Mental Health "Parity": Why Waste Money, Endanger Civil Liberties?
Special to The Seattle Times, Thursday, February 10, 2005
By Keith Hoeller

With a $2 billion shortfall in Washington state's budget, fueled by the skyrocketing costs of health insurance and prescription drugs, what are our legislators doing to solve our health-care crisis? They are pouring gasoline on the fire of our burning health-care system.

Our Legislature is rushing through two bills to mandate equal coverage of mental-health treatments by insurers in our state. Legislators have swallowed all of the false claims made by the mental-health movement, all of whose branches are heavily funded by the drug companies who stand to profit from the parity these bills require.

Believing that you can have something for nothing, legislators appear eager to force insurers, including the state itself, to pay for hundreds of millions of dollars in mental-health treatment that is not now paid by insurance. The idea that having insurance pay for this new coverage will not lead to higher premiums, reduced benefits and dropped coverage defies the laws of economics.

For example, the bills may cause the costs of the Basic Health Plan, our state's severely strapped insurance plan for the poor, to rise as much as 5 percent a year at a time when the state is threatening to drop people from the plan.

Mental-health proponents repeatedly scream that mental illness is like other illnesses and it is wrong for insurers to discriminate by not providing equal coverage for mental-health treatments.

But mental illness is not at all like physical illness in at least three significant ways.

First, no credible scientific evidence has been offered to conclusively prove that any mental illness has a biological or genetic cause or origin. Indeed, in 2003 I was a member of a scientific panel put together by the psychiatric survivor group Mindfreedom to challenge the American Psychiatric Association to provide conclusive scientific evidence that any mental illness had a biological cause. Despite an exchange of several letters, the APA failed to do so.

That is why no physical test (blood test, X-ray, brain scan) has been developed to determine if anyone actually has a mental illness. Unlike physical illnesses, all mental illnesses are diagnosed only from a list of symptoms created by the APA. Indeed, many mental illnesses are diagnosed by counselors and therapists who have no medical training.

Second, regular medical doctors do not hospitalize their patients against their will and force their treatments on them. Yet, mental-health treatment rests on the routine use of police force and coercion. Mental-health laws in every state permit the incarceration and forced treatment of mental patients. The very threat of involuntary treatment is often enough to coerce mental patients into accepting treatment "voluntarily." These parity bills would require insurers to pay for mental-health treatment, regardless of whether it was chosen by patients or forced on them.

Third, our health-care system rests on the twin pillars of patient autonomy and informed consent, both of which are sorely missing from the mental-health system. Not only are mentally ill patients routinely denied their right to refuse treatment, they are often not told either the potential side effects or the alternatives to mental-health drugs and treatments.

The mental-health movement has wrapped itself in the mantle of the civil-rights movement, shouting equality and protesting discrimination. But nearly every spoke of the movement stands in opposition to the fundamental civil right not to be a mental patient and not to receive unwanted treatment.

The two mental-health parity bills in the Legislature endanger not only the economic health of our state, but also endanger the civil liberties of every one of our citizens.

Let's hope a few of our state legislators will have the courage to stand up to the drug companies and the mental-health lobby and vote against these bills for the eighth year in a row. If not, let us hope that Gov. Christine Gregoire, who was willing to stand up to the tobacco companies, will show a similar determination to stand up to the drug companies and to protect our economic and civil health by vetoing them.

If our legislators really want to mandate expanded health-care coverage in our state, there are three more-deserving places where they can begin. First, they should increase the number of citizens in our state's Basic Health Plan for the poor, including children. Second, they should mandate that health insurers increase coverage for vision and dental care. Third, they should end the massive unequal treatment and discrimination against our state's elderly by insisting that insurers pay for nursing-home care.

Keith Hoeller is editor and publisher of the interdisciplinary "Review of Existential Psychology and Psychiatry," based in Seattle. He is the editor of eight books, including "Thomas Szasz: Moral Philosopher of Psychiatry." He holds a doctorate in philosophy and a master's degree in psychology.