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Vol. LXVI, No. 16
August 1, 2014

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Glied Talks Affordable Care Act, Mental Health Parity at NIMH Outreach Meeting

Dr. Sherry Glied of New York University
Dr. Sherry Glied of New York University
Representatives from mental health organizations across the country recently came to NIH for the 15th annual meeting of the NIMH Outreach Partnership Program. The OPP is a nationwide network of 55 state mental health organizations representing all states, the District of Columbia and Puerto Rico that aims to deliver science-based mental health information to the public.

The meeting is an opportunity for partners to share ideas with each other and representatives from more than 80 national organizations, as well as learn about the latest research and policy advances from NIMH scientists and thought leaders.

Dr. Sherry Glied, dean of the Robert F. Wagner Graduate School of Public Service at New York University, gave the keynote address, Implementing Mental Health Parity in the Current Health Care Paradigm.

“Dr. Glied is, without question, one of the national experts, if not the national expert on mental health parity reform,” said NIMH director Dr. Thomas Insel. “She was right in the center of this historic shift in the way that services would be provided in this country.”

Glied was confirmed by the U.S. Senate as assistant secretary for planning and evaluation for the Department of Health and Human Services in 2010. During her 2-year tenure, she ensured that policies for coverage of mental health and substance use disorders were on par with those for other medical conditions in the Affordable Care Act.

“The interesting thing about the ACA is that it hardly mentions mental health or substance abuse at all, and yet it is likely that the ACA will have a tremendous effect on mental health and substance abuse provisions, access, financial availability and even on the way care is provided,” Glied said. “The impact of this law on people with mental illness is actually much bigger than it is for the population overall.”

To put the ACA into perspective, Glied described how changes in federal policies and programs over the past several decades unintentionally benefited people with mental illness.

“Back in 1957, if you were not actually hospitalized in a psychiatric institution, there was very little chance you were going to get any mental health services anywhere else,” Glied noted. By the 1970s, an expansion in social programs such as social security disability benefits improved the lives of people with serious mental illness. The share of people who received mental health services also increased due to a growth of insurance-based health care financing.

Glied noted that it took two failed attempts at comprehensive federal health care reform by both the Nixon and Clinton administrations and over a decade of advocacy and research efforts that eventually led to mental health parity legislation in 2008. This required that private insurance plans that included any mental health benefits provide those benefits in the same manner as all other health benefits.

Health care coverage under the ACA will provide what Glied calls “parity plus”—wherein mental health benefits are officially considered essential health benefits. The ACA will also expand people’s access to affordable services and treatments. Glied estimates that when the ACA is fully in place, 30 million people who were previously uninsured or underinsured will gain mental health benefits.

“This is a critical area for mental health advocacy,” Glied told the audience. She proposed that mental health workers and advocates could help shape the future of the ACA by monitoring its effects within their own communities, in terms of financial burden, access to care and stigma.

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