Testimony on
SB No. 4 and 5
Senate Health Policy Committee
May 28, 2003
Submitted by Tom Bissonnette, MS, RN

Good afternoon, my name is Tom Bissonnette. I am a Registered Nurse with a master's degree in psychiatric/mental health nursing and a member of the Michigan Nurses Association. I work as a Program Director for the Michigan Health Professional Recovery Corporation.

I am here today speaking on behalf of the Michigan Nurses Association in support of Senate Bills 4 and 5 to establish Mental Health parity.

Senator Hammerstrom is to be commended for recognizing that comprehensive health care for Michigan's residents includes legislative and regulatory support for coverage of mental health and substance abuse treatment.

Nurses are the largest group of health care providers. We deliver the most continuous and direct care in virtually every treatment setting.

As advocates for patients, nurses speak in support of this legislation to address the inequities in insurance coverage for Michigan citizens who require mental health or substance abuse treatment. A core value of the profession of Nursing is that the biological, psychological, and social sciences are basic components for health. Failure to recognize any of these components means a less than optimum outcome for patients, their families, and for Michigan.

Parity for mental illness and substance abuse treatment refers to insurance companies and employers providing the same benefits for the treatment of mental illness and substance abuse that apply to any medical condition, such as asthma, diabetes, or heart failure. The management of chronic conditions through health provider visits and through routine medication administration is an equal burden for Michigan citizens suffering from mental as well as physical illnesses.

Mental illness and substance abuse affect millions of Americans of every age, ethnic and racial group, of both genders, and at all educational and income levels.

The U.S. Department of Health and Human Services in conjunction with the Institute of Medicine, National Academy of Sciences released its report Healthy People 2010 which details major public health concerns in the United States. The objectives of this report are to serve as building blocks for community health initiatives. Goal # 18 of Healthy People 2010 is to " Improve mental health and ensure access to appropriate, quality mental health services". According to this report

" Approximately 20% of the United States population is affected by mental illness during a given year.
" More than 19 million adults in the U.S. suffer from depression, the most treatable of any of the mental illnesses.
" Available medications and psychological treatments can help 80% of those with depression.
" Depression is associated with other medical conditions such as heart disease, cancer, diabetes, anxiety, eating disorders, as well as with alcohol and drug use.
" The rate of depression in geriatric hospital inpatients is 12%;
" The percentage of older persons with depression living in nursing homes ranges from 15-25%.

The total estimated direct and indirect cost of mental illness in the U.S. in 1996 was $150 billion.

The prevalence of substance abuse disorders in the American population is estimated at 7-15%. The impact on the American workforce is significant and the importance of treatment may best be reflected in the results of a study conducted by the Rimrock Foundation. For those employees of the Oldsmobile plant in Lansing, Michigan who entered substance abuse treatment there was found to be a:

" 49% Decline in lost work hours;
" 29% Decline in health benefits costs;
" 56% Reduction in absenteeism;
" 82% Decline in number of plant accidents.

To those that oppose parity because of cost...there is data to indicate
" The cost of untreated mental illness to families, criminal justice and social welfare services is $4 billion/year
" Lost productivity at work due to mental illness is estimated at $63.1 billion
" Patient data reported by an HMO indicated patients with clinical depression or anxiety cost the HMO twice as much in one year as patients without those illnesses. Providing mental health services leads to a "cost-offset" effect, which is a decline in the use of general medical care.

A number of states have already passed some form of mental health parity laws. (Table attached). We can design a model based on the experience of others that will meet the needs of all stakeholders in Michigan.

The Michigan Nurses Association stands ready to assist in your effort to eliminate the discrimination and stigmatization experienced by those suffering from mental illness and substance abuse. Providing legislation that ensures equal insurance coverage for mental health is a vital strategy in supporting these individuals to be productive, contributing citizens of Michigan.

REFERENCES

Healthy People 2010 from www.healthypeople.gov

Thomas, N. and Leavitt, J. (2002) Mental Health Parity: A Call for Nursing Action. Policy, Politics & Nursing Practice. Volume 3 (1) February 2002 43-56. Sage Publications

Results of Employees Entering Treatment, Large Corporations. (2002). Rimrock Foundation, Billings, Montana.

All content © 2007 Michigan Nurses Association