Coverage for mental health is not equal

Ateenager trapped by depression. A daughter addicted to heroin. A son lost to suicide.

More than a million Coloradans face a mental health or substance use disorder, but only half get the care they need.

The consequences can be catastrophic: crowded emergency rooms and prison cells, increased unemployment and homelessness, and one of the highest suicide rates in the nation.

This crisis is not simply statistical — it’s profoundly personal.

Dani was 16 when she was diagnosed with anxiety and depression. Her parents tried and failed to get treatment for her in Colorado. They finally found a facility in Wisconsin and anoth er in Utah. And then they had to fight their insurance company to pay for her stay.

Alicia spent eight months in treatment for heroin addiction. Her parents spent even more time battling three different insurers to cover her care. Alicia is now two years sober. Her parents are $85,000 in debt.

Zac suffered from depression and psychosis. He was denied coverage for inpatient care at a residential facility. By the time his insurance company reversed its decision and agreed to pay for his treatment, Zac had died by suicide. He was 14 years old.

Why would we condemn anyone to a life like this, or to an early grave? How do we mend Colorado’s mental health?

We can start by enforcing the law.

This month marks the 10th anniversary of the Mental Health Parity and Addiction Equity Act, a federal law that requires equal coverage for mental and physical care. Colorado’s own mental health parity law is even older; it was enacted in 1997.

But these laws, like any, are effective only if they’re enforced. The evidence suggests that’s not happening.

Under state insurance rules, Coloradans should have to wait no more than a week to treat a nonurgent mental health condition or 24 hours in urgent cases. In practice, many families are waiting far longer.

Insurance companies say they can’t find enough mental health providers to fill their networks. But that should come as no surprise; Colorado’s insurers pay mental health professionals 30 percent less than they pay other health care providers.

Some mental health profes sionals tell us even when they try to join insurance networks, they’re turned away. As a result, Coloradans are going out of network seven times more often for mental health and substance use services than for physical care.

If you’re fighting a mental health or substance use disorder, or caring for a loved one who is, you probably don’t have enough time or money to fight an insurance company. And you shouldn’t have to.

The good news: Help is on the way.

This year Mental Health Colorado persuaded the legislature to create a state mental health ombudsman. This office will help Coloradans access mental health and substance use services, whether they have public insurance, private insurance, or no insurance at all.

The new law also strengthens the enforcement of mental health parity. The insurance commissioner will report annually on his or her efforts to bring carriers into compliance with state and federal law, beginning next year.

We don’t need to wait until then to take action. If you’ve been denied mental health care, please let us know at mentalhealthcolorado.org/survey.

Together we can ensure that equal coverage is more than a paper promise. Justin Mock, Vice President of Finance and CFO; Bill Reynolds, Senior VP, Circulation and Production; Bob Kinney, Vice President, Information Technology