The 2008 Mental Health Parity and Addiction Equity Act pushed insurance companies to cover mental health like other medical treatments. It was a necessary law. For too long, insurance companies have charged punitive co-pays and deductibles for mental health treatments. Yet the law is far from perfect. Its enforcement mechanisms are weak and too many loopholes remain.
Nevertheless, the real challenge with American mental health is not laws or regulations, but perceptions. Because today, fearful of the stigma that still sticks to mental health conditions, too few Americans are seeking treatment for serious health issues.
As the National Alliance on Mental Illness (NAMI) notes, one in five Americans will experience a mental illness, and one in 25 Americans now live with a serious mental illness. But get this: 60 percent of adults and 50 percent of children with these conditions did not seek treatment in 2014.
Racial discrepancies are also at play: African-Americans, Hispanic-Americans and Asian-Americans are two to three times less likely to seek mental health treatment than whites.
Imagine if those statistics applied to physical conditions? There would certainly be many visibly ill and discomforted individuals walking on our streets. As a society, we would not stand for it. We would demand action.
The real challenge with American mental health is not laws or regulations, but perceptions
Still, this is just the beginning of the mental health statistics horror show. NAMI also points out that mental illness has physical impacts on society. Twenty-six percent of homeless shelter residents, and 70 percent of youth in state and local juvenile systems have an underlying mental illness. In addition, 37 percent of mentally ill students aged 14 and older drop out of high school.
In each of these cases, we see the possibility of better lives imprisoned in a mental health abyss. These statistics testify to an ongoing American tragedy.
But at its hardest edge, America’s mental health crisis is also existential. According to NAMI, 90 percent of suicide victims had a mental illness before they took their lives. Suicide is now the third leading cause of death those aged 10-24.
The correlation between mental health treatment and untimely death is transparent. Thus, so is our national responsibility. After all, if reforms could save just 10 percent of these lives, surely they are worth our energy.
So what should be done? A few things.
First and most important, we need a social awakening to mental health. Specifically, we must end the stigma that goes with saying “I have a mental health condition.” As someone diagnosed with obsessive-compulsive disorder, I understand this quandary personally. It is hard to admit to friends — let alone acquaintances — that you have a mental health condition. And in large part, that’s because our society continues to regard mental health as somehow taboo.
That said, there’s a simple way of addressing this issue: discussion. By broaching into the statistics that show how many Americans suffer from mental health problems, and how many lives these problems are degrading, we can bring mental health out of the shadows. Public figures can play a key role here. Just as George W. Bush used his struggle with alcoholism to inspire other sufferers, public figures should be encouraged to come forwards and talk about their own mental health challenges. Former British Prime Minister Tony Blair’s former chief spokesman, Alistair Campbell, offers a stellar example here. Campbell makes frequent high-profile speeches on his own mental health struggles.
The crucial point is that these discussions don’t simply de-stigmatize mental health issues, they guide others to treatment options. And in some cases at least, those treatment options need not be expensive. Whether it’s Alcoholics Anonymous, Narcotics Anonymous or Cognitive Behavioral Therapy, participatory mental health groups improve many lives.
Second, we need to fill gaps in coverage. While the federal government is improving enforcement mechanisms for the 2008 Mental Health Act, we need to make more insurance plans cover more mental health issues.
These discussions don’t simply de-stigmatize mental health issues, they guide others to treatment options
Consumer pressure is the best mechanism for this ambition: there are enough sufferers out there! Autism treatment options for children represent an especially concerning problem. As of December 2015, 43 states and the District of Columbia required insurers to provide autism coverage for children in health plans. But seven other states did not. Republicans and Democrats should work together to close that gap.
The American Medical Association should also prioritize mental health treatments in the same way as its British equivalent. It could, for example, expand grants for psychiatric physicians in training. At present, too few mental health professionals are available. As with primary care physicians, mental health treatment shortages are especially problematic in rural areas.
Third, while we retain our exceptional medical research efforts — critical for developing new mental health pharmaceuticals — we must also ensure that U.S. pharmaceutical companies export their drugs at higher prices. This will reduce cost discrepancies that U.S. consumers pay for mental health focused pharmaceuticals in contrast with Europeans. The understanding here is simple: if mental health related pharmaceuticals are cheaper, more Americans will be able to purchase those drugs to improve their situation. Sadly, Obamacare immorally raises the costs of health care rather than reducing them.
None of this is to say that addressing our mental health crisis will solve every major social issue. We must not assume, for example, that improving mental health treatments would solve homelessness. Regardless, this is a task worth our attention. Just as cancer does not discriminate between Democrats and Republicans, neither do mental health conditions. This issue affects individuals regardless of class, race or creed.
In bipartisan spirit then, we should work together to make things better.
Tom Rogan is a foreign policy columnist for National Review, a domestic policy columnist forOpportunity Lives, a panelist on The McLaughlin Group and a senior fellow at the Steamboat Institute. Follow him on Twitter @TomRtweets.