By Maridith Yahl
NKyTribune health reporter
The importance of mental health care is increasingly coming to the forefront, but strides still need to be made to move forward according to a panel of advocates at a recent “Your Mind Your Business” webinar hosted by the Metropolitan Club.
“I think that we have this tendency to underplay the importance of mental health even though all of our data shows that it feeds right into physical health and productivity and everything else that they are directly correlated by,” says Dr. Mike Kalfas, Addiction Medicine Physician, St. Elizabeth Physicians.
Chris Faust, President and CEO, Clovernook Center for the Blind & Visually Impaired, echoes Dr. Kalfas’ sentiments. “I believe mental health helps with physical health and if your employees feel good and they’re healthy, they end up being more productive. If the person is made whole and healthy, the rest will follow, Faust says.
Leadership teams need to connect on a personal level with their employees says Maria Sulcer, Outreach Specialist, The Lindner Center of Hope.
“To connect with people, we have to get personal, so we have to learn about ourselves and our own self-awareness. We have got to check in with people,” says Sulcer.
Connecting with people means both on a personal and professional level. “I think that’s the key right now. We all know mental health and physical health [are connected]. We’ve got to address that as the same because the mental, emotional effects the physical and the physical effects the mental, emotional. So being there for people is what’s key,” Sulcer says.
“In terms of policy, the fact is that mental health is not treated the same as physical health,” says Faust. Issues between providers and insurers must be resolved. Mental health coverage is based on in-network, says Faust. “If none of the providers want to work with the health insurance companies, there’s nobody in-network and it’s cost-prohibitive for a lot of individuals in order to get the help that they need,” he says.
To help this he suggests a much larger focus from a national perspective on insurance carriers. “I just don’t understand how they have not connected mental health with the physical side. Maybe there would not be so many medical bills on heart attack and high blood pressure if things were treated on a mental side. They’re treated completely differently, and they shouldn’t be,” says Faust.
“Until companies insist that they get better mental health care coverage and it’s not this little help, this little bubble on the 15th or 16th page, nothing is going to change. Hopefully, this is one good thing that’s coming out of this is we’re realizing that mental health is, we got a brush fire going on and then if we need insurance coverage in-network coverage and providers to be available,” says Trevor Steinhauser, Advocate for Mental Health & Addiction; host of Stigmatized, Behavioral Health Podcast.
Mental health is always the first coverage to get cut, says Dr. Kalfas. When employers and insurers review the premium to determine costs, the first place they automatically cut is mental health. Then premiums, deductibles, and copays are raised to reach an agreement on a price.
Dr. Kalfas says he is relieved when he sees a patient has Medicaid. From experience he knows going through commercial insurance will be a struggle to get the recommended treatment.
Parity is a medical-legal term which makes something a priority from a legal standpoint, says Dr. Kalfas, it becomes required to accept that. “I think parity laws need to be tightened a little bit, making mental health service compulsory in the health plans.” This provides an avenue for legislative remedies, but someone must take this on.
“I think ultimately, we’ve been making these types of things the government’s job, so I think by default it is their job to see that it’s done,” says Dr. Kalfas. However, because of nuances in different regions, he believes it should be handled at the local and state level. Around Northern Kentucky the opioid crisis is big, but somewhere else it may be alcoholism.
A national plan sets the tone says, Faust. When there is no support for mental health care at the national level, it makes it harder for states. “When there’s national pressure on the insurance industry and others to open up the plans to allow for more access, that could be the role they play and then let the states and local counties do what they need to do,” says Faust.
The government needs to lead the way for mental health, but communities need the flexibility to design what works for them, says Steinhauser. “One particular community is going to come up with a solution that can be copied in other places,” he says. Making a one size fits all plan will stifle creative solutions, denying ideas others will want to emulate. Allowing the development of many solutions is necessary.
Also, Dr. Kalfas says to look at policies that are now in place but causing problems and then reverse engineer them. Research and investigate what led to the problem and correct those. Some of the policies were state and federal, some from payer issues, and some parity issues.
Human-centric solutions are needed, these advocates say. Businesses need to take a stand and demand quality, affordable mental health care from their insurance providers. The national government needs to set the tone in requiring mental health and addiction coverage.