Companies are Placing Limits on Mental Health Therapy

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Treatment for mental illness is a major driver of health care inflation and second only to heart disease, according to a new study in the journal Health Affairs. Among mental health treatments, antidepressant drugs known as SSRIs are a big contributor to that cost inflation, the study concludes. Over the last year, pharmacies filled more than $146 million in prescriptions for SSRIs.

These growing costs have led many employers to view mental health benefits as a potential drain on profits, making businesses reluctant to provide health insurance coverage for mental illness.

This might not be the wisest decisions for companies since an estimated 26.2 percent of Americans ages 18 and older, or about one in four adults suffer from a diagnosable and treatable mental disorder.

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Those feeling the pinch the most appear to be state and municipal employees who get their insurance through the Group Insurance Commission, a quasi-state agency that provides mental health coverage for more than 100,000 workers and their families.

Dolores Mitchell, executive director of the Group Insurance Commission, said her agency tightened its rules because mental health insurance rates in some of its employees’ plans jumped 22 percent in the past year. “I don’t think we’ll have savings with these changes, but I think we will put the brakes on increases,’’ Mitchell said. The commission is studying whether its rules comply with federal regulations, she said.

Dr. Rhonda Robinson Beale, United’s chief medical officer, said the recession has forced many of the companies for which it provides coverage to make tough choices. “Our customers are facing downsizing or laying off people,’’ Beale said, “and they’re also trying to maintain benefits for people and trying not to increase their out-of-pocket costs.’’
Lexington psychologist Stephen Schlein said that in the last several months United Behavioral Health reviewers decided to terminate coverage of mental health sessions for three of his patients, including a 21-year-old suicidal college student and a man in his 60s who has terminal cancer and depression.

“In all my years, I have not seen anything like this,’’ said Schlein, a 40-year veteran. He said that he spent hours on the phone fighting to save his patients’ coverage and that ultimately his appeals were successful. But he said he felt so bullied that he will no longer accept new patients with United Behavioral Health coverage.

Meanwhile people who feel they may want good mental health therapy can utilize their companies EAP program or the many affordable clinics in their community that offer sliding scale. Many counselors in private practice use sliding scale fees as well making therapy more attainable to those whose insurance no longer covers them or gives them anonymity.

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