October 23, 2013

'Obamacare' and Mental Health Promoted

We have all heard about the can of worms. Fishermen love them and most people shrink from them. This article in WebMD is another can of worms. It is time that mental health came back and became part of medicine. We even understand and appreciate the coverage of pre-existing conditions as a benefit.

One of the factors is not mentioned and this is the lack of trained doctors to treat people needing treatment. This may the reason behind the new guideline manual the Diagnostic and Statistical Manual (DSM5). In the manual they have a medication for every conceivable mental health issue and almost say to forget counseling from a positive perspective to enable their patients to take charge of a mental health problem and overcome it. Medications are now the only answer. This may have been anticipated that other doctors will need to help fill the shortage in an as needed basis.

The psychiatrists and psychologists are in short supply in most states and this is one reason many governors discouraged mental health exams for gun owners and this confirms the continuing shortage. See my blog here about the medications being encouraged for most mental conditions.

According to the WebMD article, an estimated 32 million people will gain mental health or substance use disorder benefits, or both, as a result of the Affordable Care Act (ACA). This results from the requirement that small group and individual insurance plans offer coverage for mental health issues and substance abuse services. The author claims most large insurance plans already include such coverage; however, my blog here shows how large insurance companies side step their obligations. Maybe under ACA they will not do this as much.

The author quotes Susan Lindau, a licensed clinical social worker and associate adjunct professor at the University of Southern California School of Social Work in Los Angeles, as saying, "parity has been written into the law so mental health coverage ostensibly should be much easier to access."

Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness (NAMI), is quoted as saying, "We're still waiting for the final regulations. And, because of the Supreme Court decision, the Medicaid expansion is optional, and a large number of states are talking about not participating. There are a high percentage of people that have a diagnosable mental illness living below the poverty line."

There are two sides to this issue and for the most part, more people will have more mental health care than before, but a large number may still be unserved. This is a loophole that needs to be eliminated, but with the current congressional climate, may not be for several years.

With the current DSM5 guidelines, many other doctors may see the shortage as a way of using prescription medications recommended under DSM5 as a way to treat more patients. Mental health care will fail under this treatment and more serious mental health problems may become worse.

With the problems people with diabetes have, this may not be good for people with diabetes needing treatment for depression.

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