Increasing Access to Care

Our active federal and state policy efforts encourage expanded availability of mental health screenings and early identification of mental illness for all adolescents.

Working closely with government and advocates, we support demonstration projects, collaborate with expert panels, and serve as a resource for Congress, state legislators, federal agencies, state health and Medicaid commissioners, and state suicide prevention offices.

Our work with health plans focuses on developing best practices to implement federal regulations and guidelines recommending annual adolescent mental health screenings.
Read more.

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008

Signed into law in 2008, MHPAEA provides federal protections that stipulate mental health and substance use disorder benefits offered by employer health plans be on par with medical and surgical benefits. View the legislation. These protections build on the 1996 federal parity law which prohibits discriminatory annual and lifetime benefit limits for employers’ plans offering mental health coverage.

Interim final regulations clarifying how parity protections apply were issued in February 2010 – view them here. These regulations provide strong consumer protections, with copays, deductibles, visit limits, gatekeeper requirements and medical management included.

Who Receives Parity Protection

The Mental Health Parity protections passed in 2008 applied only to employee health plans covering 51 or more employees. However, the Patient Protection and Affordable Care Act of 2010, (the Affordable Care Act or ACA), expanded parity protections to new types of plans.

Consequently, parity protections will extend to individual and small group plans offered in the Exchange – new marketplace for insurance created by the ACA — as well as to adult Medicaid managed care plans and coverage offered through the Children’s Health Insurance Program (CHIP). Read more details.

What Parity Means for Patients and Families

Consumers should understand and help monitor implementation of the law. Analysis of state-level mental health parity protections in New York found that many consumers and even health plan employees are unaware of the state benefit protections. See the full report here. Monitoring implementation of the federal law will be equally important.

For resources to help you understand and monitor how federal mental health parity protections apply in your own health plan, visit the Parity Implementation Coalition.

Health Care Reform

The federal health care reform bills signed into law in 2010 will expand access to care; provide new consumer protections for privately purchased health care; and spur innovation in health care payment, quality and delivery practices. The law extends mental health parity protections to new groups of covered individuals and mandates access to certain preventive services – including mental health screening — at no cost to patients. Read more.

Preventive Services Covered under the Affordable Care Act – New resources on www.heathcare.gov explain the importance of preventive care and list the recommended preventive services to be offered without cost-sharing under the health care reform law.

Medicaid

The annual well-child checkup covered by Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit requires that an adolescent mental health assessment be offered during the visit. Evidence suggests that few states require mental health screenings as a regular part of the covered well-child visit. The TeenScreen National Center offers policy options at the Federal level to improve state practice. Read more.

The Massachusetts Experience: Massachusetts has some of the most comprehensive requirements for the inclusion of mental health screenings in Medicaid’s Early and Periodic Screening, Diagnostic and Treatment benefit (EPSDT) primary care visits. Other states are using this experience as a model for expanded mental health screenings through EPSDT. See fact sheet.

Rosie D. and Mental Health Screening: Rosie D. and Mental Health Screening: A Case Study of Providing Mental Health Screening at the Medicaid EPSDT Visit. provides an in-depth review of the impact of a landmark class action suit, which prompted Massachusetts’ broad implementation of mental health screening at Medicaid well-child visits.

Summaries of key insights learned from the Massachusetts experience are available for both policymakers and health plan leadership. See our Brief for Policymakers and Brief for Program and Plan Directors.

Quality

Defining mental health screening as a covered benefit is not always sufficient to ensure that it is provided in clinical practice. Quality measures, such as those proposed by the Children’s Health Insurance Program Reauthorization (CHIPRA) legislation, can help to improve both recognition of the need to provide this service and the rate at which it is offered.Read more.

Suicide Prevention Programs

The TeenScreen National Center informed the design of the nation’s first national suicide prevention legislation, the Garrett Lee Smith Memorial Act. Local TeenScreen sites are helping to implement federal suicide prevention efforts. Forty-four states have suicide prevention plans in place that mention screening as a key method of early identification and prevention. Nine of these states specifically endorse the use of local TeenScreen programs in: New York, Florida, Iowa, Nebraska, New Mexico, Oregon, Vermont, Delaware and Montana.

TeenScreen and the Garrett Lee Smith Memorial Act. Read more.
State Suicide Prevention Programs. Read more.

Policy Partnerships

Seven of the nation’s leading mental health organizations, and more than 20 professional groups, endorse mental health screenings for every young American. Read more.

Policy Events

TeenScreen National Center’s policy events and briefings highlight the challenges, the opportunities and the progress being made to increase access to adolescent mental health screening and early identification of mental illness.