Petition Closed
Petitioning President Barack Obama and 2 others

Mandate Mental Health Equality for Health Care Coverage

We are outraged. Why? Because comprehensive and consistent mental health care coverage isn't available to all.


The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) does not offer equality.

Parity and equity are not equality.

Separate is NEVER equal.


We have a mental health crisis in this country. Recent events only serve to emphasize that mental health care is sub-par in this country. Patients with mental illness can't obtain the care, time and commitment they so desperately need. If they do receive care, their treatment options are often limited by health insurance restrictions, state law, and/or a lack of adequate resources.

This must change. A significant number of individuals have chronic mental health disorders that will require them to seek continuous, sustained care throughout most of their lives.


·         Suicide is the 10th leading cause of death in this nation and the 3rd leading cause for people aged 15 to 24 years.

·         1 in 4 adults experiences mental illness each year.

·         1 in 5 adolescents aged 13 to 18 suffer from severe mental disorders in a given year.

·         1 in 10 children and adolescents from the ages 8 to 15 suffer from severe mental disorders.

(statistics from the National Institutes of Health, National Institute of Mental Health, 2012)


In addition, a 2012 report by the American Hospital Association cited several studies noting:

·         Almost 50% of all Americans will be diagnosed with a mental health condition in their lifetime.

·         In 2011, 34 million adults—17 percent of American adults—had comorbid (both) mental health and physical medical conditions.

·         Monthly costs for a patient with a chronic disease and depression are $560 more than for a person with a chronic disease without depression.

·         Individuals with serious mental illness die, on average, 25 years earlier than the general population. 



Time and time again it has been proven that consistent and comprehensive treatment leads to positive outcomes in the lives of many of these impacted individuals. Again, the American Hospital Association report from 2012 cites several studies regarding the impacts of inadequate mental health and substance abuse care:


·         In the majority of cases, behavioral health conditions are serious enough to cause limitations in daily living and social activities

·         Behavioral health disorders also can have a profound social impact. Individuals with behavioral health conditions are more likely to live in poverty, have a lower socioeconomic status, and lower educational attainment.

·         Lack of treatment amplifies these outcomes and increases the likelihood that individuals will end up homeless or incarcerated.



There is no shame in having a mental illness or a substance abuse problem. Continuing the current system of limited to nonexistent treatment options for mental health care and substance abuse only serves to strengthen the stigma and ignorance about mental health and substance abuse. By treating psychiatric conditions equally to physical medical conditions would reduce and combat current misconceptions and perceptions of psychiatric care and mental health conditions.

The true shame is that, as a nation, we still allow significant barriers and obstacles to occur when individuals and their families are brave enough to seek help.

Unfortunately, even fairly recent legislation has not done much to assist in removing these horrible barriers. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) generally requires insurance groups that that already offer mental health or substance use disorders to provide the same level of benefits provided for physical medical treatment.


·         However, there is no mandate for insurance plans that do not currently offer mental health coverage to begin offering those services.

·         While the Affordable Care Act (ACA) requires insurance plans to cover mental health and substance abuse services and treatments offered through state and federal health insurance marketplaces, there is no federal mandate that requires plans offered outside of the marketplace or plans in place prior to the enactment of ACT to offer mental health and substance abuse services.


It is time to overhaul the Mental Health Parity and Addiction Equity Act beginning with its name.


It is time that those with mental health and substance abuse disorders, their family members, their friends and their communities demand nothing less than EQUALITY before we are faced with another senseless tragedy, before we face another loss of life. Mental health and substance use conditions require PREVENTATIVE care just as EQUALLY as physical medical conditions.

We, the people, demand mental health and substance use be treated EQUALLY to physical medical conditions by insurance companies.


We demand that the Mental Health Parity and Addiction Equity Act be amended to be the Mental Health and Addiction Equality Act. No more parity or equity. Separate is never equal. We ask for the following for all patients:


1.     A mandate that all (including pre-existing plans prior to the ACA amendments) individual and group health insurance plans, both individual (in state and out of state) provide coverage for diagnostic purposes and the treatment of mental health and substance use disorders. 

Why we want it:

Health insurance coverage should not only coverage services and treatments for physical medical conditions. Mental illness is a medical condition and plans prior to the enactment of ACA and plans not on the Marketplace can exclude mental health coverage. We need a mandate now so those with mental health and substance use issues have equal access to the services and treatments they need.


2.     A definition of specific mental and nervous disorders covered under the Act that would include serious mental illness (i.e., schizophrenia, bipolar disorder and major depression) but also include but not be limited to post-traumatic stress disorder, dysthymia, cyclothymia, social phobia, agoraphobia with panic disorder, general anxiety disorder, personality disorders and eating disorders.

Why we want it:

Currently, state law defines what specific types of mental illness require coverage. Depending on what state a citizen lives in will determine whether a condition may be covered under the plan. Just as all physical medical conditions are treated at some level of care, all mental health conditions should be treated at some level of care. Such conditions affect daily living and affect physical health.  


3.     Coverage to address the mental health issues of individuals with developmental disabilities and physical health conditions.

Why we want it:

Insurance companies which already treat the physical medical needs of individuals but do not offer mental health coverage ignore the devastating and profound damage that physical medical conditions do to mental health.


4.     No lifetime or annual dollar caps for hospitalization and outpatient services. 

Why we want it:

Just as there is no lifetime or annual dollar caps for physical medical conditions, individuals with mental illness deserve EQUAL treatment for their hospitalization and outpatient services.


5.     Equal coverage for mental health medication.

Why we want it:

Mental health of an individual is dependent upon ease of access to medications. Such medications can be very costly. Discontinued use of medication due to financial constraints should not be occurring in this nation.


6.     Equal co-insurance and deductibles for mental health care visits from physical health care visits.

Why we want it:

Currently, insurance companies can set separate amounts for co-insurance and deductibles for mental health needs creating obstacles for obtaining necessary care. We need to remove barriers from care not allow insurance companies to build them.

In addition, we ask for the following in regards to children and adolescents.


1.     Coverage for children and adolescent for the treatment of “V” code conditions of the most current version of the DSM (specifically, V61.21, Child Neglect, Physical/Sexual Abuse of a Child, V62.82, Bereavement, and V71.02 Child or Adolescent Antisocial Behavior) and conditions that meet the diagnostic criteria of the ICD-10 (Behavioral and emotional disorders with onset usually occurring in childhood and adolescence).

Why we want it:

A child grappling with issues like neglect, physical and/or sexual abuse, the loss of a family member needs to process these large life-changing events. The sooner we reach these children, the sooner they can begin to heal so that we do not have adults grappling with these issues that lead to perhaps even greater mental health issues. Earlier treatment of adolescent behavioral and emotional disorders can lead to more positive mental health outcomes into adulthood. Ignoring these conditions, such as conduct disorders, in the young will only lead to greater issues in adulthood.


2.     A screening for mental health conditions (including the aforementioned V code and ICD-10 conditions) without cost-sharing for children and adolescents.

Why we want it:

Currently, screening for autism is offered to children. Just like autism, the sooner a child is identified, the better the potential outcome for the child. Parents of children with mental health conditions ask only for equal treatment for their children.


3.     Parents should have the option to purchase a policy solely for a child when current coverage does not include the mental health services their child needs.

Why we want it:

Currently, parents of children of autism have this option. Parent of children with mental health conditions only ask for equal opportunity.  

Why I want it…

My name is Debbie Tam. I am the mother of a 13 year old girl with bipolar disorder, Asperger’s syndrome and post-traumatic stress disorder that resulted from repeated sexual assaults at the age of 7. I have personally encountered obstacles while trying to obtain treatment for my 13 year old daughter who has expressed the desire to receive help. 

You can hear our story here:

Diligent and conscientious individuals seeking to thwart tragedy are thwarted by a bureaucracy which demands tragedy before service. Insurance companies will not treat the mentally ill equally to their physically ill counterparts and toss them back into the community where no true supports are offered.

I tell my daughter there is hope. Tell me I have not misplaced my hope in our government to fix this broken system.

This petition is for my daughter, all the children like her, and all the adults who invisibly and bravely fight their battles against mental illness and substance abuse.

May they believe there is hope.

These changes will not solve the deficiencies in social services for the mentally ill in this country but it’s a start if individuals with mental health and substance abuse issues have access to treatments and services through their health plans.

We ask the members of the Senate HELP committee and the House Subcommittee of Labor, health and Human Services, Education, and Related Agencies to be committed to hope and wellness.

*Special thanks to Clare Fish who co-authored this petition*


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