VOLUME 30 , NUMBER 5 May 1999
Congress is listening, says Sen. Ted Kennedy
© 1999 Robert Turtil
1999 could be a landmark year for improving the nation's access to mental health services, the senator predicts.
By Sara Martin
Monitor
staff
Thanks to advocacy by APA and other groups, Congress has never been more receptive to improving mental health care in America, believes Sen. Edward M. Kennedy (D-Mass.). And, with the continued support of APA and its members, "this Congress will make the right decisions on mental health for all Americans and their families."
Kennedy, this year's recipient of APA's 1999 Outstanding Leadership Award, rallied the 400 state and provincial psychological association leaders the night before they visited their representatives on Capitol Hill during the March State Leadership Conference. His words met with several standing ovations and enthusiastic shouts of support.
"We have a real opportunity to get [mental health] legislation passed," he said, urging the state psychological association leaders to press their representatives for support legislation that includes what he calls "the four Ps of mental health care": parity, privacy, primary care and the Patient Bill of Rights.
"When you visit your representatives, ask them, 'What are your problems with [these ideas]?'" he said. "We're not going to take 'no' for an answer."
'The four Ps'
Already, advocacy by APA and other mental health organizations has given Congress and the public a better understanding of mental illness and treatment, said Kennedy.
"It's significant, for example, that in the aftermath of the tragic event like the killing of two Capitol police officers in Washington last year, the public discussion has been more about the gaps in our community treatment system instead of knee-jerk responses like, 'We should just lock up all those mental cases,'" he said.
But, while that's a step in the right direction, that understanding must be deeper and access to mental health treatment must be improved, he added. To do so, Congress should support four initiatives:
* Mental health parity. In 1996, Kennedy worked with Senators Paul Wellstone (DMinn.) and Pete Domenici (D-N.M.) to secure passage of the Mental Health Parity Act, which requires health-care plans to provide the same lifetime and annual dollar limits for mental health conditions that they provide for other conditions.
Although that legislation was a victory, said Kennedy, many employers and health plans have violated the spirit of the law by limiting mental health treatment and charging greater co-payments for people who receive mental health services. He seeks to change that by pushing for full parity.
"It makes no sense to restrict effective psychological treatments for people who can genuinely benefit from them," said Kennedy. "Full parity will lead to improved health and lower overall costs and it can be done for less than a 2 or 3 percent increase in premiums."
* Privacy of patient records. Privacy is a particularly sensitive issue for people with mental disorders, he said. "Breaches of confidentiality are used to take away jobs, deny benefits and expose patients to public embarrassment." Kennedy wants Congress to establish nationwide standards stipulating who should have access to medical records and how that information can be used.
* Primary care. Too often primary-care physicians fail to recognize the mental health problems of their patients, said Kennedy. And even when they do recognize the problems, they don't provide enough medication or counseling. At the same time, he said, many people with severe psychiatric disorders have serious physical ailments, but never see a primary-care physician. To help these patients, he called for psychologists to cooperate more effectively with their primary-care colleagues.
"New models of consultation and cooperation in primary-care settings are being developed around the country," he said. "We need to convince managed-care organizations that it's cost-effective to support these efforts."
* The Patient Bill of Rights. This year, Kennedy reintroduced his Patient Bill of Rights legislation, which seeks to prohibit abuses by managed-care organizations. Its protections include enabling patients to sue their health plans for injury caused by plan negligence and to see appropriate specialists and appeal decisions about payment and medical necessity.
(As the Monitor went to press, a Senate committee passed a version of the Patient Bill of Rights legislation written largely by Sen. James M. Jeffords (R-Vt.). That bill allows people in employer-sponsored health plans to appeal decisions that deny them coverage for specific services. Democrats say the bill doesn't go far enough to protect patients because it doesn't make it as easy for patients to sue their health plans as Kennedy's bill would have.)