Find How Your Insurer Measures Up on Mental Health Parity

But first, delight in the dedication of a bestie who (mostly) understood the assignment.

A new tool is showing where mental health coverage falls short

Most people assume their health insurance equitably covers mental health care — only to find out when they’re in need that it doesn’t. A new index is now showing users exactly where and why those gaps exist.

Last month, The Kennedy Forum, in collaboration with the American Medical Association, Third Horizon, the American Psychological Foundation and Ballmer Group, launched the Mental Health Parity Index. The first-of-its-kind, open-access tool measures how well commercial insurers are actually delivering mental health coverage compared with physical health coverage. 

The index draws on real-time, in-network payer files made available through federal Transparency in Coverage rules. According to the MHPI data, in 43 states, people enrolled in plans from the country’s four largest commercial insurers face measurable gaps in access to in-network mental health and care for substance use disorders.

The numbers are bleak. Mental health clinicians are paid at a rate 16% to 59% lower than their physical health counterparts by the same insurers. The payment disparity drives the provider shortages that patients experience when they go looking for help. For most Americans, this isn’t an abstract problem. Data suggests patients will have less in-network mental health or substance use disorder providers across 7 in 10 counties relative to physical health providers.

When people can’t find in-network care, they’re often forced to make a tough decision: pay high out-of-pocket costs or forgo care altogether. You can use the parity index to view data about your community and learn if, and where, the system is failing. In fact, helping users gain clarity about what their coverage does and does not include is a primary goal of the index’s creators.

That clarity has practical value, and empowers consumers to compare plans, understand where access may be stronger or weaker and ask better questions — whether choosing coverage during open enrollment or while hitting walls with a plan they already have. If your insurer isn’t covering mental health care the way it should, the index can put that experience in context.

Too often, the gap between what users anticipate and what they experience isn’t a fluke but a documented disparity. The index offers concrete evidence to support appeals after coverage denials, submit a grievance or push back when coverage doesn’t match what you were led to expect.

The Kennedy Forum also invites individuals and families to directly help enhance its content. “Data is important, but it’s even more powerful when paired with real people’s experiences,” says Nathaniel Counts, Chief Policy Officer for the organization.

If you’ve been denied coverage, struggled to find an in-network provider or been forced to pay out of pocket for care your insurance should have covered, your story can help inform policymakers with the power to change these systems. Share it here: thekennedyforum.org/approach/patient-education/tell-us-your-story.

Just about anyone can get a GLP-1. For people with eating disorders, that’s the problem

Behind the hype for GLP-1s, which have rightfully transformed the treatment of metabolic conditions and obesity, a quieter crisis is unfolding. People with disordered eating are taking the drug — and ending up in treatment centers and hospitals. 

For people living with eating disorders like anorexia and bulimia, the danger is very real. Appetite suppression, which makes GLP-1 drugs so effective, makes them destabilizing for people whose recovery depends on rebuilding a relationship with hunger.

“These medications do the same things that actual anorexia does,” Wendy Oliver Pyatt, co-founder of the eating disorder treatment platform Within Health and the treatment center Galen Hope, told The Washington Post.

The scale of the problem is only beginning to come into focus. Rebecka Peebles, vice president of adolescent medicine at Monte Nido, a national eating disorder treatment provider, says that the rate of usage of the drugs is rising. Her team encounters at least three patients a day struggling from using GLP -1s — prescribed not for diabetes but for weight loss. Others developed disordered eating patterns only after starting the medications.

A perspective article in the New England Journal of Medicine estimated that more than 420,000 people in the United States could develop an eating disorder with long-term use of these drugs.

Compounding the problem is GLP-1s’ remarkable accessibility. Anyone with a credit card — teens included — can go online, misrepresent their weight and health history, and receive a prescription within days, sometimes hours.

Stevee Williams, 27, ordered Wegovy through an online platform after falsifying her stats. “I just wanted to be smaller,” she said. Williams, who had been diagnosed with anorexia at 17, stopped taking the medication before it produced results but says the feeling of control it gave her felt familiar and frightening.

For AJ Jasper, a 40-year-old social worker in Chicago who has battled anorexia for nearly three decades, the consequences were devastating. After purchasing GLP-1s through various apps without ever seeing a doctor, he dropped 50 pounds in just a few months, leading to triple organ failure. He has since returned to a healthy weight, but says plainly, “Anyone with an eating disorder should stay far away from these medications.”

Beyond online platforms that could use more restrictive processes to prescribe the drugs, medical organizations whose members treat patients with obesity and dietary issues recommend that physicians thoroughly screen for eating disorders before prescribing GLP-1s. Doing so could prevent harm to vulnerable patients before it occurs.

Still, providers emphasize that no screening protocol replaces specialized, trauma-informed treatment that addresses the psychological roots of disordered eating, not just its physical symptoms. Until that standard of care becomes the rule rather than the exception, the culture that made GLP-1s a phenomenon will continue to put the most vulnerable patients at risk. 

In other news…

Women weren’t born to do invisible labor, even if our societal norms say otherwise. Mental load — the unseen, exhausting work of tracking schedules, delegating tasks and keeping all lives in a household running smoothly — has traditionally been heaped upon women. Long-held myths claim that women are simply wired for the work of multitasking due to their gender. But “the research doesn’t show that,” sociologist Leah Ruppanner told NPR. “What it shows is that none of us can multitask.” Studies also disprove the common and frustrating misconception that men can’t see household mess,  since they rate room cleanliness equally to women. Besides debunking harmful myths with concrete evidence in her new book, Drained: Reduce Your Mental Load to Do Less and Be More, Ruppanner also offers research-backed tools to empower women and men to reclaim vital headspace.

How exactly does that work? Ruppanner suggests starting with a simple audit, categorizing everything you’re carrying mentally into buckets like life organization, emotional support and individual upkeep. From there, identify what drains you and what replenishes you. “You cannot, every day, pull your mental load into deficit,” she says. “You need to have some energy.” Don’t consider how to do more things more efficiently. Focus on doing what matters and let go of the rest. If you feel like an audit might take too much time right now, Ruppanner’s even created a quiz — the Mental Load Measurement — so you can quickly check where your mental load is heaviest.

The evidence is clear: good mental health doesn’t begin in a therapist’s office. Shiloh Kantz knows this through her work as executive director of the Oklahoma Policy Institute, an independent nonprofit dedicated to equitable, evidence-based policy that works for all Oklahomans. As Mental Health Awareness Month wraps up, she urges us to widen our lens — because the conditions in which people live matter just as much as their access to quality clinical care. “Stable housing, fair wages, accessible health coverage, and well-resourced schools all create conditions that give people a better chance of maintaining their mental well-being,” Kantz writes in The Journal Record. 

Living without those basics, she argues, feeds chronic stress that promotes mental and physical illness — one that “no amount of ‘self-care’ can fully offset.” Policymakers would therefore do well to build and sustain the systems that promote well-being for everyone, rather than focusing so intensely on individual experiences. Good policy which ensures that people have what they need to survive is proper mental health work, too.