Report Highlights Shortfalls Of Mental Health Coverage.

A new report by the U.S. surgeon general on mental health can be a tool to push for federal legislation that creates parity between mental health care and general health care, the head of a mental health-care association said.

Pamela Greenberg, executive director of the American Managed Behavioral Healthcare Association, said she hopes the surgeon general's report results in increased availability of mental-health services. The Washington-based association of nine managed behavioral health-care organizations provides coverage for more than 100 million people needing mental health and substance-abuse services.

Surgeon General David Satcher's report, which was released Dec. 13, revealed that nearly two-thirds of people with diagnosable mental disorders don't seek treatment, with lack of insurance being one of the reasons.

The report states that private health insurance is generally more restrictive in coverage of mental illness than in coverage for bodily illness, partly because insurers fear coverage of mental-health services costs more, reflecting long-term and intensive psychotherapy and extended hospital stays.

They also were reluctant to pay for long-term hospital stays that were guaranteed by the public mental-health system, the provider of "catastrophic care." These factors encouraged private insurers to limit coverage for mental-health services, according to the surgeon general's report.

If insurers are concerned about runaway costs for mental-health care and substance-abuse treatment, it's no longer a valid concern with the advent of managed behavioral health care, Greenberg said.

"That's why we came to the health-care scene. Because costs were escalating and people were being overtreated," Greenberg said. "It used to be that you received a certain amount of treatment whether you needed all of it or part of it. We make individual assessments of what people need to make sure there is not overtreatment."

Some private insurers refuse to cover treatment for mental illness, and others limit payment to certain services, the report said.

Those offering coverage imposed financial restrictions, such as separate and lower annual and lifetime limits on care, per-person and per-episode of care and separate and higher deductibles and copayments.

As a result, people paid out of pocket for a higher proportion of mental-health services than for general health services and faced catastrophic financial losses and possibly transfer to the public sector when the costs of their care exceeded the limits.

Greenberg said the report was calling for parity between mental health and general health care. "Whatever the limits are for general health care, they should be the same for mental health care," she said.

Currently, 27 states have mental-health parity legislation. Greenberg said her group would lobby Congress and use Satcher's report as a lobbying tool to push for federal mental-health parity legislation.