The American Psychiatric Association and Mental Health Parity

The latest issue of "Psychiatric News," the American Psychiatric Association's newspaper, has an informative article on the recently passed mental health parity law. If you're interested in the dynamics of advocacy or in mental health policy, the article is very worth reading. (I wrote about aspects of the law in a previous posting.)

A year ago I wrote about "Ethics and Elbow Grease" -

"Organizational ethics isn’t just about hospitals, group practices and health plans.The larger system within which health care occurs can usefully be regarded as a form of organization structured – for better or worse – around values. Advancing key values requires elbow grease. And time."

The APA has been working on behalf of parity for 30 years. That's time!

The otherwise excellent APA article leaves out one inconvenient truth. Parity wouldn't have been achievable without managed care. It's only because the mental health carve out companies that psychiatrists love to hate have demonstrated that mental health care need not be a bottomless pit of ever increasing cost that the lobbying could be effective.

Here's how James Scully, the APA Medical Director, summed up his view about progress in ethics:

"You don't get what you want just because your cause is right and just. You have to do the hard work of building coalitions and getting allies."