Erasing the Stigma

“Wisconsin is really behind the times,” said a physician testifying before the Senate Health Committee last week. “We know there is a connection between mental and physical illness. But, because of the stigma of mental illness, Wisconsin creates an artificial difference.”

“Come out of the basement” challenged Lieutenant Governor Barbara Lawton. “Wisconsin is only one of eight states that does not have some form of mental health parity.”

Parity means the same; the committee hearing was about mental health “parity”. That is treatingmental illness the same as physical illness. The bill in question would require insurance companies to treat mental illness the same as physical illness.

Physicians, social workers and advocates testified that we now know common mental diseases like depression are related to brain chemistry; just like epilepsy or Parkinson’s disease.

The link between mind and body and health cost is amazing. A person with diabetes is twice as likely to be depressed.  And a depressed diabetic costs four and a half times more to care for than a diabetic who is not depressed. This is just the tip of the iceberg.

If you are depressed, you are more likely to have a heart disease; if you have arthritis and treat your depression, you can move around better; if you have frequent asthma attacks you may suffer more mental illness but mental health treatment will decrease your physical asthma symptoms. We can no longer ignore the link between mind and body.

One psychiatrist asked us “Why give people access to full insurance coverage for high blood pressure and tell them to watch their diets and deny them access to alcoholism care when the data show that a person’s alcohol use contributes just as much risk to their blood pressure as does their salt intake!”

If patients are left untreated, there are all sorts of costs – to the patient, the family, coworkers and employers.

Representative Sheryl Albers (R-Reedsburg) the Assembly lead sponsor reviewed a long list of costs to business. Did you know, in Wisconsin, we lose 170,000 work days a year to depression alone and workers with mental illness are more likely to draw on unemployment compensation or workers compensation? Amazingly, the cost of adding mental health to insurance plans is minuscule – between 0.4 and 0.9 % of premiums; in Minnesota, where the legislation passed in 1995, premium costs rose just 26 cents per member.

What happens to people when they have no coverage for mental illness or not nearly enough? The costs are shifted to taxpayers and we all pay for treatment. We heard testimony from doctors that encouraged patients to quit their jobs and sign up for disability. However, the doctors told us they didn’t want to recommend this course of action because work was really the best thing patients could do. But this was the only choice the messed up system left them. 

Treating mental illness saves all of us money. Take addiction. We heard testimony that for every dollar spent on addiction treatment, we save $7. That’s partly because the real cost of addiction is not treatment but all of the other problems addiction costs us – property loss, vehicle crashes, crime, physical injury and illness. The costs of alcohol addiction alone to business are over $150 billion a year in lost productivity, absentee employees, disability and job turnover.

I learned the limits on mental health coverage have not been changed in Wisconsin law in twenty years. For the past ten years, the bill to correct the problem has been introduced and still the legislature has not acted. Not a single person testified against the bill. But several business groups including Wisconsin Manufacturers and Commerce registered against the bill.

It seems to me, it’s time to get this job done.

As the bill’s Senate sponsor, Senator Dave Hanson (D-Green Bay) testified “Current laws that allow for the inequitable treatment of mental illness and substance abuse disorders are nothing more than legalized discrimination. Mental illnesses are medical problems, not character flaws, and should be treated as such.”

Above all this is a human issue and human resources are our most precious. Lieutenant Governor Lawton addressed this concern, “We are facing a national work force crisis. We are fighting for human resources and we can’t afford to squander any of them. Every single one of us is only one time removed from this problem.”

We must erase the stigma of mental illness now and forever.