0 Fight for Your Right to Behavioral Health Benefits

By Carol McDaid, Co-Chair of the Parity Implementation Coalition

In 2008, Congress passed a law that requires health plans to provide benefits for addiction and mental illness that's equal to other medical benefits. Unfortunately, many people still don't know about this law called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (named after two bipartisan senators who experienced addiction/mental illness in their families).

Parity is personal to me. Did you know that 23 million people have a diagnosed substance use disorder but fewer than 10% receive any help for that condition? I am one of the lucky ones who got the treatment I needed to recover. When my insurance failed twice to provide the coverage promised in my employer-provided health benefit package, I got support from family and employers to help pay for the care I deserved.

When my insurance company refused to pay for any of my last residential treatment (after years of failed attempts at outpatient programs), I fought back. I used all of my internal and external appeals rights. It took me three years and a blizzard of paperwork, but one day a check for half of my treatment appeared in the mail.

Sadly, the average American family with a loved one suffering from addiction or mental illness lacks the resources to fight a three year battle with their insurer to get benefits they are entitled to - by law. Often afraid to discuss their illness with employers, they suffer in silence rather than using their behavioral health benefits promised by insurers. These victims become sicker and even unemployable – causing the burden of paying for their treatment to be shifted to the public sector, where taxpayers like you and me are forced to pick up the bill for health plans that simply will not pay their fair share.

Today, I use my skills as an advocate and former employee benefits analyst to fight for the rights of those coping with addictions and mental illnesses. I'm driven by the passion of my personal parity experience with insurance discrimination and my sense of justice and equality. Help for these conditions should not be limited to those who can afford to pay out-of-pocket or have the fortitude to fight long battles with insurers.

If you or a loved one have been unable to get your insurance to pay for addiction or mental health treatment, please share your story. 

I've been in the halls of Congress fighting this fight since 1993. I realize that laws and regulations are complex and often take many years to be fully implemented. I intend to fight this fight as long as it takes to end insurance discrimination against people suffering from addiction and mental illness. But, to be successful, we need your stories and a collective sense of outrage.

Join me. Share your personal parity story by sending an email to hsf@psych.org. Fight for your rights. Every 15 minutes in the U.S., someone dies from suicide. The clock is ticking.

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0 Caring for the Mental Health of Your College Student

By Roberto A. Blanco, M.D.

A recently released national survey on the state of mental health for entering college students revealed that this year's freshmen class has the highest stress levels in the history of the 25 year survey.  There are several reasons.  According to study authors, students face increased competitiveness and demands in high school as well as more financial challenges due to today's economy.

Although it's an exciting time, your child's transition to college can be a difficult one - especially if he or she suffers from a mental illness.  Here are some things that you and your prospective college student should be thinking about prior to choosing a university and heading off to school:

1.    What can I do to ease the college transition? 

Some schools offer an orientation program over the summer to help students become comfortable with the campus and surroundings, learn organizational and study skills and socialize with fellow freshmen.  

Apart from these organized programs, it is important that, as a parent, you work on transition issues and independence.  Make sure that your child has all materials needed for school including an organizer and a computer.  If your child is getting psychiatric treatment, teach your son or daughter the importance of their medicines, therapy and attending their appointments regularly.  If they haven’t yet been self-administering their medications, before going to college, it is important that they learn and start taking their medicines without supervision.

If you have serious concerns about how your child will do with the college transition, you may want to consider schools close to home.  Depending on the amount of concern, it may be best to choose a school which would allow your child to drive home for the weekend if needed.

2.   What’s the quality of the college's mental health program?

Some colleges and universities do not have mental health services available through the school.  If they don’t, you need to understand how a student can go about getting help.  If the school is not in a major city, you need to make sure that there are enough providers close by so that your child can get the services that he or she needs in a timely manner.

Some universities have therapists but no psychiatric providers on staff.  Others offer both counseling and psychiatric services but put a cap on the number of appointments at the university mental health center prior to referring students out to the community.  All of this information should be provided by each individual school.  And you should know all of this information prior to committing to a particular school, especially if your child is likely to use mental health services.

3.    What is the educational environment of the university?

Some universities are known to be high-pressure, unforgiving environments.  This could be due to the rigor, expectations or challenges of courses.  Sometimes, this can be eased by a strong academic support team or advising system.  Often, peers can make the university culture overly competitive in unhealthy ways.  Some places are notorious for students stealing other students’ lecture materials and notes or not helping out when needed.  If your child is particularly sensitive to stress, it may be best to go to a school where the environment is more collegial and supportive.

Other schools are notorious for having easy access to drugs or alcohol on campus.  While drugs and alcohol are available at most schools, they are easier to get at some schools which are located in major cities or areas of high accessibility.  If your child has a history of drug or alcohol abuse, you should be extra considerate of these location factors.

4.    Will the financing of this school put my child in overwhelming debt?

While a good college education is one of the most important investments, your child should not mortgage his or her future by creating large amounts of unnecessary debt.  In addition, universities with higher tuition may necessitate your child working during school to avoid excessive debt.  This can also add stress.  If schools are relatively equivalent in meeting your child’s long-term career goals, choose the college which will put your child in a better financial position after he or she graduates.

Of course, after your children go to college, you will want to monitor how they are doing intermittently.  Particularly stressful times are usually at the beginning of school, around exam time (midterms and finals) and anytime a romantic relationship ends.  Checking in around these times may be the most beneficial.  If it turns out that they need more help than some parental TLC, make sure that they see a professional.

I hope that these suggestions have been helpful.  Feel free to leave comments or questions for further discussion.

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0 Thanksgiving – the true spirit of this holiday season.

By Roberto Blanco, M.D.



I love Thanksgiving. It is my favorite holiday of the year. Each year my family gets together to catch up, share quality time and make plans for the future. Leading up to the holiday season this year, however, I had been feeling less than excited about the holidays. Having become accustomed to my daily routine, I found myself searching for a way to escape that monotonous, empty feeling.



So, this year, in celebration of Thanksgiving, I began a list of gratitude: 100 things for which I am thankful. This is not a list of wants or obligations that we create for ourselves - a Christmas wish list, a list of New Year’s Resolutions, or a ‘Bucket List’ (a list of things to do or see before you die). It is a celebration of that with which you have already been blessed. On my list included things like having my health, living in a country with tremendous opportunity, and being able to spend time with family.



Nobody’s family, financial, or personal situations are perfect. For evidence of this, just look at the personal lives of celebrities. And so it’s not surprising that many people can get down during the holiday season because it often reminds us of what we don’t have or didn’t accomplish. This often leads to feelings of emptiness or longing that set the stage for self-destructive situations.



Many individuals take what they have been blessed with for granted and don’t truly appreciate what they have until it’s gone. If you have ever lost something dear to you, you understand this adage all too well. This year, let’s try not to make the same mistake. This year, let’s focus on what we have rather than what we don’t.

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0 Does “The Most Wonderful Time of the Year” leave you with the blues? Thoughts on how to make this holiday season less stressful and more enjoyable.

By Gina Newsome Duncan, M.D. 

The holiday season can, indeed, be a wonderful and exciting time of year, but for some, it can also be stressful and overwhelming. Many of us tend to overextend ourselves during the holidays, both with our time and our finances. This can take a huge toll, leaving some of us physically exhausted and financially spent come January.

With the current economy, some people may feel pressured to make up for the cutbacks they’ve had to make in recent months by spending above their means. Others may be more realistic about what they can afford, but worry that they won’t be able to have a good holiday on a budget. We tend to think of the holiday season as a time for family, however, bringing everyone together can also be stressful if there are unresolved tensions within the family.

If you’re worried about being able to afford gifts this holiday season, talk with your loved ones about the real meaning of the holidays for your family. Do things that are consistent with your religious and cultural traditions.

The season may be bittersweet for some adults. If reminded of losses such as the loss of a loved one, find a way to incorporate old traditions and honor your loved ones during this season.

Here are some tips to help you cope with the holiday blues:

Don’t focus on having the “perfect” holiday. Focus instead on having an enjoyable holiday, and that includes time for relaxation.

Examine and then lower expectations—both those that you have of yourself and those that others have of you. Do you expect that you have to create the perfect holiday and give the perfect gift? Do you expect others to give you the perfect gift? Do you expect your children or relatives to be on their best behavior at all times? If so, you will likely be disappointed. Things are rarely (if ever!) perfect. Having this mindset will make it more likely that you will run yourself ragged and end the season feeling exhausted and inadequate.

Avoid overspending, as this will only cause increased post-holiday stress when you get your bank statement. Where possible, consider giving homemade gifts. Baked goods make delicious presents and are a lot less expensive than individual store-bought gifts. They also allow you to give something of yourself in a tangible way.



Do something nice for yourself. Take a break from your shopping and make time for a bubble bath or a nice walk.



Don’t be afraid to say no. Setting limits can be difficult. But overextending yourself can leave you feeling underappreciated and resentful. It’s hard to have the “holiday spirit” when you feel that way!



If worried about not having enough, try giving to the less fortunate. This can often produce a change in our perspective.



Shop online if the mall is too stressful.



For some, the holiday season itself is always enjoyable, but the months that follow can be difficult. The winter season in some areas of the country may not end until late March or early April. Some find that their moods go down predictably during this time of year. Read Dr. Felicia K. Wong’s recent post on Seasonal Affective Disorder for tips on coping with this common form of depression.

Detail: Does “The Most Wonderful Time of the Year” leave you with the blues? Thoughts on how to make this holiday season less stressful and more enjoyable.