Children's Mental Health Parity Act

Mental-health parity is a vital issue in the battle to remove the barriers to care for the mentally ill. In addition, the history of the Mental Health Parity Act of 1996 is a constant reminder of the difficulties that healthcare advocates face in promoting legislation to ensure patients' rights to treatment.

Mental health has taken center stage as a broad public health concern in the last couple of years. Between 1999 and 2001, U.S. Surgeon General David Satcher issued around six mental health-related reports, which included the landmark Surgeon General's Report on Mental Health. U.S. Department of Health and Human Services and the Report of the Surgeon General's Conference on Children's Mental Health showed A National Action Agenda. The most recent publication was basically a supplement focusing on culture and ethnicity and mental health.

It wasn't just the United States of America that was focusing on the mental health as a broad public health issue. In 1996, the World Health Organization (WHO) also issued a report on the global burden of disease (Murray & Lopez, 1996). It wasn't surprising that the report found that mental disorders are among the most common conditions causing loss of healthy years of life.

Between 15- to 44-year-olds, depression was the second major leading cause of health burden, and self-inflicted injuries, alcohol-use disorders, schizophrenia, and bipolar disorder were ranked among the top 10 illnesses producing significant health burden. Most recently, the WHO focused its 2001 World Health Report on those who had been suffering from mental health. It confirmed what most mental health providers have known for quite some time, like, that mental disorders are common, universal, have significant economic repercussions, and produce negative effects on the quality of life of individuals and families.

The report's subtitle-Mental Health is a New Understanding, New Hope that reflects the new emphasis on mental illnesses as treatable health conditions that are within the mainstream of public health concerns. Among the recommendations in the report was that nations should develop the policies and also the legislation based on current scientific knowledge and human rights concerns. A specific recommendation was that health insurance policies should not at all discriminate against people with mental disorders.

Throughout these reports, there is a consensus that the needs of those who are mentally ill are not being adequately addressed either in the United States of America or globally. In this context of consensus on the need to lower the barriers to treatment for mental illnesses, it is not surprising that a mental health parity bill was introduced by the Congress. It is somewhat surprising, and clearly disappointing, that the Congress ultimately failed to pass it.

On January 1, 1997, the Mental Health Parity Act of 1996 became quite effective, but it included a provision that required it to sunset on September 30, 2001. Thus, the benefits of the 1996 act would cease unless the Congress passed a new bill in order to continue the provisions of the original bill. The proponents of true mental health parity saw this as a major opportunity to strengthen the original act, which had a number of gaping loopholes. The 1996 act required businesses with more than just 50 employees that offer mental health benefits to set the annual and lifetime caps equal to those set for medical and surgical conditions.