In the immediate aftermath of
the suicides of Kate Spade and Anthony Bourdain Gov. Cuomo issued a press
release about new funding to address the rising rate of suicide.
He stated: "Two high-profile
suicides this week put mental illness front and center, but while those names
were the ones in the press, every day there are thousands of New Yorkers who
struggle with suicidal thoughts, and we must do everything we can to support
them. Depression does not discriminate. It affects every part of society and
people from all walks of life."
I applaud the Governor for
bringing this matter to light. He stated, “Depression does not discriminate.”
Nevertheless, health insurers that do not comply with federal parity law,
denying timely access to care, do discriminate. When New York State government
does not enforce this law, they aid and abet discrimination against the
“thousands of New Yorkers,” who the Governor referred to as those “who struggle
with suicidal thoughts”.
The difficulty people have
accessing mental health and addiction care is not simply a matter of stigma. It
is a matter of discrimination. This is a civil rights issue that an
announcement of new funding alone will not solve.
On December 15, 2017, North
Shore Child and Family Guidance Center held a press conference at its
headquarters in Roslyn Heights and issued the results of a research study –
Project Access that we conducted in collaboration with LIU Post Department of
Social Work.
In this year-long study,
hundreds of Long Islanders were surveyed about their experiences attempting to
obtain help for mental health and addiction problems.
Of the 650 Long Islanders who
took part in the survey, almost half said that it was more difficult finding
help for mental health or substance abuse problems than finding help for
physical illnesses, nearly 40 percent said that their insurance company did not
have an adequate number of providers and two-thirds said that their insurance
company was not helpful to them in finding a suitable provider for themselves
or a loved one.
NY State Senator Todd
Kaminsky, who attended the December 15th press conference, stated that the
findings were “Damning.”
In a bipartisan effort,
Kaminsky and Senator Elaine Phillips wrote to the Department of Financial
Services (DFS) on January 9, 2018 citing the Project Access study and
requesting “a thorough investigation to determine why insurance companies are
not being held accountable for network adequacy.” Network adequacy is the part
of the federal parity law that states that health insurers who cover mental
health and addiction care must have an adequate number of providers in their
network. Many more people wrote directly to Gov. Cuomo, requesting the same.
Almost five months later
Scott Fischer, Executive Deputy Superintendent for Insurance, a division of
DFS, responded in writing to the Senators. Fischer wrote: “DFS’s review of the
various networks has confirmed that each of the insurance companies in Long Island
exceeds the standards for mental health and substance use providers, for the
purpose of the commercial products sold outside of NYSOH.”
Translation: There is no problem. There is nothing more
to do. This does not square with the results of Project Access.
Health insurers and
government ignoring federal parity law is discrimination. When it comes to
suicide prevention: access delayed, is access denied.
Discrimination deserves a place alongside stigma when the conversation turns to access
to care.
It’s a matter of civil rights.
Long after the tragic deaths
of Kate Spade and Anthony Bourdain fade from the front pages, the lack of
compliance and enforcement of federal parity law will persist and the thousands
of people that the Governor spoke of in hispress release will still be unable
to access care.
Andrew Malekoff
This article was published in the NYS Behavioral Health News, Summer 2018
Andrew Malekoff is the
Executive Director of North Shore Child & Family Guidance Center, which
provides comprehensive mental health services for children from birth through
24 and their families. To find out more, visit www.northshorechildguidance.org. To read more about Project Access go to: https://www.northshorechildguidance.org/wp-content/uploads/2017/12/north-shore-project-access.pdf
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