m of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious e

Many health plans discriminate against millions of Americans with mental disorders by limiting mental health and substance abuse healthcare by imposing lower day and visit limits, higher co-payments and deductibles and lower annual and lifetime spending caps.

From a clinical standpoint insurance is a huge obstacle. In psychiatry in general there are limits to insurance coverage which could hinder a patients treatment. An insurance company that would not limit the number of days a person with diabetes can get treated in a year asks someone with a mental illness to pay out-of-pocket for days not covered.

The National Mental Health Association (NMHA) and its local and state affiliates support comprehensive health insurance parity legislation, which would ban these practices by requiring the same health insurance coverage for mental disorders as physical disorders.

A biologically based mental illness is any mental or nervous condition caused by a biological disorder of the brain that results in a clinically significant syndrome that substantially limits the persons functioning; specifically, the following diagnosis are defined as biologically based mental illnesses as they apply to adults and children: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anorexia nervosa, bulimia nervosa, and drug and alcohol addiction.

But, coverage for biologically based mental illnesses continue to be different and separate from coverage for other illnesses, for purposes of determining deductibles, benefit year or lifetime durational limits, co-payments and coinsurance factors.

According to the National Association of Anorexia Nervosa and Associated Disorders, only a handful of states specifically name eating disorders in their parity law, which forces insurances companies to recognize both physical and mental illnesses as being of equal importance.

Unfortunately, there are still over a dozen states that have no parity law whatsoever, and even those which do still tend to favor physical over mental health concerns.

To date, 34 states have made into law some form of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious e

al illness to pay out-of-pocket for days not covered.

The National Mental Health Association (NMHA) and its local and state affiliates support comprehensive health insurance parity legislation, which would ban these practices by requiring the same health insurance coverage for mental disorders as physical disorders.

A biologically based mental illness is any mental or nervous condition caused by a biological disorder of the brain that results in a clinically significant syndrome that substantially limits the persons functioning; specifically, the following diagnosis are defined as biologically based mental illnesses as they apply to adults and children: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anorexia nervosa, bulimia nervosa, and drug and alcohol addiction.

But, coverage for biologically based mental illnesses continue to be different and separate from coverage for other illnesses, for purposes of determining deductibles, benefit year or lifetime durational limits, co-payments and coinsurance factors.

According to the National Association of Anorexia Nervosa and Associated Disorders, only a handful of states specifically name eating disorders in their parity law, which forces insurances companies to recognize both physical and mental illnesses as being of equal importance.

Unfortunately, there are still over a dozen states that have no parity law whatsoever, and even those which do still tend to favor physical over mental health concerns.

To date, 34 states have made into law some form of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious e

e following diagnosis are defined as biologically based mental illnesses as they apply to adults and children: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anorexia nervosa, bulimia nervosa, and drug and alcohol addiction.

But, coverage for biologically based mental illnesses continue to be different and separate from coverage for other illnesses, for purposes of determining deductibles, benefit year or lifetime durational limits, co-payments and coinsurance factors.

According to the National Association of Anorexia Nervosa and Associated Disorders, only a handful of states specifically name eating disorders in their parity law, which forces insurances companies to recognize both physical and mental illnesses as being of equal importance.

Unfortunately, there are still over a dozen states that have no parity law whatsoever, and even those which do still tend to favor physical over mental health concerns.

To date, 34 states have made into law some form of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious e

ational limits, co-payments and coinsurance factors.

According to the National Association of Anorexia Nervosa and Associated Disorders, only a handful of states specifically name eating disorders in their parity law, which forces insurances companies to recognize both physical and mental illnesses as being of equal importance.

Unfortunately, there are still over a dozen states that have no parity law whatsoever, and even those which do still tend to favor physical over mental health concerns.

To date, 34 states have made into law some form of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious e

m of mental health parity. Several have enacted laws that require insurance parity only for a small set of specified diagnoses or serious mental illnesses, however. These laws discriminate against children and adult whose illnesses can be as disabling as those specified in the laws, but do not fit neatly within the statutes’ criteria.

Adults excluded from protection under these laws include those who have multiple personality disorders, anorexia nervosa and bulimia, post-traumatic stress syndrome, and substance abuse disorders. Children with serious emotional disturbances and substance abuse disorders are also excluded. Therefore, NMHA advocates for inclusion in laws all disorders listed in the Diagnostic and Statistical Manual of Mental Disorders—IV (DSM-IV).

The laws in three states can serve as models for legislation other states that are either considering the issue for the first time or are considering revising their existing parity law. These states are Vermont, Maryland and Connecticut.

In 1996, Congress passed the Mental Health Parity Act (P.L. 104-204), which made it unlawful for companies with more than 50 employees to set annual and lifetime dollar insurance limits for mental health care (unless the same dollar-limits apply to medical and surgical care). Many employers and insurers violated the spirit of that law, however, by placing other restrictions on mental health benefits, such as limits on the number of covered outpatient office visits and number of days for inpatient care.

Repeated legislative efforts in Congress to close these loopholes have won broad bipartisan support. President Bush at one time expressed support for, and pledged to push for enactment, of parity legislation, but has not renewed that call. Congressional leaders have blocked efforts to bring an expanded parity bill to an up-or-down vote, however, and Congress has instead simply kept the 1996 law in force, through a series of one-year extensions.

This year, Reps. Jim Ramstad, R-Minn, and Patrick Kennedy, D-R.I., have introduced the Senator Paul Wellstone Mental Health Equitable Treatment Act, H.R. 1402, a measure that would require employers with more than 50 employees to provide comprehensive mental health and substance-use parity. While a parity bill has not been introduced this year in the Senate, Sens. Pete Domenici, R-N.M., and Edward Kennedy, D-Mass., who sponsored parity legislation in the last Congress, continue to work on this issue behind the scenes with an eye to passing a bill this year.

Until parity laws become enacted and effective in every state, mental health patients continue to be victimized twice -- once by the devastating disorder, and then again by a health insurance system that is not equipped to handle these complex and m