CAPITOL HILL REPORTCongress Acts To Create Parity For Coverage Of Mental Illness
Volume 16, No. 2, Spring 2008
CAPITOL HILL REPORTBy Congressman Bill Delahunt
The recent tragic teen suicides on Nantucket bring to light a serious health issue that roughly 54 million Americans and their families are dealing with–mental illness.
Perhaps one of the largest factors playing a major part in preventing an estimated two-thirds of the mentally ill from getting the treatment they need is the discrimination that continues to be associated with this disease.
It is a tragedy that, because of this, many continue to suffer.
It is important that we address this issue and that is why I was a proud supporter of H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act. This legislation was passed by the House of Representatives by a vote of 268-148 last month. The Senate passed its own version of this bill back in September and the differences between the two acts were being resolved as this was written.
This landmark proposal, authored by Congressman Patrick Kennedy (D-RI), would establish mental health parity and end the disrimination perpetuated by the insurance companies against those suffering from mental illness or substance addiction.
According to the Congressional Research Service, private health insurers often provide less coverage for mental illnesses than for other medical conditions.
Historically, health plans have imposed lower annual or lifetime dollar ceilings on mental health coverage; limited treatment of mental health illnesses by covering fewer hospital days and outpatient office visits; and increased patient’s share of costs for mental health care by raising deductibles and co-payments.
This lack of parity reflects insurers’ concerns that mental disorders are difficult to diagnose and that mental health care is expensive and often ineffective.
However, the 1999 Surgeon General’s report on mental health concluded that mental illnesses often have a biological basis, just like many other traditional medical conditions. It also found that most mental disorders are treatable.
However, if mental illnesses are left untreated, these conditions cost our country a staggering $550 billion annually. They also take a devastating toll on families, communities and millions of individuals for whom the lack of adequate insurance remains the sole barrier to obtaining necessary care.
The U.S. Surgeon General reports that one in five Americans–children as well as adults–suffers from a mental or brain-based illness. It is imperative that every child deserves the chance for a healthy start in life, including treatment for physical or mental conditions. Without the availability of adequate care, the ability of children who suffer from mental illnesses to learn and succeed in school is negatively impacted to a major degree.
This legislation specifically requires group health plans to offer mental health and substance abuse benefits equal to their medical and surgical benefits. The measure would extend to all Americans the same standard of coverage as that enjoyed by their Members of Congress, and would bar insurers from charging higher deductibles, co-payments, and out-of-pocket expenses than for standard medical care, or imposing restrictive limitations on the length of mental health treatment received.
It is time that the Congress takes long overdue action on the issue of mental health parity. I am hopeful that legislative differences between both versions of this proposal will be resolved and it will soon be signed into law as we finally address the stigma of care faced by those suffering from mental illness and substance abuse.
Eating Smart By Debra Gibbons, R.D.
Ever hear anyone say “if it tastes good it must be bad for you?”
Most of the time they are talking about a food or meal that is high in either fat or salt, which are the lazy ways to season food. Many people have gotten used to eating salty foods at restaurants and from eating a lot of convenience foods. Now take into consideration that there is ever-growing evidence that highly processed foods are contributing to many health problems. So isn’t it time to start making changes in what you plan and prepare to feed yourself and your family and friends.
If you’re seeking the right guidelines to help you eat healthier, look no more. The DASH eating plan, which is the result of a National Institute of Health study, can help you lower your sodium intake while increasing your potassium, magnesium, calcium and fiber intake.
DASH stands for Dietary Approach to Stop Hypertension and it can reduce your risk of high blood pressure, stroke and heart disease.
The DASH eating plan recommends limiting your intake of sodium to 2,300 mg daily, which is almost half the amount most Americans consume. The basic plan provides 2,100 calories and recommends consuming two to three servings of fat free or low fat milk or milk products such as cheese or yogurt; six ounces of lean meats, poultry or fish; four or five servings of nuts, seeds or legumes; lots of whole grains; plus four or five servings each of fruit and vegetables. At the same time, limit your saturated fats and concentrated sweets.
Of course, the number of servings would vary with the calorie level, particularly the amounts of fat and sweets.
You probably will need to make some changes in your current food choices. For instance, you may have noticed that this plan is abundant in fruits, vegetables and whole grains. Check out what fruits and vegetables are in season and gradually increase your intake of them and drink adequate fluids.
Learning to season your food while limiting the amount of saturated fat and sodium will take some experimenting. Be creative. Using fresh herbs and spices along with various salt-free seasoning blends is an easy way to enhance the flavor of a food. And it’s far better for you than adding a lot of salt and high fat cheese to jazz up a dish.
The DASH plan has some interesting recipes to start you in the right direction as well as sample meals and snacks.
To get more details go to www.nhlib.nih.gov and click on health information and publications and scroll down to DASH eating plan or call 301-592-8573 to order the booklet.
(Ms. Gibbons, a Registered Dietician and Certified Diabetes Educator, provides outpatient nutrition medical therapy at Cape Cod Hospital.)
It’s a clubhouse. But a clubhouse with a purpose. They call it Baybridge. It’s in Hyannis.
And on June 20 the folks are staging their annual fund-raising concert on the village green, 11 a.m. to 9 p.m. It’s called Localfest. And it also has a purpose. Two of them.
The event serves to raise donations and awareness for the clubhouse, but it also encourages local musicians by giving them performance exposure.
The first such clubhouse, Fountain House, was established in New York in 1948 and the concept has spread to where there now are over 320 such establishments worldwide.
The Fountain House model provides a social intervention in community rehabilitation for people who experience mental illness. At Baybridge, they follow this model of psychosocial and vocational rehabilitation; assisting their members to gain access to work-valued roles.
Founded here on the Cape in 1987, over the years Baybridge has helped hundreds of individuals as part of a network of services offered by the Department of Mental Health through its auspice agency, the May Institute.
A clubhouse is a place where people are regarded as members, not patients or clients, and it relies on the skills, talents and strengths of those members to function. Members and staff work side by side and share responsibility for all everyday operations.
The clubhouse “day” is designed to mirror a normal work setting, operating from 8 a.m. to 4 p.m. Monday through Friday. This work-ordered day engages members and staff in six working units.
The philosophy here is based on the belief that work is a key factor in rehabilitation to lead a successful, productive life.
Participation in the clubhouse is totally voluntary. Supported by the clubhouse community, members have the opportunity to direct and work towards their vocational and personal goals at their own pace. Baybridge stands as is a place for friendship, hope and community that offers assistance and support for the Cape Cod residents in their recovery.
Employment is both the building block and the goal of the clubhouse model. Meaningful work first is considered a step towards recovery wherein members can return to engage in gainful employment as productive members of their community. This generally takes place under a three-step program: Transitional Employment, Supported Employment, Independent Employment.
There are no barriers to enrolling in the Baybridge program. They accept referrals from health care providers, hospitals and the DMH as well as family members and friends who feel their loved ones need help. The number to call is 508-778-4234. Or potential members can even self-refer just by walking through the door at 278 Main Street.
Baybridge is open 365 days a year. They run an active social program six evenings a week. Saturdays are social trip days and Sundays are all about brunch and reading the Sunday papers. Just like the rest of us.
By Denise Dever
Your dad’s neighbor just called to tell you that your 79-year-old father sideswiped his parked vehicle and nearly hit a child standing nearby. Was it an isolated slip-up or the sign that it’s time for your dad to think about giving up his car keys? And how do you begin the discussion about such a potentially volatile subject?
Sensitive issues like this prompted my company to launch a public education campaign called the “40-70 Rule.” This program is designed to help adult children begin to address difficult issues with their parents such as driving, finances, independence and even romance. The 40-70 Rule means that if you are 40, or your parents are 70, it’s time to start the conversation about some of these difficult topics.
The campaign is based on research conducted in this country and Canada by Home Instead Senior Care, which revealed that nearly one-third of adults in the United States have a major communication obstacle with their parents stemming from a continuation of the parent-child role.
Because of this obstacle, adult children may wait until an emergency or crisis to begin talking to parents. The 40-70 program provides practical tips for adult children to initiate these conversations before they’re faced with such dangerous situations as misuse of medications, self-neglect and accidents.
The core of the program consists of a free guide of conversation starters for sensitive senior-care subjects. It is available free from the local Home Instead Senior Care office. The guide was compiled with the assistance of Jake Harwood, Ph.D., national author and communication professor from the University of Arizona who is the former director of that school’s Graduate Program in Gerontology.
Dr. Harwood says that starting conversations early is particularly important for end-of-life issues such as power of attorney and wills.
“All conversations should be broached with care,” he adds, “And it’s crucial to begin these conversations assuming ‘if’ rather than ‘when.’ Many older adults continue to drive safely as they age. So personal circumstances should determine how much discussion needs to occur.”
In general, the Home Instead Senior Care survey found that Boomers have the most difficulty talking with their parents about independence issues, such as continuing to live in their own home, and that their parent’s desire to remain independent makes it challenging to address such sensitive issues as health and money.
This can be particularly difficult if the parents still platy a supportive role in their grown children’s lives.
(Ms. Dever is president and local co-owner of Home Instead Senor Care of Centerville, which provides non-medical support services for the elderly. They have developed a free conversation-starter booklet and complementary Web site (www.4070talk.com) to help adult children learn these techniques. Home Instead may be reached at 508-778-8613, 1-877-257-3124 or dmdever@capecod.com.)