Illness -- a Treatable Disease

February 20, 1994

For years the nation's health insurance industry has discriminated against people suffering from mental illnesses. These unfortunate people had higher co-payments on doctor visits, shorter hospital stays and lower lifetime limits for hospitalization for their illnesses. Health insurers justified their discriminatory practices by claiming that mental illness was different from cancer, diabetes or multiple sclerosis.

As a result, patients with schizophrenia, manic depression, obsessive-compulsive disorders or chronic depression had to dig into their pockets to pay for medicine, hospitalization or therapy visits that would have been covered if they had heart disease. Many receive no treatment at all and are doomed to non-productive lives of mental torment.

As long as society believed that psychosis was the result of incorrect toilet training and could be corrected with five weekly sessions with a psychoanalyst, these differing levels of reimbursement may have been justified. But as research in neuroscience progresses, the biological origins of mental illnesses are becoming increasingly evident, thus eliminating the historic dichotomy between mental and physical diseases.

Physicians may not know the precise cause of schizophrenia, for example, but they have developed powerful medicines that have proved effective in alleviating many of its symptoms. Numerous studies have shown these pharmaceutical therapies are generally effective between 60 percent and 80 percent of the time, the same rate as with other drugs. The rationale for treating diseases of the brain differently from diseases of other organs in the body no longer makes sense.

The General Assembly is in the process of putting the final touches on legislation ending the deplorable practice of denying needed benefits to the mentally ill. Last year, lawmakers passed legislation mandating that health insurers offer policies including mental health coverage. Claiming the law was vague and contradictory, health insurers used the courts to stymie the new law's implementation. Within the past month, mental health advocates and health insurers compromised on legislation clarifying those ambiguities.

Yet there are still cynics who believe mandating insurance coverage for mental illness is misguided and will result in the squandering of precious health dollars. Considering that medical treatment has been effective in turning people with mental illnesses into productive citizens, nothing could be further from the truth. With the passage of the Health Insurance Parity Act, Marylanders with severe mental illnesses, substance abuse or a raft of psychological disorders will have access to insurance coverage that other sick people in our society have been enjoying for years.

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