Disparity, Not Parity | Mental Health America

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Disparity, Not Parity

By Paul Gionfriddo, President and CEO, Mental Health America

It’s disparity, not parity, that’s the norm for mental health status and services in America.

That’s what you’ll discover as you look through the pages of Mental Health America’s ambitious new report, “Parity or Disparity: The State of Mental Health in America.” The disparities are striking across regions, populations, and age groups. We used the most recent available data, and they paint a challenging and discouraging picture of the outcomes of our mental health policies across the nation.

Here’s why we did this. In simple terms, we think facts matter. 

There’s been an information void in many of the recent mental health policy debates, and that’s a problem. As legislators, advocates, and interest groups have argued over whether one policy approach is better than another, they’ve often argued from the heart.

But when they’ve tried to respond to crises, they haven’t really taken a deep dive into the facts existing on the ground before the crises occurred.

That’s what this report does.

I won’t numb you in this blog post with the details of the charts and tables, because they’re all just a click away. But I will share three of my own observations:

First, many of the states that have most forcefully rejected recent federal assistance in improving services to people with mental illness – such as the Medicaid expansion (which largely affects the people we care about) and the Affordable Care Act with its inclusive set of essential health benefit mandates – are among those that, compared to other states, have done the worst jobs of developing, funding, and improving access to mental health services on their own.

Second, the states that have invested in mental health services – no matter what their political leanings – have invested wisely. They have lifted up the people who needed help. Conversely, those that have not invested in these services have often started with a healthier population, and then compromised that health by failing to offer access to needed services.

Third, there’s a solution to disparity, no matter what our philosophical leanings may be. 

And that solution is simple and straightforward. 

We need to invest more heavily in early identification and intervention. As we argue at Mental Health America, we need to invest before Stage 4 (#B4Stage4) – long before mental health concerns become mental health crises, when recovery is easiest to attain.

By issuing this report, we try to make that just a little more difficult to ignore facts as we debate mental health policies in Washington and across the states. We present the facts as they are, and use them to compare and – yes – rank the states across them all. But in creating these rankings, we rely solely on the facts, and not our, or anyone else’s, opinion of whether those states are passing or failing in their mental health policy efforts. 

We do tell you a little about what the facts mean. And we also give you some real-life examples of the way Mental Health America’s innovative affiliates are changing the realities of their states and counties on the ground. 

Finally, we tell you where we stand in our policy recommendations. And then we let you decide – after putting the facts under your own microscope – what you think it will take to make parity the reality envisioned by President George W. Bush, Rep. Patrick Kennedy, and so many others back in 2008.


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I agree a HUGE problem is not only number of options, but quality of care. I literally got PTSD from being in an ER or two days. I was suicidal, obviously already having a really really bad day. So did not need to be bullied from beginning to end, deprived of food and water, lied to and about, put INTO a life-threatening condition on PURPOSE by the doctor, etc. etc. And not one person who had the power to address these issues did a thing. Some did not even believe.

Edited on January 20, 2015.

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