(Nov. 14, 2013) The mental health community cheered last Friday when the Obama administration announced that under the Affordable Care Act private insurers will be required to provide coverage for mental illness equal to what they provide for physical illnesses (“Rules to require equal coverage for mental ills,” the New York Times, Nov. 8).
This is a great step forward that will provide needed resources for those with psychiatric disorders who are able to voluntarily seek treatment and it’s certainly worth cheering about. But, these new regulations don’t address the population of people who need treatment the most, those who are too sick to recognize their illness.
These are the people who suffer from a condition called anosognosia, an anatomical brain condition that affects approximately 50% of individuals with schizophrenia and 40% of individuals with bipolar disorder. People with anosognosia are simply unable to recognize their own illness – no matter how painfully obvious it may be to everyone around them.
Individuals suffering from anosognosia, regardless of insurance status, won’t necessarily benefit from the new rules and they are the ones who are most likely to suffer from the consequences of untreated serious mental illness. They are the people sleeping on the front steps of a community clinic, but who will not walk inside to seek treatment.
If we really want to address the most vulnerable people we need to foster universal adoption of mental illness treatment laws based on a person’s need for treatment and provide sufficient public psychiatric beds to treat individuals in psychiatric crisis.
While we have seen great strides towards equality for those suffering from mental health issues, these new regulations should only be a precursor to ensuring equal treatment for those too sick to seek it on their own.
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