DOLORES KONG
New York Times Syndicate - December 13, 1999
BOSTON In the first-ever US Surgeon General's
report on mental health, the nation's top public health official Monday said
that one out of five Americans experiences a mental illness in any one year, yet
the majority of those who need treatment do not seek it.
Hoping this report will do for mental health
what previous surgeon generals' reports have done in raising awareness about
smoking and exercise, Massachusetts mental health officials and advocates Monday
welcomed the 450-page volume as important evidence that mental illness should be
viewed as treatable and covered by insurance the same way physical illness is.
``People pay attention. . .when the surgeon
general speaks,'' said Marylou Sudders, Massachusetts Department of Mental
Health commissioner, who attended the White House news conference releasing the
report. Surgeon General David Satcher ``gives stature to an issue that many of
us have believed in and have worked on,'' Sudders said. ``He has given it this
incredible national platform.''
The report uses the latest statistics and
research to argue that the effectiveness of treatments for mental illness rivals
that of treatments for physical illness, and Satcher joined mental health
officials and advocates in criticizing the lack of parity in insurance coverage
for mental illness around the country.
``Parity calls for equality between mental
health and other health coverage,'' according to the report. ``We have allowed
stigma and a now unwarranted sense of hopelessness about the opportunities for
recovery from mental illness to erect. . . barriers. It is time to take them
down,'' said Satcher in his preface to the report.
More than two dozen states have passed
so-called mental health parity legislation in the last several years, and
Massachusetts is the only New England state that has not yet done so. A parity
bill was approved by the Massachusetts Senate in October and is now in House
Ways and Means, but has met objections from about a half dozen patient advocacy
and civil rights groups concerned about its effect on patient confidentiality.
``Now's the time for Massachusetts,'' said
Sudders, who added that she believes the parity bill as written should pass,
while other legislation should be used to take care of concerns about
confidentiality. ``There's strong support for this bill to pass. I'm hopeful.''
Some groups that support parity in
Massachusetts object to the bill for repealing the state's pioneering
confidentiality law, which limits insurers' access to mental health records.
``We hold back our full support because it is framed in this trade-off
language,'' said Paul K. Ling, a Quincy psychologist who leads the Consortium
for Psychotherapy, which advocates for quality care and is one of the groups
objecting to the bill as written, along with the Andover-based National
Coalition for Patient Rights and other organizations.
Other groups, however, like the Massachusetts
Association for Mental Health, throw their full support behind the bill as
written. ``It's not an issue for me,'' said Bernard J. Carey, executive director
of the nonprofit advocacy group. Insurers say they favor the current version of
the mental health parity bill because it allows them to determine whether a
treatment is medically necessary.
But both Carey and Ling agreed on the
significance of the Surgeon General's report in calling for breaking down the
insurance barriers and removing the social stigma.
The surgeon general's report reviewed hundreds
of studies, many of them published recently, and concluded that while in the
United States, ``mental disorders collectively account for more than 15 percent
of the overall burden of disease from all causes and slightly more than the
burden associated with all forms of cancer,'' nearly two-thirds of people with
diagnosable mental illness do not seek treatment. At the same time, the report
reviewed the scientific literature on the growing effectiveness of treatments
for everything from depression to bipolar disorder (formerly known as manic
depression).
``The science is so good, the treatments are
so well-documented, there's enough there for people to take action and to
discuss,'' said Judith Kurland, New England regional director for the US
Department of Health and Human Services, who reviewed the report put out by
Satcher. ``Usually when the surgeon general issues a report, it's to say,
`Here's what we know, here's the state of the art, here's the action we must
take.' He's pretty clear about saying, `We have to provide parity and coverage,
we have to provide greater access','' Kurland said.
c.1999 The Boston Globe
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