Rant-o-Rama: Mental Health Parity for 9/11 Survivors
Where is Patrick Kennedy when we need him?!
Recently, the folks drafting rules for the 9/11 Compensation Fund announced that the $2.8 billion fund created by Congress last year will not cover mental health problems caused by 9/11.
The Special Master notes that as in the Fund’s first iteration, the statute limits eligible injuries to those consisting of ‘‘physical harm.’’ Accordingly, as in the Fund’s first iteration, the statutory language does not permit the Fund to cover individuals with only mental and emotional injuries, even if the mental and emotional injuries are covered by the WTC Health Program.
Apparently, the fund’s newly-appointed special master, Sheila Birnbaum, hasn’t heard about the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). I understand that the statute governing the 9/11 Compensation fund governs her duties to disburse the money to deserving survivors.
However, couldn’t Birnbaum take a stand and argue that because the brain is a part of the human body – ergo “PHYSICAL” – that “mental and emotional” injuries should be covered – especially since the MHPAEA is now the law of the land? In the spirit of parity don’t you think the government ITSELF should voluntarily commit to mental health parity when it comes to using tax dollars to provide ANY KIND OF HEALTH CARE!
That’s the law that former Rep. Patrick Kennedy (D-I), Rep. Jim Ramstad (R-MN), Sen. Pete Domenci (R-NM) and Sen. Paul Wellstone (D-MN) relentlessly pursued and finally got passed with some clever political slight of hand in 2008. The law requires that any group health plan that includes mental health and substance use disorder benefits along with standard medical and surgical coverage must treat them equally in terms of out-of-pocket costs, benefit limits and practices such as prior authorization and utilization review.
Seems a tad hypocritical for lawmakers to impose mental health parity requirements on insurers and private businesses but exempt itself from such requirements. And if I could digress for a moment, what’s up with using the word “ONLY” to describe “mental and emotional injuries”? If you know anyone who lived through 9/11, you know their mental and emotional injuries can be just as debilitating as physical injuries.
How can the mental and emotional injuries resulting from the terror of being trapped in a stairwell with hundreds of other people, not knowing if you will get out before the building collapses, not be covered by the fund? Watching people jump to their death, working week after week in rubble strewn with body parts or being trapped in twisted debris – how can any human being with a shred of compassion describe the post-traumatic stress, anxiety disorders, depression and substance abuse of these survivors as “ONLY mental and emotional injuries?”
So, how does Special Master Birnbaum intend to decide which injuries merit compensation?
In order to make these determinations in a fair manner, I intend to look to the evidence that scientists and medical professionals rely on in exercising their best professional judgment. I also intend for the Victim Compensation Fund to keep pace with the evolving science and to ensure that as we learn more about conditions that may have been caused by the crashes or related debris-removal efforts, we are able to compensate claimants accordingly.
Oh, really? What about the research by Dr. Emily Stern and Dr. David Silbersweig at the Functional Neuroimaging Lab at Brigham and Women’s Hospital/Harvard Medical School in Boston? Or the work of Dr. Sandro Galea from the University of Michigan, who is studying post-traumatic stress disorder, in conjunction with physical illnesses, such as asthma and heart disease, associated with 9/11. Or the research by Dr. Rosemarie Bowler, of San Francisco State University and Dr. James Cone, the WTC Health Registry’s Medical Director, who are studying depression, post-traumatic stress disorder (PTSD) and substance use among police first responders. This study will help determine the prevalence of 9/11-related PTSD and its risk factors.
I could go on, but what’s the point?As long as lawmakers and policy makers preface “mental illness” with the word “ONLY” we are back to where we were pre-MHPAEA. You just can’t legislate away stigma.
Stapleton, C. (2011). Rant-o-Rama: Mental Health Parity for 9/11 Survivors. Psych Central. Retrieved on April 28, 2015, from http://blogs.psychcentral.com/depression/2011/07/rant-o-rama-mental-health-parity-for-911-survivors/