The long road to mental health parity

April 18, 2023

By Courtney Wise

---

Health insurers still routinely violating parity laws, attorneys say

Rose, 17, struggles with severe depression, anxiety, and suicidal ideation. By age 15, she’d made six attempts on her life before her parents, Michael and Rochelle, were able to secure residential mental health treatment their insurance would cover. (She and her parents are being identified only by their middle names to protect their privacy.) But two months into her stay—just when treatment started working—the family’s insurer refused to cover further treatment. “I was in my office when we got an email that included a copy of the fax denial,” Michael told NPR. “I was shocked.”

Rose’s experience is not unusual. Despite the Mental Health Parity and Addiction Equity Act passed by Congress in 1998, which forced insurers to remove language from contracts that limited treatment for mental health conditions, not much has changed in practice, experts say. 

Insurers still routinely deny families access to mental health coverage and violate parity laws, said Ellen Weber, VP for health initiatives at Legal Action Center. Rather than treat mental illnesses as chronic conditions, other experts said, insurers tend to view them as acute health issues. In the case of suicidal patients, once a person is past an immediate suicidal crisis, insurers seek to move them to less expensive care.

---

“We need a way to tell useful mental health tech from digital snake oil”

That’s the title of a guest column that psychiatrist Tom Insel recently wrote for STAT News. (Insel is a co-founder of MindSite News and a member of its editorial advisory board.) He traces our current consumer protection back to the Food and Drug Act of 1906 – a time when morphine was still being used in “soothing syrups” for infants – and the eventual creation of the Food and Drug Administration. Today, we are in need of an additional regulatory standard, Insel argues – one that regulates digital psychiatric tools.

“Digital mental health is in its ‘wild west’ stage,” Insel writes, “when marketing and scale have trumped rigor and evidence.” Some mobile apps are designed to improve mental health or increase access to professional care. But the sheer volume of options makes it almost impossible for consumers to determine which ones are legitimately helpful and don’t violate their privacy. Insel’s suggestion:  A “shared oversight board” that includes a reliable federal agency working with both industry and consumer groups. 

---

Touch therapy: Filling the need for human connection?

TikTok user Matye Lisbeth went viral online recently for expressing how a lack of touch has affected her mental health. “I feel like I’m dying from touch starvation, y’all. I don’t get hugs. I don’t know. I feel like if I were to get the kind of hug that I f**king really want, I would crumble into pieces,” she said. Her video sparked an internet conversation about the significance of intimacy and physical touch from other human beings in our lives, Essence reports. 

A lack of physical contact can cause stress, anxiety, depression, and increases in cortisol, but touch therapy can bring relief, says Ashley Brodeur, a therapist and yoga instructor. Massage therapy, reiki and acupuncture are among the suggested techniques, as well as self-massage and deep breathing. “Touch can bring you back into your body…and regulate our nervous systems,” she told Essence. “I believe touch can help us increase our capacity for discomfort. As a therapist, I believe many people could benefit from increased touch from safe loved ones. I think that when we invite touch… we increase our ability to connect as humans.”

---

In other news…

Your email does not constitute my emergency. This is the headline of a New York Times op-ed on the need to not be on call 24/7. The author explains that over the course of a year, he found that the phrase “sorry for the delay” had appeared no less than 547 times in his inbox. Being reachable around the clock and feeling pressured to reply quickly to every email, he says, “is a recipe for burnout.” He encourages you to take your time, stop apologizing for a tardy reply and just say “thanks for your patience” when you do write back.

Land reparations may help heal the mental and physical health of people of color, argues Farah Tanis in Yes! Magazine. Citing a 2021 article published in the International Journal of Environmental Research and Public Health on the benefits of exposure to nature, Tanis says that “black land collectives, whether through deeded lands or land trusts, are a remedy for the collective grief from which Black people have struggled to recover.”

Homelessness seems to be increasing in New Orleans, alongside growing concerns for the health and safety of the unhoused and nearby businesses. Jennifer Avegno, director of the city’s health department, told NOLA.com that the community believes the city struggles with more homelessness than other similar cities, but it’s not the case. “We’re actually pretty average. It’s just that they’re very visible, in areas where lots of people go,” she said. “What the city has lacked for years is someone whose sole focus is homelessness.” Now New Orleans has hired Nathaniel Fields to lead its newly formed Office of Homeless Services and Strategy. 

---

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

---

Recent MindSite News Stories