Page 18 - Mar2019_BarJournal

BarJournal HEALTH CARE LAW

JULY/AUGUST 2015
fEaTUrE access your Mental Health

Insurance Benefits, Too

BY RITA BRYCE

f your health insurance plan offered to The reason insurance companies put mental day-to-day functioning, relationships, family
pay for a gym membership, would you health on par with physical health is because they background, trauma or abuse, education, health
consider joining a gym? If you had a chronic are the same thing. Mental health is integral to history, medications, history of substance abuse,
cough would you take advantage of health and inseparable from overall health. The things exercise, nutrition, spirituality or religion and
I insurance to get treatment? If you noticed that occupy the mind affect heart rate, blood leisure activities, the things the patient enjoys in
you were feeling markedly worried, down or pressure, digestion and the immune system. life. Sometimes the patient may not see questions
listless, would you think about taking advantage Real physical symptoms, such as a racing heart as relevant. For instance, it is fundamentally
of your insurance to get treatment? rate, unexplained pain, or shortness of breath, important for the therapist to assess whether each
Most of us understand that health insurance can be manifestations of mental health issues. patient is suicidal. The most effective way to get
pays for treatment and prevention of physical The medical profession has been aware of the this information is usually to ask the question
ailments. The ABA and the CMBA Committee interconnectedness of mental and physical health directly. Some patients may be confused or
on Mental Health and Wellness have been for some time. But, because of stigma attached surprised by such a question, but the question
working to normalize treatment for mental to treatment for mental health issues, the legal is essential to keeping a patient safe. Once all
health concerns, as well, so that lawyers attend profession is still catching up with the idea that this information is assessed and a diagnosis is
to their whole health. The National Institute of mental and physical health are seamless components developed, future sessions focus on treatment.
Mental Health found in 2016 that 18% of the of overall health, both requiring regular maintenance. Therapists may specialize in different approaches
U.S. adult population experienced some type of Patients seek out a therapist for many of the to address behavioral issues, though most employ
mental health issue. By comparison, a 2016 ABA same reasons clients hire a lawyer: They have more than one approach because patients present
sponsored study of 13,000 practicing lawyers experienced a trauma, or there is a chronic a variety of issues. Two of the most commonly
found the following: 28% experience some level issue in their lives or businesses, and they need applied are psychodynamic psychotherapy (usually
of depression, 19% suffer from anxiety and 23% help addressing that issue. They want to get in just referred to as psychotherapy) and cognitive
struggled generally with excessive stress. control of their lives, and they need someone to behavioral therapy. Both approaches are generally
If your health insurance provides mental guide them through that process to resolution. covered by health insurance plans for therapists
health and substance abuse disorder benefits, they Looking through this lens, perhaps more lawyers who are designated providers for the plan.
are available on par with physical health benefits will view — or even consider recommending — Psychotherapy patients usually see a therapist
such as doctor and hospital visits. The Federal mental health treatment for colleagues, clients and weekly. In the context of a trusting relationship
Mental Health Parity and Addiction Equity Act themselves, as a normal component of health care. between patient and therapist, through talking,
(2008) generally requires parity between benefits In this context two questions arise: What the patient gains access to unconscious thoughts
for mental health and substance abuse disorders, mental health benefits will insurance typically and feelings that negatively affect current
and benefits for medical and surgical treatments. cover (after deductibles, of course)? What will behaviors. With the patient’s overarching goals
If your primary care physician is a provider under a patient’s experience be like? in mind the therapist listens for patterns. Through
your insurance plan and you pay a co-pay for The first covered visit to a therapist is termed the psychotherapy the patient finds words for
a primary care visit, then you would likely also Mental Health Assessment. In this visit the therapist previously unconscious feelings. Without words
pay a similar co-pay for a mental health therapist gathers information that will lead to a diagnosis for experience, people sometimes “act out.” They
who is a provider under your plan. which informs treatment. Much like a lawyer looks at feel intensely without knowing why and develop
Insurers may offer monetary incentives to the code, or common law, to fit the facts to elements, physical or behavioral symptoms. By learning a
members to meet incremental health care goals a therapist assesses the symptoms a client exhibits language of feelings, the patient builds “emotional
that are likely to lead to improved health. These to determine a diagnosis. Also, similar to a lawyer’s muscle” to exercise in future relationship issues.
incentives apply to physical and mental health. first interview with a client, a therapist will have a When feelings are expressed in words there is
My insurance company offers a financial incentive great deal of information to gather, but typically less need to express feelings through maladaptive
(about $120 a year) if I check in online weekly this information comes out in a conversation rather behavior or bodily symptoms.
and track not only my exercise and eating habits, than a stilted set of interrogatories. In contrast, cognitive behavioral therapy (CBT)
but also if I give a rating of my stress level (low For the most part the first therapy appointment is a structured approach designed to achieve change
to high, 1 to 5) and my mood (“Happy,” “Okay,” is an opportunity to engage with another person in specific behaviors. CBT assumes that certain
“Down” or “Sad,” as depicted by increasingly and unburden yourself of problems in a supportive situations trigger negative, automatic thoughts,
gloomy facial expression emojis). context. A therapist will gather information on termed cognitive distortions, that result in
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