Deaths from drug and alcohol misuse and suicides are soaring, yet the majority of states fail to provide equitable mental health and addiction services.

Thirty-two states, including Georgia, get a failing grade for statutes designed to ensure equal access to mental health and addiction treatment, according to a report being issued today on the 10^th anniversary of the Mental Health Parity and Addiction Equity Act (MHPAEA). The report, “Evaluating State Mental Health and Addiction Parity Statutes,” will be released by the Kennedy-Satcher Center for Mental Health Equity at the Morehouse School of Medicine, The Carter Center, The Kennedy Forum, and the Well Being Trust (WBT).

The new state-by-state report cards assess the strength of mental health and substance use disorder parity statutes. Georgia received a score of D, 60. Wyoming (F, 10), Arizona (F, 26), Idaho (F, 36), and Indiana (F, 38) received the lowest scores, while Illinois (A, 100), Tennessee (C, 79), Maine (C, 76), Alabama (C, 74), Virginia (C,71), and New Hampshire (C, 71) scored the highest.

“It’s hard to believe that 10 years later, the promise of parity remains elusive to so many people struggling with mental illness and addiction,” said former U.S. Rep. Patrick J. Kennedy, co-sponsor of MHPAEA, founder of the Kennedy Forum, and former member of the President’s Commission on Combatting Drug Addiction and the Opioid Crisis. “People are still being denied care and have few resources to advocate on their own behalf.”

The Carter Center worked with key partners including The Kennedy Forum, Kennedy-Satcher Center for Mental Health Equity at the Morehouse School of Medicine, and Well Being Trust to develop a consumer brief, designed to help people navigate and understand mental health and substance use benefits and parity protections under federal and state laws.

“The inability to access treatment for mental illness and substance use disorders is leading to the loss of parents, children, friends, and co-workers,” said Dr. Eve Byrd, director of the Carter Center’s Mental Health Program, started by Rosalynn Carter more than 20 years ago. “Individuals and families need to understand their rights and should not have to risk financial ruin to pay for treatment not covered by their health insurance.”

“Evaluating State Mental Health and Addiction Parity Statutes” assessed key elements of state statutes relating to parity and identified three key issues and recommendations for improvement based on frequent deficiencies found in the analysis:

1. How mental health and substance use disorders are defined. Mental health and substance use disorders (MH/SUD) must be recognized as broadly as physical health conditions. As such, states should define MH/SUD to include all disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) with no exclusions.
2. How mental health and substance use disorders are covered. Conditions that share the same characteristics should be treated in the same way. As such, co-pays and out-of-pocket costs must be the same for MH/SUD services as those for physical illnesses. States should require that benefit management processes and treatment limitations, specifically non-quantitative treatment limitations (NQTL), ensure parity in coverage.
3. How compliance with the parity law is monitored and enforced.  States shouldstrengthen enforcement and compliance activities by empowering regulatory agencies to enforce parity laws, including the Federal Parity Law, and require monitoring agencies to regularly report on steps taken to enforce compliance. In addition, states should mandate that all health benefit plans submit regular (e.g., annual) analyses demonstrating compliance with the relevant laws.

To address the alarming results of the state-by-state parity report cards, Kennedy also announced “Don’t Deny Me” – a first-of-its-kind consumer action campaign designed to empower American families to fight back against illegal insurance denials of mental health and substance use disorder treatment services and spark a movement that pressures elected officials, insurance commissioners, and attorneys general to enforce parity laws. More information about the consumer campaign can be found at DontDenyMe.org.

The Carter Center’s Mental Health Program works to promote awareness of mental health issues, reduce stigma and discrimination, and demonstrate progress toward inclusion of behavioral health public policy within local, national, and global health policy and practice. Each year, the Center convenes the Annual Rosalynn Carter Georgia Mental Health Forum to provide a platform for consumer, advocate, service provider, and policy maker engagement and discussion of critical policy issues across the state including parity, access to services by vulnerable populations, and other key issues identified by community partners.