CHRIS FITZSIMON: Discrimination Against the Mentally Ill Continues
There are good news, bad news, and disturbing news in the continuing struggles of the state's mental health system to meet the needs of patients and families who need help across the state.
The good news is that a group of state lawmakers led by Sen. Martin Nesbitt and Rep. Verla Insko seemed determined to fix the system that has fundamentally failed to live up to the promises of the 2001 reform efforts, leaving families unable to find adequate services and placing the mentally ill in rest homes ill-equipped to care for them.
Nesbitt and Insko co-chair the Mental Health Oversight Commission, and it was the commission's work last year that prompted the General Assembly to invest $100 million in new money in the mental health system -- a fraction of what is needed, but a good start nonetheless.
The commission has been wrestling with a consultant's report that found the system has a long list of problems, including funding needs that the report pegged at more than $2.5 billion over the next five years.
Nesbitt said this week that he thought the real figure was closer to half a billion, but even that is a significant increase in funding, especially at a time when legislative leaders and Gov. Mike Easley are warning that money is tight and education and other human services also are in dire need of more resources.
That brings us to the bad news. Despite the leadership from Nesbitt and Insko, it is still not clear exactly what the needs of the mental health system are. There is the consultant's report, but it is more a list of the problems than a roadmap to a better mental health system.
Nesbitt's frustration is obvious. He told the commission recently that he thought that by now lawmakers would have been presented with a detailed list of the needs of the state, a not too thinly veiled swipe at Easley's Department of Health and Human Services.
The most dedicated legislators in the world can't solve the problem without full cooperation from the Easley administration, and it's clear that Nesbitt and other lawmakers don't believe they have gotten it.
That is bad enough, but the most disturbing part of it all might be that hardly anyone is talking about one proposal that would help immediately, by providing mental health services to people who currently can't afford them even though they have health insurance.
Thirty-seven states now prohibit insurance companies from discriminating against people with mental illness by requiring them to cover treatment for mental illnesses the same way they cover treatment for physical ailments.
Parity opponents continue to insist that it would dramatically increase the cost of insurance and prompt businesses to drop coverage altogether. Others claim parity would cost North Carolina jobs, the standard cry of wolf that is usually employed by much of the business lobby.
There is little evidence to support either claim. Insurance premiums in Maryland increased by less than 1 percent after the state adopted parity legislation. A national study by the Rand Corporation found similar results. State employees have had mental health coverage since 1992 and saw insurance costs decline after it was added.
More funding for the state's mental health system is desperately needed and so is a better explanation of what's missing from the folks who are supposed to be making sure that services are provided. But while that debate rages on, lawmakers could help immediately by ending the legal discrimination against people with mental illness. It is the least they can do.
Chris Fitzsimon is the executive director of N.C. Policy Watch.
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