News that insurance coverage of mental illnesses must be equal to coverage of any other health care challenge is heartening, wise and a long time coming. Now the real work begins.
On Friday, the Obama administration officially clarified that insurers may not discriminate against people facing mental health and substance-abuse issues. Building upon the Wellstone-Domenici Mental Health Parity and Addiction Equity Act of 2008, Friday's declaration set in stone a no-tolerance policy for insurance companies who, for decades, have legally treated Americans with mental illnesses as second-class citizens.
It was common, for example, for people to pay more out-of-pocket for mental health treatments than for physical treatments. Hospitals or insurance companies might cover 85 percent of physical ailments, but 60 percent of mental health concerns. And someone with a knee replacement could be covered for a rehabilitation facility until healed. That's not generally true for someone with an eating disorder.
While most individual and small-group policies remain exempt, our state's new online health insurance exchange, called MNsure, will follow parity in coverage of mental health and substance-abuse issues.
"Even more people will get covered," said a buoyed Sue Abderholden, executive director of NAMI, the National Alliance on Mental Illness Minnesota.
But mental health parity is only part of the healing. Larger copays are a minor frustration to people facing shaming or silence from co-workers, family members and friends who would never shun someone with a cancer diagnosis.
While people facing cancer, heart disease or MS are often called courageous, Abderholden said you never hear that word spoken about someone with a mental illness, although you should.
And when was the last time any of us sent a get-well card to a friend in the hospital dealing with bipolar disorder?
To change that thinking, Abderholden has been involved in a groundbreaking public-awareness campaign, called "Make it OK," which launched Oct. 25 and will continue into 2014 (www.makeitok.org).
Partnering with HealthPartners, Regions Hospital, Twin Cities Public Television (TPT) and many nonprofits, the $1 million campaign seeks to make it OK to talk openly and honestly about mental health.
To make it OK to bust media-fed myths. In fact, only 5 percent of violent crimes are committed by people with mental health illnesses.
To make it OK to have hope and to not be defined by one's diagnosis.
And to make it OK to admit that we often do not know how to comfort someone with a mental illness, even when we really want to.
The centerpiece of the project, which includes conversational tips, print ads, bus signs and radio spots, are four documentaries airing on TPT now and into the spring featuring Minnesotans sharing deeply personal stories, some of them publicly for the first time.
"I'm not worried about people finding out, but what will they think?" wondered Janet Ruth Havens of Edina. Havens, 40, received a bipolar diagnosis at 21, and also suffers from a panic disorder. She is filmed taking a walk alone around Minneapolis' Lake Harriet, a seemingly mundane act, but herculean for her.
"I really wasn't sure I could do it," she said. "It was a relief," she said. "A sense of accomplishment." Courageous.
Havens has tried many medications and treatments over the years, including electric shock therapy, "which has been very instrumental in restoring my mental health." She's built a happy and focused life thanks to a "wonderful, wonderful" therapist, a strong support system of family and friends, hobbies including cooking and baking, compassionate employers and a strong Christian faith.
"The more open I am," she said, "the more people rally around me."
Melissa Hensley is an assistant professor of social work at Augsburg College. Some of her students also know that, when she was about their age, she was diagnosed with bipolar disorder. She was eager to share her story for Make It OK.
"We have to be realistic," said Hensley, 44, whose story (www.tpt.org) aired earlier this month. "One public awareness campaign is not going to solve the whole problem, but the documentary helps put a face on mental illness. A diagnosis does not equal destiny."
Dan Abdul, 34, is a U.S. Army veteran and technology executive who suffered severe depression with post-traumatic stress disorder after a military accident in 2004. A husband and father, he's learned to identify his "triggers" and manage his disease through therapy, sleep, biofeedback, meditation and medication.
"We're trying to get the message to people that recovery is possible and you can go out and live whatever life you choose," said Abdul, who has lost friends who didn't believe that his struggle was biological.
"There is nothing negative about an individual living with mental illness. We need to talk about it. If you're going to say something, say, 'Hey, I'm here for you if you need anything.' For me, that's the absolute best thing."
Feedback about the campaign has been highly positive, said HealthPartners senior vice president Donna Zimmerman.
"But we wanted it to be more than a media campaign," she said. "It was very motivating for our team to change the paradigm, where people feel safe to talk about their issues. Most people will get better. The stigma remains, but it's nice to know we're turning the corner."