Parity for mental health.

Byline: The Register-Guard=

Oregon hasn't been a trailblazer in mental health reform, but "better late than never" sounds pretty good right now to Oregonians with group insurance who need treatment for mental illness.

On Jan. 1, the new mental health insurance parity law took effect, making Oregon at least the 25th state to require health insurers to provide mental health coverage on equal terms with coverage for physical illness. Such laws vary widely from state to state. Although late to address the issue, Oregon's law is among the most comprehensive in the nation.

In addition to using a broad definition of mental illness that incorporates most of the disorders catalogued in the latest edition of the "Diagnostic and Statistical Manual of Mental Disorders," Oregon's law also covers "chemical dependency" - addiction to drugs or alcohol.

The definitions are crucial for establishing covered conditions, but the law has left it to the insurance industry to decide which treatments will be authorized for any specific illness. That's sure to spark conflict as patients seek reimbursement under the terms of the parity law.

The advent of mental health insurance parity is a big step toward removing the stigma long associated with mental illness. The brain is an organ just like the heart, but that otherwise obvious fact has only recently made a difference in discussions about access to treatments and equality in insurance coverage.

Everyone stands to gain from the recognition that access to care im- proves outcomes for any kind of illness, mental or physical. An estimated 22 percent of adults suffer from a diagnosable mental disorder every year.

Comprehensive mental health insurance stands a decent chance of reducing overall spending on mental illness because seriously ill patients would not be forced to discontinue life-saving medication or treatment when they reached arbitrary caps in coverage. Continuous coverage could keep these patients from suffering a crisis that prompted a trip to the emergency room, or worse.

Suicides alone account for more annual deaths worldwide than homicide or war, according to the World Health Organization. Mental illnesses such as bipolar disorder have a higher mortality rate than some forms of cancer.

The parity law is a welcome and important advance, but it only applies to the one-third of Oregonians who are covered by private group insurance. It doesn't affect people covered by individual health insurance policies, self-insured companies or the staggering 600,000 state residents who have no health insurance at all.

The new law also will have to undergo what's likely to be a contentious shakedown as insurance companies and patients battle to define crucial elements such as "medically necessary" treatments.

Hard work remains as insurers develop definitions for what constitutes equivalent treatment. But Oregon has taken a vital and compassionate step forward in its recognition that illness is illness, whether it's mental or physical.