Struggle for control: Mental-health care coverage is lacking

Published: Wednesday, April 26, 2006 11:51 p.m. MDT
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Utah's medical insurance system, it seems, would rather Jill Roberts be sick than well.

If the young woman stayed home, moped around, had wild mood swings and stayed really ill, she would be covered by one of a couple of government medical insurance programs.

But because Roberts is attending college and trying to live on her own after battling suicide attempts and mental health challenges, the 21-year-old has been blacklisted.

Medicaid denied Roberts coverage.

Insurance offered through the state college system wasn't approved because the plan doesn't cover psychiatric care.

Blue Cross denied Roberts coverage. So did Intermountain Health Care.

"You have an incurable disease called bipolar disorder," one rejection letter said.

"It amazes me," says Roberts. "The system would rather I sit home on the couch, versus going out, bettering myself and going to school. It's really frustrating."

Roberts' story is repeated hundreds of time in Utah households.

In the context of youth suicide, the discussion of medical insurance coverage for mental health issues is volatile.

An estimated 23,840 Utah children suffer from a serious emotional disturbance, according to the Utah Insurance Commission's Catastrophic Mental Health Survey. About one-third of those in treatment suffer from depression, a major factor in suicide.

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In Utah, experts believe 90 percent of young people who commit suicide have some form of severe mental illness — and for a variety of reasons, most are not taking medication when they do themselves harm.

Many mentally ill children don't receive treatment, and University of Utah child psychiatrist Doug Gray said insurance companies are often an obstacle.

"Insurance companies are trying very hard to eliminate child psychiatry," he said. "They wish we would all go away."

Elisabeth Buchman, behavioral health director for Regence Blue Cross Blue Shield, said she understands the insurance frustrations of both consumers and mental health care providers.

"One real bad experience can paint everyone with the ugly brush," she said. "I think the industry needs to be held accountable."

Mental health care plans have been restrictive, but Buchman said she believes that is changing. "We are trying to get people into services, not limit it," she said.

Nanci Klein, a Salt Lake clinical psychologist, disagrees.

"It's deteriorating," she said. "It's not getting better."

Jane Sudweeks' 10-year-old son was diagnosed as bipolar two years ago. Her insurance allowed 30 sessions a year. When they hit the limit, she was forced to pay $98 per counseling session out of pocket.

"We had to stop the therapy because we couldn't afford it anymore," she said.

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Jill Roberts, seen in a photo illustration, has had difficulty getting health insurance to cover treatment for bipolar disorder.  (Keith Johnson, Deseret Morning News)
Keith Johnson, Deseret Morning News
Jill Roberts, seen in a photo illustration, has had difficulty getting health insurance to cover treatment for bipolar disorder.