Mental Health Parity Now Critical
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| Written by Annan Boodram, Caribbean Voice/NY. |
However, given that
mental healthcare, globally, but more particularly in developing nations, has
been lagging far behind physical healthcare, the upsurge could be another
pandemic according to many specialists and experts such as New York City-based psychiatrist, educator, and writer, Robert T. London and Mark Henick, a
Canadian mental health strategist and speaker.
According to an April
27, column by Benjamin
F. Miller in USA Today, “Mental illness is an epidemic within the
coronavirus pandemic”. As well, an April 10, report in JAMA Internal Medicine says to expect an “overflow of mental
illness that will inevitably emerge from this pandemic,” and that the surge
will itself be a pandemic.”
In fact, nations such
as China already have a mental health crisis resulting from the pandemic. In
developing nations where mental healthcare is either an after-thought or
literally non-existent, the situation would be much direr. Thus, the
need for mental health parity will be even more urgent.
Mental health parity
refers to the equal treatment of mental health conditions and substance use
disorders in insurance plans and healthcare services. When a plan has parity,
it means that if you are provided unlimited doctor visits for a chronic
condition like diabetes, then you must also be offered unlimited visits for a
mental health condition such as depression or schizophrenia.
Parity would also
ensure that all healthcare institutions must not only have medical personnel
trained to diagnose mental health issues, but also to follow up with the requisite
treatment. In effect, mental healthcare must be as normal as care for physical
illnesses and must, therefore, include the presence of clinical counselors,
psychiatrists, psychologists, traumatizes and other mental health experts at
all healthcare institutions.
Of course,
establishing a mental healthcare system parallel to the physical healthcare
system would not be economically feasible for developing nations, especially
those with very small economies and populations like the Caribbean countries.
Thus, the World Health
Organization (WHO) has been touting an integrated health care system whereby
mental healthcare can ‘piggyback’ onto the existing physical healthcare system.
Nurses and doctors can be provided with a certain degree of mental health
training such as WHO’s Mental Health Gap Action Program (mhGAP), which has
already been implemented in nations such as Guyana and which, “aims at scaling up services for mental,
neurological and substance use disorders for countries especially with low and
middle-income”.
However, the process of
parity must begin with updated and expanded mental health legislation that
takes into consideration all developments in mental healthcare and current
mental health-related laws must be revised to update and maximize provisions
for mental healthcare. In Guyana, for example, the Mental Health Ordinance has
not been updated since the 1930s, St. Kitts & Nevis since 1956, and Antigua
& Barbuda since 1957. A few have mental health plans or policy that have
been approved with only Jamaica, Suriname, and Belize having both.
As well the average percentage of
the health budget dedicated to mental health in the Caribbean is 4.33%. Four
countries receive more than 5% of the health budget and seven countries receive
less than 3%. Parity would mean a greater
percentage of the overall health budget dedicated to mental health.
Mental health parity also
means that insurance – private of government - must cover mental health care in
the same manner they cover physical health care. For without this coverage an
integrated health care system will still not be able to provide parity. And
because globally mental health is still highly stigmatized, parity would
necessitate ongoing sensitization and information dissemination on various
mental health issues in the same manner as happens with respect to various
physical ailments.
However, with the expected
economic fallout from COVID 19, developing nations will struggle to provide
physical healthcare for quite a while and it’s almost certain that mental healthcare
will be neglected, if not totally abandoned. Thus, it is important that as
nations strive to rebuild their healthcare system, they focus on parity via
integration of physical healthcare with mental healthcare.
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Editor’s note. The Caribbean
Voice offers free counseling. Please email them at caribvoice@aol.com or thecaribbeanvoiceinc@gmail.com; Also check out our website at www.caribvoice.org for more information.
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