Some victories fought on behalf of patients with mental illnesses take years to win.

One cause for celebration has been the passage of a national “parity” bill to end discrimination in insurance policies, which offer far less adequate coverage for psychiatric illnesses than for other medical illnesses.

True parity should be a moral imperative guaranteeing equal insurance treatment for all illness at both state and national levels.

Many individuals and organizations, including the American Psychiatric Association and the National Alliance for the Mentally Ill, have worked for decades to end unfair treatment by health insurers.

People with psychiatric illness and their families are made to feel like second-class citizens who are being placed at greater risk for medical bankruptcy.

Their disorders, which affect the most complex organ in our bodies, are nobody’s fault, in spite of what your grandmother might believe. By contrast, diseases of some other organ systems, which can result directly from poor lifestyle choices, are insured to the max.

Cardiovascular problems linked to lack of exercise and chronic overeating, for example, have never been penalized by higher co-pays and deductibles, limits on hospital days and lifetime caps heretofore routinely imposed on coverage for psychiatric illnesses.

Any CEO of a big Insurance company proposing such a thing would be risking his or her job, or much worse.

Growing public understanding and diminishing stigma surrounding mental illness should make access to care for schizophrenia, bipolar disorder and other serious mental illness more affordable and available.

Unfortunately, the current economic downturn and adversarial political climate is having the opposite effect. As legislators and administrators in every state grapple with the painful decisions about what services to cut, some oxen are being gored more seriously than others.

In Colonial days, bleeding, using leeches to drain blood from the mentally ill and other patients, was a harmful, misguided treatment. In a different way, we are “bleeding” those people again here in Maine, this time through health benefits.

In their quest to eliminate any and all mandated benefits through LD 882, our governor and Legislature are in the process of reversing mental health parity benefits, which Mainers now enjoy.

An article in the newspaper highlighted some of the ways that Maine citizens with mental illness are already in jeopardy.

Daniel Wathen is a respected former chief justice of the Maine Supreme Court, and the court master appointed to oversee implementation of a 1990 consent decree mandating adequate services for a group of more than 12,000 mental patients.

For years, he has been warning anyone who will listen that Maine is out of compliance, chronically failing to deliver promised community and hospital treatment. Increasing numbers of those people ineligible for Medicaid are not getting needed services.

Staff cutbacks at Riverview Hospital, formerly Augusta Mental Health Institute, and Dorothea Dix Hospital, formerly Bangor Mental Health Institute, risk further compromise of patient care and safety.

Wathen doesn’t mince words: “We’re in danger of slipping from a program of recovery to … command and control (of those with severe and persistent mental illness).”

Simply warehousing patients in hospitals or jails is unacceptable. If it is true that any civilization is judged by how well it cares for its most unfortunate and impaired members, all of us should express to our legislators, our governor and to the state Department of Human Services, our profound concern about cuts to services and to adequate insurance for our citizens.

James H. Maier, M.D., practices adolescent and pediatric psychiatry and psychiatry in Scarborough. He received his medical degree from Tufts University School of Medicine, Boston, 39 years ago.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.

filed under: