Some Good News for Mental Health Parity

The New York Times reported on Friday that the administration has issued new rules that will ensure mental health coverage for more than 140 million people.

In general, under the rules, employers and group health plans cannot provide less coverage for mental health care than for the treatment of physical conditions like cancer and heart disease.

Insurers cannot set higher co-payments and deductibles or stricter limits on treatment for mental illness and addiction disorders. Nor can they establish separate deductibles for mental health care and for the treatment of physical illnesses.

This law is named for the late Sen. Paul Wellstone (D-Minn.) and Sen. Pete Domenici (R-NM), both of whom are great advocates for mental health and who worked together for quite some time to get mental health parity passed.

It’s comforting to know that come July 1, there will be more of a safety net for Jim and myself. We won’t expect surprise hospital bills in the mail like we did this month for a hospital visit that happened more than a year ago! We’re still trying to figure out why we got the bill, but suffice it to say that since the visit had to do with a mental health issue, the insurance company decided we should bear more of the brunt of the bill.

Unfortunately, the rules do nothing for the millions more who are still uninsured or who can’t work because of their mental illness. Remember, this rule affects those who are employed at organizations with 50 or more employees. It also doesn’t apply to the individual marketplace, which is still something like shopping for coverage in the wild west.

Now can we have health care?

What Can Happen When Mental Illness is Ignored

I came across a fascinating piece about mental hospitals and the role conscientious objectors to WWII played in exposing the deplorable conditions of said hospitals.

The story focuses on Philadelphia State Hospital, also known as Byberry. More than 3,000 conscientious objectors, or CO’s, were assigned to work at mental hospitals across the country instead of being drafted to fight overseas. What the men assigned to Byberry found were conditions that seemed like something out of a Nazi concentration camp. They also witnessed much abuse from the attendants who were hired to care for the patients.

The “incontinent ward” was what the men called A Building. It was a large open room with a concrete slab for a floor. There were no chairs. There were no activities, no therapy, not even a radio to listen to. So hundreds of men — most of them naked — walked about aimlessly or hunched on the floor and huddled against the filthy bare walls.

Nearby was B Building; it was called the “violent ward” or the “death house,” because angry men sometimes violently attacked one another. In one room, rows and rows of men were strapped and shackled to their bed frames.

The story also includes photos from Charlie Lord. A CO who sneaked a camera into the hospital to document the things going on there.  Check out the slideshow. Lord and the other CO’s featured in the piece were instrumental in improving conditions for mental health hospitals all over the country. They even got a skeptical Eleanor Roosevelt to pay attention to the issue.

According to Steven Taylor, a professor of disability studies at Syracuse University, Roosevelt assumed these were photos from some institution in the South. She said she knew about those kinds of conditions in Mississippi or Alabama. When told that they had actually been taken at an institution in Philadelphia, Roosevelt then promised to support the reform campaign and wrote about what she’d seen to government health officials and journalists.

I can’t say I have much experience with state mental hospitals, but I do have experience with the psych wings of two hospitals. Jim has been hospitalized twice for his bipolar disorder.  I’m glad that the conditions at these hospitals was nothing like what is documented in the NPR story, but I was moved when reading it as I’ve become more sensitive in the last couple of years to mental illness.

The story is a good reminder of what can happen when we forget about our most delicate citizens. It should also serve as a wake-up call to America and Congress to increase funding for mental health hospitals and institutions. At a time when states are facing massive budget shortfalls, it is imperative that resources for these hospitals are kept intact.

Another Byberry is completely beyond the realm of possibility, especially as more and more mental hospitals are forced to close.

The health care reform deal that will be hammered out next week must include increased funding for the states so they can keep their mental hospitals open and so they can provide high quality mental health care to those in need of it most.

Finding Happiness at Halloween: Lifting the Veil off Mental Health

(cross-posted from The Bilerico Project)

Halloween is my partner Jim’s favorite holiday. He loves it more than Thanksgiving and more than Christmas. Around this time of year, it’s not uncommon for our apartment to smell of baked pumpkin seeds and hot cider infused with mulling spices. Indeed, fall is when Jim seems to be the happiest.

But what if that which normally brings happiness and joy fails to do so? How do we reclaim that feeling? What if the only way to feel happiness seems to be only through unhealthy means?

I have been asking myself these questions because I have been helping Jim reclaim that feeling about Halloween. This holiday season has been a little bittersweet since it has arrived on the heels of a mild manic episode. As he has been coming down, he has become almost nostalgic for the time when he wasn’t in treatment and when his mania seemed to run wild.

Halloween is a perfect holiday to feed that mania as revelry and mischief are in the air and all around us. Jim’s drug regiment and treatment, however, preclude him from indulging too much in that revelry and this has caused some anxiety for us both.

According to Jim, being manic is like having the best “high” he can ever hope for. He feels invincible, special, sexy, creative, fun…and happy. In short, being manic for Jim is sort of fun, the subsequent crash notwithstanding. He craves happiness and joy the way we all do, but in his case (and, I presume, in the case for many who have experienced mania) joy in its most potent form has only been discovered while manic.

Happiness is a drug that makes us feel great so I can understand why Jim would want to get back to a place that seems to provide ample amounts of it. My struggle has been to help him find other sources of joy that do not involve a manic high. Recently, we talked about which aspects of Halloween make him happiest. The costumes are certainly at the top of his list.

But then there was the drinking, the parties, the sex…the drinking. These are all fun, to be sure, but doing these things whilst manic has in the past resulted in blackouts and questionable behavior. For Jim, drinking was fun, but not when it involved him disappearing for hours or when he couldn’t remember where he was. And the forceful downward swings that it often caused were not fun for either of us.

We have slowly realized together that his illness has forced us to redefine what fun is and what makes us both happy. We are still in that process and this Halloween will certainly be a test, but I am confident in him. He is more stable than ever before in his life and his outlook is generally positive.

His laments over his mania are just that, laments, and it is important for me to remember that he is still human and, like all of us, he just wants to have fun and be happy.