From Deseret News archives:

Struggle for control: Mental-health care coverage is lacking

Published: Wednesday, April 26, 2006 11:51 p.m. MDT
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"We had to stop the therapy because we couldn't afford it anymore," she said.

Sudweeks' son now resides at the Utah State Hospital because she had no other option. "That's the only place we could have put him," she said.

The boy comes home on weekends, and Sudweeks said he's doing much better.

"It doesn't take long before you run into a lot of expenses," said Sherri Wittwer, executive director of the National Alliance on Mental Illness, Utah chapter. "Mental illness can be financially devastating as well."

Utah Attorney General Mark Shurtleff has gone the rounds with his insurance company over treatment for his 13-year-old daughter, who deals with several mood disorders.

"The whole decision about therapy is how long the insurance will last as opposed to what's best," he said. "They don't care. It's a money thing for them."

Not all mental health care plans are created equal. Benefits vary widely depending on what insurance companies offer and what employers purchase. Insurers typically cap the number of annual mental health visits.

"If your appendix bursts, the doctor doesn't say, 'Sorry, your six-day benefits have run out.' But that happens for mental illness," Gray said.

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This is precisely the complicated factor that separates mental health concerns from "traditional" physical ailments.

Parents know exactly what to do if their child gets hurt on a skateboard: Go to the emergency room. If their child has a fever, they make an appointment with the family doctor.

But what does a parent do when their child's brain doesn't seem to be working right?

"People don't know where to turn for mental health services," said Wittwer.

It's not likely they have a family psychologist or psychiatrist. Even if they did, it might take weeks to get in. Preauthorization might be needed. And there's no guarantee their insurance carrier would pay for treatment until the child became well.

"There's no way this country would stand for getting treated like that for physical treatment," said Klein.

She and her colleagues say the managed care model doesn't work for mental health. It's a model, they say, that works for physicians who have a high volume of patients — quick visits for a sinus infection or sore throat — but not for psychologists who see only one patient per hour.

Another barrier mental health providers see comes from what employers call an "employee assistance program" or EAP. It provides crisis intervention, phone consultations, referrals and usually at least three free visits with a social worker or psychologist.

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Jill Roberts, seen in a photo illustration, has had difficulty getting health insurance to cover treatment for bipolar disorder.

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