Even though more than one-in-four Americans have received treatment or therapy from a mental health professional, few people know that health insurers are required to provide coverage for mental health, behavioral health and substance-use disorders that is comparable to coverage for physical health.

The Mental Health Parity and Addiction Equity Act was passed in 2008, but only 4% of Americans say they are aware of the law, according to a survey released this week by the American Psychological Association. Awareness of the law has not increased since APA last surveyed on this issue in 2010.

Also see: Mental health focus of new workplace campaign

The low level of awareness doesn’t surprise Mike Thompson, a principal and NY-metro health care practice leader with PricewaterhouseCoopers Human Resource Services. “Most people are just not aware of the benefit,” he says. “That doesn’t, of course, stop them from having access to equal benefits and the [mental health parity law] forced employers and insurers to even up the playing field for employees and their families.”

Under the parity law, insurance companies must provide mental and behavioral health coverage that is equal to or better than coverage for physical health, with no annual limits or higher copays or deductibles for treatment of mental health disorders or substance use. The law applies to most employer-provided health plans and to individual plans purchased through the new state and federal health insurance exchanges.

Still, while the mental health parity law leveled the playing field in theory, it hasn’t always leveled it in practice, notes Thompson. “There’s serious disparities still in terms of availability of providers in mental health versus other procedures,” he says.

While the APA survey found that 61% of adults reported that they have adequate mental health coverage, many report details of their insurance coverage that are at odds with provisions of the parity law. Almost three-in-ten (29%) Americans said their insurance has different copays or other limits for mental health care. Almost one-in-four (24%) said they aren't sure if their insurance offers the same coverage for mental and physical health and only slightly more than one half of people (56%) said that their current health insurance provides coverage to see a psychologist or other mental health professional.

When asked why they or a family member would not seek treatment, the cost of treatment was the most frequently cited reason, with 22% saying that cost was a barrier to seeking treatment. When asked what information they would need before being treated by a psychologist or mental health professional, 75% said they would need to know if they take insurance, whereas 68% said they would need to know if they are comfortable with their provider.

Also see: Rethinking mental health: 6 tips for employers

“Under treatment of mental health can be costly so it’s imperative employers be proactive in promoting the benefits and reducing the stigma around mental health,” says Thompson, a former president of the New York City Metro chapter of the National Alliance on Mental Illness. Last fall, Thompson participated in NAMI’s public service campaign, “I Will Listen”.

“The focus on reducing stigma is a growing area,” he says. “Because of stigma people tend not to identify issues in their families, or tend not to get treatment they need or stick with treatment and that impacts recovery. Leading companies are finding that the front line to battling mental illness starts with a proactive approach to battling the stigma.”

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