A Tale of Two Patients—and One Deadly Form of Discrimination

Consider the experience of these two patients:

Patient One has a heart attack. He goes to a hospital, and like most patients who have suffered a heart attack or have pneumonia, he is admitted. An electronic notice will be sent to his insurance company the next business day.

Patient Two is deeply depressed and has tried to commit suicide. He goes to a hospital for help. Before treating the patient, the doctor first must call a toll-free number, “present the case in voluminous detail, and get prior authorization,” Dr. Paul Summergrad, president-elect of the American Psychiatric Assn., said in a recent New York Times article.

Why the difference?

For decades insurance companies have been allowed to treat mental illness as if it is somehow not a real disease. Their rules and regulations made it tougher for a person suffering from mental illness or addiction to get help. While this may help an insurer’s bottom line, it does nothing to help our society.

Mental illness has been a major factor in many of the mass shootings that have devastated our nation, from the Newton, Conn. elementary school massacre, to the killings at a Naval shipyard in Washington, D.C. Drug addiction plays a major role in many more crimes every day in this country. Just ask any cop.

Treating mental illness and addiction the same way we treat physical illness seems like common sense, but insurance companies have done just the opposite—until now.

Last week, the New York Times reported that the Obama Administration completed an effort to require insurance companies to cover care for mental health and addiction the same way they cover physical illnesses.

The long-awaited regulations defining parity in benefits and treatment have been many years in the making. And they are a critical part of the president’s plan to reduce gun violence. According to the New York Times, the regulations address “an issue on which there is bipartisan agreement: Making treatment more available to those with mental illness could reduce killings, including mass murders.”

The regulations will also extend to people covered by the Affordable Care Act. These new rules are expected to be particularly helpful to returning veterans, such as those suffering from post traumatic stress disorder.

As we continue to search for a way to end the violence that terrorizes this nation, this is a major step in the right direction.

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Troubled Youth…and an Old Typewriter

UnderwoodA century ago the Underwood typewriter was high technology. It was the latest, the best, the “must have” device for anyone in the business of communicating.  Talk to the average kid today and most have never even seen an actual typewriter—and they certainly haven’t used one. The typewriter for them is a relic of a long ago past.

Our methods of communications have advanced at break neck speeds; our social policies concerning troubled youth have not. By comparison, over the years we have crawled toward more effective and humane policies; and our slow pace has cost us lives that could’ve been saved. According to the Annie E. Casey Foundation, the U.S. still leads “the industrialized world in the rate at which we lock up young people.”

“In every year for which data are available, the overwhelming majority of confined youth are held for nonviolent offenses. In 2010, only one of every four confined youth was locked up based on a Violent Crime Index offense (homicide, aggravated assault, robbery or sexual assault).”

“40% OF JUVENILE COMMITMENTS AND DETENTION ARE DUE TO technical violations of probation, drug possession, low-level property offenses, public order offenses and status offenses (activities that would not be considered crimes as adults, such as possession of alcohol and truancy). This means most youth are confined on the basis of offenses that are not clear threats to public safety.”

Since 1995 the overall picture has started to improve. From a peak in 1995, the rate of youth in confinement dropped by 41% in 2010.  But we still have a long way to go. Huge disparities exist between the confinement rates of youth of color in comparison to their white peers. The Annie E. Casey Foundation reports:

“African-American youth are nearly five times as likely to be confined as their white peers. Latino and American Indian youth are between two and three times as likely to be confined. The disparities in youth confinement rates reflect a system that treats youth of color, particularly African Americans and Latinos, more punitively than similar white youth.”

Imagine what would happen if we as a nation addressed the problems of youth with the same creativity, innovation, resources, interest and drive that took us from the Underwood typewriter to the iPhone. How would our policies look? What would our youth confinement rate be then?