As Suicides Rise, Insurers Find Ways to Deny Mental Health Coverage

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From Bloomberg: “The U.S. is in the midst of a mental health crisis. In 2017, 47,000 Americans died by suicide and 70,000 from drug overdoses. And 17.3 million adults suffered at least one major depressive episode. The Mental Health Parity and Addiction Equity Act, a landmark law passed more than a decade ago, requires insurers to provide comparable coverage for mental health and medical treatments. Even so, insurers are denying claims, limiting coverage, and finding other ways to avoid complying with the law.

Americans are taking to the courts to address what they see as an intrinsic unfairness. DeeDee Tillitt joined one lawsuit in 2016, months after she lost her son Max. He’d been an inpatient for three weeks at a treatment center to recover from a heroin addiction and seemed to be making progress. His addiction specialist wanted him to stay. United Behavioral Health, a unit of UnitedHealth Group, the nation’s largest insurer, declined to cover a longer stay for Max. Reluctantly, his family brought him home. Ten weeks later, Max was dead of an overdose. He was 21 . . .

Still, winning legal cases does only so much to change industry practices. The United Behavioral Health suit, for example, won’t result in punitive damages for the insurer, because it was brought under a labor law, ERISA, which doesn’t allow them. ‘Basically, there’s an incentive for managed-care companies to do the wrong thing, because they know that at the end of the day they don’t stand to be punished monetarily,’ Bendat says.”

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5 COMMENTS

  1. Insurers reimburse billions of dollars to psychiatrists, which increases the amount of psychiatric treatment.

    Hundreds of thousands of people die each year because the insurers reimburse these charlatans’ treatments.

    What kills most in America? Psychiatry or mafia? Just the hypnotics killed between 320000 and 507000 people in 2010 in the United States! (Kripke, 2012, p. 6, “Conclusions”)

    Whoever gives a penny to a psychiatrist is himself a criminal.

    Kripke DF, Langer RD, Kline LE. Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2012;2: e000850. doi:10.1136/bmjopen-2012-000850

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  2. “The Mental Health Parity and Addiction Equity Act, a landmark law passed more than a decade ago, requires insurers to provide comparable coverage for mental health and medical treatments. Even so, insurers are denying claims, limiting coverage, and finding other ways to avoid complying with the law.”

    My condolences to the woman who lost her child due to the insurance companies’ greed, due to her child’s need for a longer treatment than three weeks for heroin addiction.

    But on the other side, I was very grateful my insurance company refused to pay for a lifetime of inpatient care, as a hospital psychiatrist had hoped for, based upon a “bipolar” misdiagnosis.

    Perhaps, the solution lies in providing longer hospital stays for addiction patients, who actually need longer stays. And a confession that the DSM disorders are not real diseases, so attempting to hospitalize the DSM defamed for life, merely because they have good insurance, is unneeded medical care?

    But I will say, I’m glad my insurance company refused to pay for more than two and a half weeks of inpatient services, since that was actually two and a half weeks more than needed.

    And my former doctor was eventually convicted for Medicare/Medicaid fraud, because he’d been medically unnecessarily treating lots and lots of patients.

    https://www.justice.gov/usao-ndil/pr/oak-brook-doctor-convicted-kickback-scheme-sacred-heart-hospital

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    • A loss, a death, a harm that needn’t have been.

      Systems could be set up that provide more than an either or, black or white, splitting.

      Either private health and treatment to the level of cover or out, goodbye.

      People caught up in, with substances, leading to mind-altering thoughts, beliefs, behaviours, need constant, consistent, reliable, genuinely caring attention. No health insurance, No hospital bed per se – private or other, basic or palatial, provides warmth, thoughtfulness, understanding, closeness, attentiveness, quiet calm, … .

      That insurance money paid per month, would equate to a person taking a month off work and looking after their health, or the health of a family member, or maybe both.

      But the treadmill, mouse wheel, doesn’t allow for such restorative recovery time.

      Instead, we work hard, are proud of ourselves for being able to pay private health insurance – a sign of status, wealth perhaps, which when needed still leaves us with out-of-pocket expenses, and in many ways far worse for the experienced interactions.

      Maybe in glorified hotel-like mental health facilities one can dial up room service, a sauna booking, and the rest – but this is not “care”, this is a purchase, consumerism. A doctor on call, a nurse at hand, prescriptions filled within the hour, gym instructor, pilates guide, a restaurant quality meal served by 5 star staff, … this is money.

      Insurers make money. Lots of money. They project money, before they have the money.

      In the more run-of-the-mill mental health services facilities (usually private for profit), what services are actually being provided? Cafeteria foods, vending machines, an enclosed outdoor space, a bed, a private room with ensuite if you have Private health insurance top cover, some CBT, DBT, ACT, (whichever is approved by the insurer) “therapy” sessions most often provided by unsupervised trainees; nurses of various qualifications who barely acknowledge their in-house clients, patients, and yet write daily shift notes – legal document, on … what? A doctor who visits once or twice a week?

      Paying for a bed, in a strange facility, with strangers all about, forming therapy groups where not participating is not allowed, with people you don’t know, whose histories or current challenges are triggering, or not really for your ears, is what Health Insurance, insurers, consider beneficial to mental health! ??

      We are fear-mongered and even threatened.

      Time off work – malingering. Opportunity loss. Job loss.

      Suicidal thoughts, ideation – see a prescriber for a brief consultation and a prescription for drugs.

      Depression – two weeks already! Here, some prescription drugs for you.

      Add those and many more influences to the already full daily load and a cocktail for decline and depletion is in the making.

      How so that some cope and manage and some don’t? – The attitudes and mindsets of other people towards them.

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  3. According to Burgess and his team, only drug prevention policies are associated with a decrease in the suicide rate. Mental health policies, mental health programs, mental health legislation and especially “therapeutic” psychotropic policies (which are used to “fight” against illegal drug addiction) are associated with a severe increase in the suicide rate.

    Burgess, P., Pirkis, J., Jolley, D., Whiteford, H., & Saxena, S. (2004). Do Nations’ Mental Health Policies, Programs and Legislation Influence their Suicide Rates? An Ecological Study of 100 Countries. Australian & New Zealand Journal of Psychiatry, 38(11-12), 933–939. doi:10.1080/j.1440-1614.2004.01484.x

    Evidence That More Psychiatry Means More Suicide

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    • Any cheap reactive policies are likely to negatively effect and affect mental ill-health outcomes.

      Cheap! Billions of dollars! Cheap?

      The patient, client, person on the receiving end of Mental “care”, receive inferior, not good-enough, often harmful, unnecessary, interventions – At the lowest possible delivery costs, with the most minimal effects, that are “evidence – based” to be effective over a certain number of prescribed sessions (usually 8, on average), delivered as a one-size-fits-all “therapy program”, and only those therapies that are reimbursed or covered by Government funds.

      Such interventions are not what cost billions of dollars per year, or two.

      The billions of dollars go towards: building “new” facilities, creating “new” services, expanding information “clinics” to “new” areas, research, research, and more research, “new” jobs, “new” executive and or leadership positions;
      and salaries, incentives, benefits, “executive and leader” training, professional development, allowances, …

      What’s left is what might be provided to a person with a mental health need, but only after they have provided details of where they live, their regular doctor’s name, their private health insurance cover, and social benefits number if relevant. This all reads as incoming financial revenue.

      With private health insurance, the person will be attended to almost immediately, again depending on the level of their cover. Of course Top cover gets priority, and if you are someone of note, you go straight to the best service immediately – you get choices and options.

      Without private health insurance, but you can pay out of your own pocket, you will wait a short while or maybe not all, if no Top cover people are taking up the places. You are put on the “if there is a cancellation, we’ll call you” list. What that translates to – if a Top cover booking doesn’t come along, you’ll be called last minute to fill the money gap.

      No insurance cover, no money to pay privately – sure, there is a public mental health service and you can go on their waiting list – no time frame given. If in crisis go to the emergency department of your nearest hospital. Or dial the number for emergency services and an operator will take your call.
      The people in these services will do the bare acceptable minimum unless or until they get a pay rise.
      Job roles, job descriptions, Codes for ethics and Codes of conduct, Standards, mean very little, even though they signed up to do the job.

      Oh, and “reach out” when you need help.

      Mental Health crises are created and perpetuated by society, trends, fads, Zeitgeist, Governments et al., Policy influencers, pharma, phaRMa, and disproportionately influential “experts”.

      Pills, ECT, are low cost resources, low expenditure, low effort, low value, cheap offerings, that give providers maximal benefits, gains, profits, for the least possible amount of input.

      So, the mental health crisis is produced by mean-spirited (their hidden dark side) people, excessively prioritising themselves and their own lives.

      Infants, babies, toddlers might need calming of their nerves and nervous systems – how does that automatically equate to psych. prescriptions for mind-altering physiology altering, cell altering, brain altering drugs.?? By consensus let’s just drug vulnerable human beings. And get paid healthily for doing harm. Yes, harm.
      “The banality of evil” disguised as mental health care – by consensus AND peer reviewed!

      Mental Health needs proactive and preventive attention.

      Mental illness, disorders, dysfunctions, disturbances, disruptions, need less psych meds and the like, Not more.

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