In the early days of mental health care, psychiatric patients were handcuffed and shackled in large, underfunded institutions.(3)(5)
Prior to World War II, mental health care was not covered by insurance.(1)
Only a few years ago before the Affordable Care Act, your insurance company could require preauthorization for doctor appointments, could deny that authorization, and could limit your visits with a mental health care provider.(6)
The onus was (and sometimes still is) on the patient to be healed of her depression, anxiety, mood disorder or addiction in a predetermined number of visits, perhaps three to six, to pay out of pocket, or to cease treatment.
Imagine being compelled to be cured of cancer on a timeline, or risk losing your benefits. Or think of a world where patients with kidney failure can only receive dialysis a limited number times.
“Access to mental health services is one of the most important and most neglected civil rights issues facing the Nation. For too long, persons living with mental disorders have suffered from discriminatory treatment at all levels of society,” stated Representative Patrick Kennedy (D-RI) when advocating for the passage of The Mental Health Parity and Addiction Act (MHPAEA) in 2008.(1)
Read below for the history of mental health advocacy that led to the eventual adoption of mental health parity laws.
A Brief History of Mental Health Care in the United States
1840s - Dorothea Dix lobbies for better living conditions for the mentally ill, persuading the U.S. Government to build 32 state psychiatric hospitals.(3)
Although institutionalized care offered patients easier and better access to mental health care, state-run institutions were often underfunded and understaffed, resulting in poor living conditions.(3)
1908 - Clifford Beers founds the Connecticut Society for Mental Hygiene, later known as the National Committee for Mental Hygiene. The NCMH was the precursor to National Mental Health Association, now known as Mental Health America.(5)
1) A Political History of Federal Mental Health and Addiction Insurance Parity. NIH.gov. Retrieved October 13, 2016.
2) Issue Brief: Parity MentalHeathAmerican.net. October 13, 2016.
3) Module 2: A Brief History of Mental Illness and the U.S. Mental Health Care System. uniteforsight.org. Retrieved October 13, 2016.
4) Landmark victory- The new mental health parity law dramatically expands coverage of mental health treatment. APA.org. October 13, 2016.
5) Our History. MentalHealthAmerica.net. October 13, 2016.
6) Ending Historic Discrimination -- Obama Streamlines Mental Health Care. NewsAmerica Media. October 13, 2016.
7) CMS finalizes mental health and substance use disorder parity rule for Medicaid and CHIP. CMS.gov. October 13, 2016.
8) Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans. ASPE. Retrieved October 13, 2016.