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Survey: Most Americans unaware of mental health parity

January 25, 2011

Washington, D.C. — An overwhelming majority of Americans remain unaware of a law mandating equal coverage of mental health benefits by insurance companies, a cause for concern by psychologists at a time when 25 percent of Americans are reported to have a mental health disorder and only a minority are receiving treatment.

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. And only 7 percent of respondents said they recognized the phrase "mental health parity."

Conducted online by Harris Interactive among 2,940 adults in December 2010, the APA survey showed that 29 percent of adults don't know if they have adequate mental health coverage and 45 percent said they are unsure if their insurances reimburses for mental health care.

Signed by President Bush in 2008 and put into effect for most plans on Jan. 1, the Parity Act extends equal coverage to all aspects of health insurance plans—preserving existing state mental health and addiction parity laws while extending protection of behavioral health services to 82 million Americans not previously protected by state laws. The law also requires parity for mental health coverage when provided both in-network and out-of-network and removes the cap on the number of outpatient visits allotted per year (as long as no cap exists for physical health-related visits).

"The implementation of mental health parity is a great milestone in recognizing that mental health care is just as crucial to a healthy life as prevention and treatment of physical ailments," said psychologist Katherine Nordal, PhD, APA executive director for professional practice. "But laws alone have clearly not been enough to put parity into full use. Our survey shows that too few Americans are aware of these new rights and too many people have avoided treatment because of costs. And without that knowledge, people may keep not getting the care needed for themselves or a family member."

More than half of respondents (56 percent) selected cost of care as a reason why they or a family member might give for not seeking treatment. The other commonly selected reasons pointed to a need for improved communications about mental health treatment: not knowing how to find the right professional (42 percent) and not knowing if seeking help is appropriate (40 percent).

Only 8 percent of adults cited stigma as a top reason for not seeking treatment, while an equal number reported their top concern as privacy or confidentiality. The majority of adults surveyed said they agree with parity for various features of mental health benefits coverage, such as equality in co-pays, prescription costs, deductibles, out-of-pocket maximums and limits on hospital days or outpatient sessions.

"Science continues to demonstrate how absolutely the mind and body are connected. Our government has mandated that insurance companies recognize that connection as well and provide for treatment of the whole person, covering physical and mental health care equally," Nordal said. "But it's also clear that we need to communicate more effectively with employers and potential consumers of mental health services so that parity can be fully implemented and people can more easily obtain the services they need."

A summary of the survey findings is available online. See also
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