After learning that the driver who was killed after a chase through Washington was not a terrorist but a woman with a baby in the car, my first thought was: “Let me guess, she had a history of mental illness.”



I’m sure I was not the only journalist in the country with that thought. In newsrooms throughout the land I’m sure there were reporters and editors who said, “I bet she had a history of mental illness” and made quotation marks in the air with their fingers when they said “HISTORY OF MENTAL ILLNESS.”

It’s kind of like when a hurricane is heading our way and we turn on all the TVs in the newsroom and take bets on who will be the first reporter to say “feeder bands.” That’s how common and trite these horrific news stories have become.

The day after the Washington shooting a guy set himself on fire at the Mall in Washington. In my head – and I bet in your head, too – a little voice said: “I bet he had a history of mental illness.”

Seems kind of ironic that in the last three weeks we have had three violent incidents by people with “a history of mental illness” and all were in our nation’s capitol – the same place where we heard all the big talk after the Newtown, Connecticut shooting last year about how we need to do something about “our nation’s broken mental-health care system.”

Remember, way back in January, when the president signed a package of 23 executive actions – called “Now is the time” – in response to the Sandy Hook Elementary School shooting. The last four of the 23 executive actions addressed mental health.

20. Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover.

21. Finalize regulations clarifying essential health benefits and parity requirements within ACA exchanges.

22. Commit to finalizing mental-health parity regulations.

23. Launch a national dialogue on mental health.

The administration claims it has made “significant progress on 22 of the 23 executive actions.” However, it does not reveal the one executive action on which no significant progress had been made. Let me guess: could it be #22?

YES! Parity regulations. We still don’t have rules to implement the Mental Health Parity and Addiction Equity Act! which was passed nearly five years ago. First, the president said proposed regulations would be out in February. Now we are hearing the end of the year – which is two months away.



As for #20: Yes, the guidance letter did go out! The guidance letter reminds states that mental health parity applies to Managed Care Organizations, but “MCOs and states will not be deemed out of compliance if the MCOs fulfill the requirements set forth in the Medicaid state plan regarding financial limitations, quantitative treatment limitations, nonquantitative treatment limitations, and disclosure requirements. However states can amend MCO contracts to promote parity.”

Like THAT’s going to happen. We also have 23 states – including Florida, where I live – that have opted out of Medicaid expansion. So, we’re not going to see more people getting this quasi-parity mental health coverage from MCOs in those states.

As for #21: Are there final regulations clarifying essential health benefits and parity requirements within Affordable Care Act exchanges? Sure. Government web sites explain that the ACA requires parity as spelled out in the 2008 Mental Health Parity and Addiction Act – which basically has no teeth because there are no regulations.

Finally, on #23 – YES we have launched a national dialogue on mental health. However, this dialogue is NOT the by-product of the White House conference on mental health on June 3. I would bet most people don’t know that even happened.

Unfortunately, the dialogue on mental health is being stoked by more headlines about the horrific and tragic deeds of people with  “a history of mental illness.” Seems “our nation’s broken mental-health care system” is still broken.