Mental Health Parity Laws Do Little to Improve Access for Patients

Mental health parity laws have created very little progress, almost none, in enhancing access and utilization of mental health services, according to a new study. There are still many unmet needs in terms of the enforcement of the utilities and alternate access points for mental health care.

In an issue brief published by the Health Care Cost Institute, author Benjamin F. Miller, PsyD, and colleagues examined the impact of the Mental Health Parity and Addiction Equity Act (MHPAEA) on access and utilization of mental health services on patients with depression, bipolar disorder and schizophrenia. The findings reveal that the act has done little to successfully meet the needs of mental health care.

Creation of Parity Laws

In United States, mental health care has always been distinct from physical health care. Mental health has distinct providers and systems as well as a separate treatment by insurance plans. However, insurance plans offered limited visits and little scope for complete treatment, which led to fragmented care, poor outcomes, and unsatisfying patient experiences.

Continued inadequate attention toward mental health treatment led to the passing of the MHPAEA. The act required health insurers to reduce the inequality between mental and physical health care coverage. The new law would largely increase access to medical services by offering benefits for both mental health issues and substance use disorders.

However, the new research led by Miller indicates the state-level parity laws were only somewhat effective to health plan beneficiaries in improving access to and utilization of mental health services.

Effects of Parity Laws

The authors compared the effect of parity laws on individuals suffering from 1 of the 3 most commonly seen mental health illnesses—depression, bipolar disorder, and schizophrenia—who resided in states with weaker parity laws with those residing in states with stronger parity laws.

The preliminary analysis examined the changes in healthcare utilization patterns before and after the implementation of the MHPAEA act on July 1, 2010. Furthermore, they compared the patterns between states with minimal parity against states with more comprehensive parity. The study was divided into “pre-period” and “post-period” and spanned for 2 years from July 1, 2009 to Dec. 31, 2011.

The research studied 3 measures of mental health care utilization over a 12-month period:

• Visits to a psychiatrist,
• Visits to a psychologist, and
• Visits to other mental health care providers.

They found that the post-period measure outcomes were almost equal to the pre-period outcomes.

No Effect on Access to Care

“If the MHPAEA increased access to mental health services, one would expect to see an increase of utilization over time,” the authors explained.

The research confirmed that simply passing the parity act has no significant effect on the beneficiaries’ access to services. It could be either because of lack of enforcement of the act or because of shortage of mental health care services.

“While conceptually, parity made great strides to help those who benefit from mental health care services, our analyses do not show any major differences in state-utilization patterns post MHPAEA,” the authors concluded.