The uncertainty in health coverage continues to grow, so does the spotlight on mental health care. 1 in 5 Americans have a mental health disorder. Mental health conditions are the most expensive medical condition in the U.S., costing over $200 billion a year. Adding to the concern of mental health is its correlation with substance abuse.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that Americans with mental health disorders are twice as likely to report a substance abuse issue compared to the general population, with a total of 8.9 million Americans living with co-occurring disorders.
Depending on the person, mental health may pre-date the substance abuse or the other way around, making it imperative that each person seek specialized treatment to determine how both mental health and substance abuse affect one another.
There is no generalized prescription or plan of care that can be labeled as a “cure” for those who suffer with mental health and substance abuse. Each person’s methods of treatment and ongoing care is different. While one plan of care may lead to recovery for one person, it may worsen another’s condition. For instance, a psychiatrist treating a patient’s anxiety disorder may prescribe anti-anxiety medication. If the patient has been known to suffer from substance abuse or an addictive disorder, there is a risk of abusing the same drug prescribed for the anxiety which would only create further mental health and substance abuse issues.
The unique circumstances surrounding those with both mental health and substance abuse disorders requires comprehensive rehabilitation. The sad reality is that only 7.5% of Americans with co-occurring disorders obtain treatment.
For those that do seek treatment, some of the most effective methods to recovery are cognitive and behavioral therapy, dialectical behavior therapy, interpersonal and family therapy, prescription medication, and ongoing counseling and psychiatric care. These methods require a variety of professionals including but not limited to psychiatrists, counselors, general physicians, specialized physicians, nutritionists, and life coaches.
Treatment for the co-occurring issues can become complex and expensive. Currently the Affordable Care Act (ACA) requires most health insurances, including all of those sold on the Marketplace, to provide coverage for 10 essential benefits, including mental health and substance abuse disorders. In addition, it requires compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) where mental and substance abuse coverage cannot be more restrictive than medical and surgical coverage. Medicare and Medicaid also currently provide a variety of covered services for mental health and substance abuse disorders. While the ACA began a journey towards expansion of these services, the future of the ACA is unstable.
The passing of the American Health Care Act (AHCA) by the House has raised concerns regarding continued coverage. The AHCA would eliminate the federal requirement to cover the 10 essential benefits including mental health and substance abuse services and instead would refer to the states to make the determination of what is required in health care coverage. The AHCA would also cut $839 billion of funding to Medicaid over the next 10 years. These changes create concern over the future of treatment. However, nothing is finalized at this point. The AHCA still has hurdles to jump before becoming law. The AHCA will head to the Senate where any changes made will then send it back to the House and then back to the Senate before heading to the President.
The provisions in the AHCA, and/or any other health care legislation, will determine if and how Americans receive treatment. While the future is unclear we can assume the need for mental health and substance abuse treatment will continue as will the concern over coverage. Contact us today for more information.