On April 10, SCH was proud to send a representative to Congressman Peter Roskam’s office (US House of Representatives, Illinois’s 6th district) to discuss the value (financially, morally and otherwise) of providing people with mental health treatment. This topic is of particular importance in today’s political environment given the movement to overturn The Affordable Care Act and more specifically the discussion around eliminating what is referred to as “Essential Health Benefits” in some insurance policies. The discussion was initiated by Nancy Meier Brown, President of Meier Clinics Foundation, and we were joined by representatives from Timberline Knolls Residential Treatment Center, NAMI DuPage, Northwest Community Healthcare and Linden Oaks.
What we all know is that healthcare today in this country is a complete mess. With total spend at nearly 20% of our GDP and with a system that is fragmented, unorganized and full of waste, what we have today is unsustainable and we all deserve better. A system that is more fully integrated, more organized and measured based on its results is what we believe is the long term solution. What many don’t know, apparently, is that some don’t feel like mental health deserves the same treatment as other illnesses and diseases, as if disease of the brain somehow isn’t on the same level as disease, for example, of the heart. Though we all know someone who has been touched with one form of mental illness or another (from depression to substance use disorder), the fact of the matter is many still don’t feel these diseases deserve the same level of compassion and treatment that other diseases have received for decades. Maybe it is because of stigma or maybe it is because of the ignorant belief that mental illness is often a “poor choice” rather than an unavoidable disease. For those of us in the room with Congressman Roskam last week, frankly we simply do not understand why or how we are even discussing eliminating mental health benefits given what we know and see every day, and what the data and literature all support. Yet the conversation is happening, and that is why we were there last week. To plead a case that needs to be plead.
Hopefully in an attempt to support our case, we were asked at the meeting to present the Congressman with some facts as to why it makes sense to continue to fund mental illness treatment. Though to us this is intuitive and we don’t see cardiologists being asked to make the case for why heart disease treatment should be covered by benefits, the data he asks for exists, and we will of course oblige him with his request. That said, this is yet another wake up call for all of us that our world of caring about those who struggle with behavioral health issues is under utter attack at the moment. The parity law is great, but there is no parity, and things appear to be getting even worse.
Some of the data we will be presenting is as follows.
First of all, proper treatment works. For major depression, panic disorder and obsessive compulsive disorder rates (of improvement) are about 70%. This is comparable to rates of improvement for people who suffer from physical disorders, including diabetes and asthma at 70-80%, cardiovascular disease from 60-70% and heart disease at 41-52% (12).
The National Institute on Drug Abuse estimates that every dollar invested in addiction treatment programs yields a return of between $4 and 7$ in reduced drug related crime, criminal justice costs and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1! (13).
The US Department of Health and Human Services estimates that for every $100,000 invested in treatment for substance use (measured in California, New York and Washington), there are savings of $484,000 in health care costs and $700,000 of crime costs were shown to be avoided. (14) In a comparison of medical expenses of Medicaid clients who received treatment, the following savings were noted (measured in Washington): $170.00/month for patients receiving inpatient; $215/month for those in outpatient treatment, and $230/month for those receiving medication assisted therapy (specifically methadone). In California treated patients have been shown to reduce ER visits by 39%, hospital stays by 35% and total medical costs by 26% (14).
Just by integrating medical and behavioral services, The National Council for Behavioral Health estimates that between $26-$48 billion can potentially be saved!
Thanks to Nancy Meier Brown for including us in this discussion, and thanks to the Congressman for taking the time to meet with us. Clearly there is a lot of work to be done, and it will be done. We have no choice. Our patients and their families deserve every ounce of time we can devote to advocating on their behalf. Please join us in the fight.