People who struggle with mental illness continue to face barriers at every turn, according to Sue Abderholden, executive director of the National Alliance on Mental Illness (NAMI) of Minnesota. “The current health care system for children and adults living with mental illnesses continues to this day to discriminate against people needing mental health treatment and supports to achieve wellness and recovery.”
Abderholden explains that, “If mental health treatment is covered under private insurance, what is covered is variable.” She adds that, “Few private plans cover the model mental health benefit set which is included under MA (Medical Assistance) and MinnesotaCare.” Furthermore, it is not yet clear how components of the Affordable Health Care Act designed to ensure equity and parity will be implemented.
Curious to learn more about NAMI and how health care reform and changes in Medical Assistance may impact people with mental illnesses? Want to take action on policies that impact the rights of those living with mental illness? Join the National Alliance on Mental Illness of Minnesota (NAMI Minnesota) and Twin Cities Media Alliance this Saturday, Sept. 8, at 1:00 p.m., to find out what you can do. You’ll also discover how to use new media tools, especially Twitter, to connect and advocate more effectively. This Get Connected! event will take place at St. Paul’s Merriam Park Library. As at all Get Connected! events, light appetizers will be served. This community meeting is free and open to the public, but space is limited and reservations are encouraged. http://www.eventbrite.com/event/4101947034/efblike
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At this point, says Abderholden, “People continue to struggle with obtaining insurance coverage, particularly with non-quantitative treatment limits and medical necessity.” For now, Medical Assistance remains the only option for many children and adults living with mental illness. “Mental health treatment is not currently mandated for self-insured plans.”
This is a problem because more than 40 percent of insured Minnesotans are covered by such plans. “Companies that self-insure can legally not cover mental health and substance abuse treatment,” said Abderholden. In addition, individual plans, under Minnesota law, can exclude coverage for mental health treatment. This affects nearly another eight percent of Minnesotans, meaning that close to 50 percent of the state’s insured population may not have access to needed mental health treatment.
Discrimination exists even under Medical Assistance, notes Abderholden. For example, under the MA-TEFRA (Tax Equity Fairness and Responsibility Act) program, children with mental illnesses are held to a different standard than those with disabilities. This results in far fewer families with children who have a mental illness being able to access the program to receive services their children need to remain in the home.
Because there is typically nowhere else to turn for help besides publicly funded programs like Medical Assistance, maintaining and improving the system is vital.
Abderholden points out that, “great progress was made in 2006 and 2007 in expanding coverage for effective treatment and supports, and in expanding access by increasing rates for mental health providers.” However, during the past two years, NAMI has witnessed the state legislature and various departments at the state level making drastic changes to Medical Assistance programs. These changes, she says, “have significantly negatively impacted people with mental illnesses and thus greatly reduced people’s ability to access needed supports to live well in the community.”
NAMI’s executive director adds that, “The most detrimental changes are ones made to the Nursing Facility Level of Care (NFLOC), the PCA (Personal Care Attendant) program, and the CADI (Community Alternatives for Disabled Individuals) program. Changes to these programs will or have already resulted in countless people with mental illnesses being tossed out of programs that provide the in-home supports they need to live at home in their communities.”
Whatever lies ahead, certain populations are likely to experience more impact than others, says Abderholden.
“Even before these changes, we have seen poor outcomes for children and adults with mental illnesses—70 percent of youth in the juvenile justice system have one or more mental health diagnoses, over 25 percent of our prisons and 60 percent of our jails are filled with people with mental illnesses, more than half of those who are homeless have a mental illness or chemical dependency, and over 500 people die every year in Minnesota due to suicide.”
The bottom line, in Abderholden’s view, is that, “the current Medicaid program isn’t totally working for people with mental illnesses and it will only get worse. The only time NAMI has witnessed significant positive changes to the mental health system was in 2006 and 2007 with the passage of the Mental Health Initiative, where we used MA funding for specific services that had evidence to prove their effectiveness and that were designed to explicitly meet the needs of people with mental illnesses.”
NAMI Minnesota is a non-profit organization dedicated to improving the lives of adults and children with mental illness and their families. Through education, support and advocacy, it promotes the development of community mental health programs and services, improved access to services, increased opportunities for recovery, reduced stigma and discrimination, and increased public understanding of mental illness.