In any given year one in four Americans will experience a mental illness or substance abuse disorder. Mental illnesses are brain disorders characterized by disruptions in thinking, moods and/or behavior. Substance abuse disorders result from the inappropriate use of alcohol, prescription drugs or illegal drugs. Up to 50 percent of the mentally ill population also has a substance abuse disorder. Given the intertwined nature of mental health conditions and substance abuse disorders, the healthcare community frequently uses the term “behavioral healthcare” when referring to the treatment of mental illnesses and substance abuse disorders.
Behavioral health conditions are no different than physical illnesses, like cancer, in that appropriate treatments and supports are necessary to help people cope with the symptoms of their illnesses and to help them lead fulfilling lives. One differentiating factor is that mental illnesses generally have a longer recovery time than physical illnesses. Behavioral healthcare can be complicated given that many individuals have a dual diagnosis of a mental illness and substance abuse disorder, but successful treatments exist for most conditions.
While progress has been made, obstacles remain in the quest to provide optimal behavioral healthcare. Over time, care for those with mental illness has shifted from more institutionalized settings to more community-based settings. Touted as a more humane way to treat patients, deinstitutionalization has resulted in a shift away from longer inpatient stays to shorter outpatient care. Yet for some individuals, longer term inpatient care is often what is needed, but the system is no longer set up to handle people who are either treatment resistant or who have more intensive needs.
Further complicating treatment for those with behavioral health conditions is the fact that employers and insurance companies have historically provided less coverage for behavioral healthcare than for physical illnesses. Higher co-payments and deductibles as well as stricter limits on treatment for addiction and mental illnesses have been the norm for the insurance industry for decades.
Fortunately, this is changing. In October 2008 federal legislation was signed into law requiring equal coverage of mental and physical illnesses. Most group health insurance plans that offer mental health benefits in their insurance plans are required to cover mental illnesses – such as major depression, bipolar disorder and schizophrenia – as well as substance abuse disorders on the same terms and conditions as other illnesses. While few provisions of the recently passed federal health reform law specifically address behavioral healthcare, the law will undoubtedly impact the behavioral health field.