黑料不打烊

By Rosalynn Carter

The Washington Post

I would like to comment on Robert Samuelson's op-ed column "Hard Call on Mental Health," which appeared in The Post on June 5.

As Mr. Samuelson noted, more people are successfully treated for mental illnesses today than ever before due to better understanding of the brain and new medications for illnesses that were once considered "untreatable." These advances are the direct result of brain research conducted in the past two decades, which is transforming the lives of people with mental illness.

In discussing concerns about the cost of implementing parity, he mentions that actuarial estimates have varied. Indeed, only time and experience will reveal what the most accurate estimates are. What we do know is that in states where parity for mental illnesses has been implemented -- and in private corporations that have used flexible, innovative coverage -- costs have been managed effectively.

Mr. Samuelson also is concerned that regarding "ordinary anxieties and disappointments as ailments" would be especially problematic. Even if everyone sought such help, in a regulated environment, criteria for medical necessity and the rigors of managed care review would prevent abuse of the system. Moreover, his comments about diagnostic reliability do not reflect the fact that mental health clinicians agree on many diagnoses 80 percent of the time, which compares favorably with the diagnostic reliability of some physical illnesses.

Finally, with regard to the notion that the parity amendment is an "unfunded mandate," (and I am not sure it is), I would ask if it is any more so than the mandate we impose on individual and corporate taxpayers when we fail to provide adequate treatment for mental illnesses. These "silent" mandates include costs to our welfare, juvenile justice, and criminal justice systems, and our historically and shamefully underfunded public mental health systems, as well as support for the homeless and loss of productivity in the workplace.

I urge everyone to look at the facts about the growing knowledge and expertise in treating mental illnesses. Those who do will see there is no reason to continue the historic discrimination against people who suffer from them.

ROSALYNN CARTER