14 Feb Mental Health and Substance Use Disorder: How Are We Doing?
Mental (Behavioral) Health and Substance Use Disorder; How are We Doing?
I wrote about mental health last year and am writing about it again as it is something near and dear to my heart. I am a licensed therapist and although I have not practiced in many years, I fully realize the seriousness of these disorders and how much suffering mental health and substance use disorders can cause to one’s self, one’s family, one’s employer, and more. And while we are slowly hearing more about it, meaning awareness is increasing, we still have a great deal of opportunity for improvement.
In a number of Milliman research studies and reports, it is clear that nationally people are likely not receiving the treatment they need, and if they do it is costing them way more than any treatment for a medical condition. According to the CDC more than 50% of people will be diagnosed with a mental illness or disorder at some point in their lifetime; one in five Americans will experience a mental illness in a given year; one in five children, either currently or at some point during their life, have had a seriously debilitating mental illness; and 1 in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression.
The Bowen Family Foundation engaged Milliman to conduct research to assess limitations to treatment by assessing third party administrative claims. An initial study was completed in 2017 and the most recent in 2019. The study looked at out of network rates for behavioral health and substance use compared to physical health interventions, as well as reimbursement rates. The study clearly showed disparity in out of network rates between physical and behavioral health/substance use, as well as disparity in the reimbursement rates. The greatest disparity occurred between substance use and physical health variables. The report also looked at children’s behavioral health and found even greater disparity for children receiving care. The report concluded that based on these findings, it would appear that compliance by employers and insurance carriers with the Mental Health Parity and Addiction Equality Act (MHPAEA) is not occurring.
In my last report on mental health I listed costs of mental health in the workplace. We know, if left untreated, mental health not only has a financial cost, but a quality of life cost to all involved: employers, employees, family members, and friends. And if we, as employers, are not complying with MHPAEA, why? I also wonder how much we, as employers, know about the cost and quality of behavioral health or substance use care and treatment our employees are receiving. Do you receive any reports showing cost and quality? If so, I would love to hear about that. This is one area that our upcoming project mentioned below will analyze.
The Kansas Business Group on Health has received a 5 year project entitled Path Forward that will focus on behavioral health and substance use treatment. The five focus areas include access to care, tele-psychiatry (mental health), mental health parity, outcome-based measurement, and collaborative (integrated) care. We are very excited about this project and have three large employers that will participate in this project. We will also involve carriers, TPA’s, providers, and other stakeholders. Stay tuned as we proceed with our project. If you want to know more about this project, do not hesitate to contact any of us at KBGH.