Carpey: Affordable Care Act de-stigmatizes mental illness, helping millions

Bryce Friedmann has health insurance, but that doesn’t mean she can see the therapist of her choice or even the one who might help her the most with her condition. 

This has been a harsh reality for many patients who deal with mental illness in America. But with the implementation of the Affordable Care Act, previous restrictions on mental health coverage (such as choosing a therapist) will be lifted, expanding options and making treatment more accessible.

According to Healthcare.gov, the website set up by the U.S. Department of Health and Human Services under the Affordable Care Act, the law will increase access to mental health and substance-abuse-disorder services in three primary ways.

First, the law creates the largest expansion of mental health coverage in a generation by covering 62 million more Americans than are now covered.

Second, the new law forces insurers to cover the costs of preventative and early detection screenings, assessments of family histories and consideration of genetic predispositions and environmental factors.

Additionally, insurers are no longer allowed to deny coverage for pre-existing health conditions, which include depression, schizophrenia, anxiety disorders or other mental illnesses.

Many are hoping this will also help erase the stigma surrounding mental illnesses.

Julie Donohue, associate professor in Pitt’s Department of Health Policy and Management, said that there are apparent differences in private insurance coverage between mental illnesses and other illnesses.

“Unequal insurance benefits for treatment for mental illnesses may have reinforced beliefs that mental illnesses are less serious and debilitating than other health problems,” Donohue said.

While private insurers may have never intended to maintain the stigma, they may have inadvertently done so by perpetuating the above notion.

Clare Krusing of America’s Health Insurance Plans, a trade association that represents companies that sell private health insurance, declined to comment when asked about the differences between mental health coverage and other types of coverage.

The World Psychiatric Association, an international organization comprised of 135 international psychiatric societies, released a study in 2006 that outlines legislation in developing countries, such as Malaysia, Sri Lanka and Nigeria, that has allowed mental illness to be treated as a legitimate disease, rather than a foreign concept to be feared and stigmatized.

Friedmann’s insurance only allows her to see therapists with Ph.D.s. She said the therapist she prefers has only a master’s degree.

This leaves her in a difficult position.

Friedmann, a senior applied developmental psychology major, said these limitations have left her to consult with a therapist in Pitt’s Counseling Center. But because of the Counseling Center’s tight schedule, Friedmann said she does not get as much time in appointments as she would like.

According to Tevya Zukor, director of Pitt’s Counseling Center, students undergo a brief screening with the first available counselor upon scheduling an initial appointment. After assessing what the student’s needs are, he or she is assigned to a counselor who specializes in those particular needs.

While Pitt does not plan on changing the policies and practices in its Counseling Center in response to the Affordable Care Act, Zukor said he thinks the legislation will give young adults access to more options of appropriate levels of care when they are not using the University’s services.

“[The Affordable Care Act] will help de-stigmatize mental illness in its accessibility to younger people,” Zukor said.

President Barack Obama’s push for universal health care may result in an improvement for Friedmann by expanding access to mental health coverage. By removing limitations and making detection and treatment available on a broader scale, the Affordable Care Act will open up the conversation about mental health and treatment options.

Other provisions of the Affordable Care Act allow for the coverage of children on their parents’ plans until they are 26. This is a relief for Friedmann, who said she would otherwise be scrambling to make ends meet to afford any insurance that would cover her mental health care expenses.

Friedmann said she believes that if the Affordable Care Act had been in effect when she was younger, her illness could have been diagnosed earlier.

“I wish that it was in place when I was younger,” Friedmann said. “It would have been great had somebody seen my personal statistics of predisposition to mental illness and made it a point to check in every now and then.”

Write Julia at juliacarpey@gmail.com.