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Health Insurers Are Still Skimping On Mental Health Coverage

Because of low reimbursement rates, Harbin said, professionals in the mental health and substance abuse fields are not willing to contract with insurers

Health Insurers Are Still Skimping On Mental Health Coverage
November 30, 201710:38 AM ET

It has been nearly a decade since Congress passed the Mental Health Parity And Addiction Equity Act, with its promise to make mental health and substance abuse treatment just as easy to get as care for any other condition. Yet today, amid an opioid epidemic and a spike in the suicide rate, patients are still struggling to get access to treatment.

That is the conclusion of a national study published Thursday by Milliman, a risk management and health care consulting company. The report was released by a coalition of mental health and addiction advocacy organizations.

Among the findings:

In 2015, behavioral care was four to six times more likely to be provided out-of-network than medical or surgical care.

Insurers paid primary care providers 20 percent more for the same types of care than they paid addiction and mental health care specialists, including psychiatrists.

State statistics vary widely. In New Jersey, 45 percent of office visits for behavioral health care were out-of-network. In Washington, D.C., it was 63 percent.

The researchers at Milliman examined two large national databases containing medical claim records from major insurers for PPOs — preferred provider organizations — covering nearly 42 million Americans in all 50 states and D.C. from 2013 to 2015.

“I was surprised it was this bad. As someone who has worked on parity for 10-plus years, I thought we would have done better,” says Henry Harbin, former CEO of Magellan Health, a managed behavioral health care company.


Prescription drug abuse leading to more grandparents raising grandchildren

Opiate Abuse

Their daughter had struggled with being bipolar and borderline personality disorder and prescription drug problems and eventually was unable to take care of her two children.

Prescription drug abuse leading to more grandparents raising grandchildren

By Steffi Lee
Published: November 24, 2017, 1:00 pm Updated: November 24, 2017, 5:49 pm

AUSTIN (KXAN) – The bond between grandparents and their grandchildren is unwavering and Gail Gallagher remembers the day more than a decade ago that feeling grew even stronger.

“The older one took the hand of the younger one and said we’re safe now,” Gallagher said.

It was the day Gallagher and her husband, Dr. W. Neil Gallagher, became parents again. Their daughter had struggled with being bipolar and borderline personality disorder and prescription drug problems and eventually was unable to take care of her two children.

Gallagher said the pair decided to step up for the safety of their grandkids, who are now 19 and 20 years old. She said her daughter’s health condition hindered her from being able to make right decisions for the children.

“There were issues beginning to form which put the children in harm’s way – physically and emotionally,” Gallagher said.

The couple went through months of legal challenges but eventually was able to adopt the kids.

Gallagher’s husband said in an interview he was already preparing to sell his business and both were preparing to move to a lake home before the dynamics of their family changed.

“Love is the action to do the right thing, whether you feel like it or not,” Neil Gallagher said.


SNL’s Pete Davidson says he’s been diagnosed with borderline personality disorder

The 23-year-old comedian said the diagnosis came after a stint at christian centers and several instances of unexplained breakdowns that he initially attributed to his marijuana habit.

SNL’s Pete Davidson says he’s been diagnosed with borderline personality disorder

Thu., Sept. 28, 2017

NEW YORK —Saturday Night Live’s “Resident Young Person” Pete Davidson revealed Monday he’s been diagnosed with borderline personality disorder.

The 23-year-old comedian explained his long-awaited diagnosis came after a stint in rehab and several instances of unexplained breakdowns that he initially attributed to his marijuana habit.

“I’ve been a pothead forever and I started in October, or September of last year, having these mental breakdowns where I would freak out like, rage, and not remember what happened after. Blind rage,” he told Marc Maron on the star’s podcast, WTF with Marc Maron.

Davidson decided to enter rehab to kick his drug habit, which he has previously said eased the symptoms of his Crohn’s disease.

Once in rehab, the doctors began to suspect that it was more than just the drugs causing his breakdowns, and prescribed him medicine to help treat what they thought could be bipolar disorder.

“I got out and then I started smoking weed again, and I’m on meds,” he said. “So I was feeling a little better, so two months go by and I just snapped. I was smoking weed every day, I just snapped and had a really bad mental breakdown. So I freaked out and I was like, it has to be the weed.”

Davidson cut out the pot and announced his sobriety, even filling in the folk at Saturday Night Live in a move that he called “very embarrass(ing).”

But after staying sober for nearly four months, he saw no change in his troubling behavior.

“I still felt the same, I still felt like something was f —up and something was wrong, and I found out I have BPD, which is borderline personality disorder,” he told Maron, explaining that one of his psychiatrists finally delivered the official diagnosis.



A recent CDC report shows that the percentage of adults with serious psychological distress who are uninsured has dropped from 28.1 percent in 2012 to 19.5 percent in the first nine months of 2015.



Look at a map of states president-elect Donald Trump won in November alongside a map of states with the highest rates of opioid prescriptions, and you’ll see they mostly overlap. Look more closely at the data, as one Penn State professor recently did, and you’ll find that Trump outperformed his Republican predecessor Mitt Romney the most in counties where opiate and suicide mortality rates are highest.

It’s little wonder, then, that mental health and substance abuse issues have become a key talking point for Trump, who has promised to crack down on drug cartels and called America’s mass shootings an issue of mental health—not guns.

He’s not the only Republican to adopt behavioral health as a priority. House Speaker Paul Ryan pushed for mental health legislation in the wake of the San Bernardino shooting. Senate Majority Leader Mitch McConnell, whose home state of Kentucky is a leader in opioid deaths, recently penned an op-ed titled “More Must Be Done on Heroin – soon.” And the Republican-authored 21st Century Cures Act, signed into law in December, will set aside $1 billion over two years to fight opioid abuse.

And yet, late last week, Senate and House Republicans set in motion the first steps of a plan that researchers warn could cut mental health and substance abuse treatment off at the knees: the repeal of Obamacare.

“I don’t think there’s anyone in the mental health community who thinks withdrawing the Affordable Care Act would be good for behavioral health,” says Sherry Glied, dean of New York University’s Robert F. Wagner Graduate School of Public Service, who advised the George H.W. Bush, Clinton, and Obama administrations on health policy. “It’s hard to even conceive of how that would be true.”



Trumpcare Will Be Catastrophic For People With Mental Health Issues

Experts in behavioral health and lawmakers who have been fighting for mental health awareness vehemently oppose the legislation.

Trumpcare Will Be Catastrophic For People With Mental Health Issues

House Republicans on Thursday passed an updated version of the American Health Care Act, which could affect the millions of people who live with a mental health or substance-use disorder.

Analysis of the GOP bill by various organizations shows a grim outlook. Not only would people dealing with mental health conditions or drug dependency have to pay higher premiums, many may not even be covered.

This could have serious consequences, with the country in the throes of one of history’s worst opioid epidemics. Drug overdose is the leading cause of accidental death in America.

And, according to experts, if Trumpcare becomes law, it may undo years of progress on behavioral health.

How the bill can affect those with mental illness and addiction

The legislation threatens to gut protections for the majority of people with pre-existing conditions, which could include mental illnesses and addiction. This means the GOP legislation could allow insurers to make coverage more costly for people with existing health issues.

Premiums are likely to skyrocket. A person around the age of 40 with a drug dependency could see increases as high as 500 percent, according to the liberal think tank Center for American Progress. Those with bipolar disorder or major depressive disorder may see a 200-percent rise in surcharges.


Why Aren’t There More Resources for Adult Self-Injurers?

Even getting adults to commit to group therapy can be a challenge. Adults are burdened with more responsibility than adolescents and may have trouble finding the time and effort to make the commitment for their own healing, even when resources are available.

Why Aren’t There More Resources for Adult Self-Injurers?

By Renée Fabian 03/21/17
Over time, self-injury itself can become a habitual, nearly addictive behavior, and 8.7 percent of self-injurers are also addicts.

Erin Hardy, a Wisconsin-based therapist, found herself in a quandary when an uptick of people who self-injured came to her about five years ago. This was a new area to her practice, so Hardy sought consultation with her colleagues on resources, but they came up empty. An internet search left Hardy with unsatisfactory results.

“All the sudden I had this flood of individuals that were engaging in self-harm,” says Hardy. “There is really nothing [online] about self-harm other than the theme of, ‘Anybody who self-injures has borderline personality disorder,’ and … ‘there’s no cure, nobody can get better.'”

Undeterred, Hardy kept searching until she found S.A.F.E. Alternatives, an organization co-founded by Wendy Lader and Karen Conterio in the mid-1980s dedicated to self-injury recovery with the belief, “people can and do stop injuring with the right kinds of help and support.” Through their S.A.F.E. Focus program, Hardy got the training and materials she needed to lead a dedicated self-injury support group in her city.

Today, a similar internet search for self-harm resources yields information focused on adolescents. As one PsychForums member put it, “I have been online searching for several hours today regarding finding help for self-harm, and I’m 40. I have been seeing that it is mostly in young people, and feeling pretty embarrassed and ashamed that I’m an adult dealing with it. I feel like I should have grown out of this long ago.”

The pervasive idea that self-injury is a behavior relegated to emo teenagers is simply false. Self-injury affects 4 to 5.5 percent of adults, yet the stigma persists, leaving millions of self-injurers to struggle in silence and feel invisible.

Defined as intentionally harming the body without suicidal intent through behaviors such as cutting, burning or hitting oneself, self-injury serves as a maladaptive coping skill to deal with difficult emotions, experiences and feeling states.