Treatment numbers for mental health and substance use disorders remain low in the United States. Partially deterred by the stigma around receiving treatment, many patients also face other barriers such as high out of pocket costs and lack of access to providers.

Mental health clinicians frequently practice individually and do not accept private insurance.  Psychiatrists also have one of the lowest Medicaid participation rates among medical specialists. Patients who do seek care for their mental health and substance use disorders are often left paying high prices out of pocket.

In JAMA, Margaret T. Morris Professor of Health Economics Richard Frank, PhD, and colleagues discuss current behavioral health parity efforts as well as offer suggestions for moving forward.

Legislation such as the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and the Patient Protection and Affordable Care Act of 2010 have sought to improve access to mental health care by making mental health and substance use disorders care parity a national priority. These acts have brought about some positive change, including the publication of annual reports on MHPAEA investigations and violations. State-level insurance commissioners are encouraging major carriers to analyze policies, procedures, and claims data in novel ways to demonstrate parity.

The authors urge continued efforts towards mental health parity in the United States, noting that regulation of health insurance is an essential first step.