Room 473-B
State House
Boston, MA 02133
Telephone: (617) 722-2230
District Office
585A Main St.
Winchester, MA 01890
Telephone: (617) 721-7285 or (617) 438-7185

A View from the Hill

Representative Casey's "View From the Hill" can be found on the web at

FOR IMMEDIATE RELEASE: February 14, 2000
CONTACT: Tommy Voltero (617) 722-2240


Out of all the eras in the history of mankind in which dramatic changes have taken place, the "Enlightenment" has been the most important. The Enlightenment symbolized the victory of science over superstition, reason over irrationality, and progress over predestination. No longer were people chained to beliefs that were passed down from generation to generation without any kind of critical analysis.

Several significant achievements came out of Enlightenment thinking. By suspending the belief that "divine influence" was the reason why things happened, scientists and others were able to get at the real causes of everyday occurrences. In the medical field, with the availability of the newly-invented microscope, people learned that diseases were caused by miniscule organisms called bacteria and not by divine will. One got sick because he forgot to wash his hands before supper, not because the "Supreme Being" was punishing him for his wrongdoings.

Mankind has obviously progressed since the time of the Enlightenment, but "old" ways of thinking still remain. We can now diagnose and treat illnesses that would have been deadly to folks in the 17th century such as cancer, polio, and hepatitis. Yet, despite our remarkable progress in medicine, some people still cling to the belief that diseases can only be physical. They refuse to recognize that illnesses can also be mental and/or emotional. But mental disorders are indeed illnesses and they do, in fact, affect a large segment of the population.

The state Department of Mental Health reports that slightly more than 15% of Massachusetts residents (about 700,000 people) have symptoms of diagnosable mental illness. On a national level, it is estimated that 40 million Americans (one-fourth of whom are children) are troubled by some kind of mental or emotional disorder. Taking all of these facts and figures into consideration, it can be said that 1 in 4 families in America are touched by mental illnesses to some extent.

Mental disorders cause a wide range of difficulties for those affected, both directly and indirectly. People with conditions such as anxiety disorders, for example, may have trouble carrying out certain tasks, like driving a child to school. Others with more serious conditions, like schizophrenia, might actually pose a serious danger to both themselves and those around them. Regardless of the severity of the condition, however, mental illnesses in general must be recognized as serious (and costly) hindrances to everyday life.

Despite the fact that mental disorders are as serious as physical ones, they are not recognized as such by insurance companies. While a person may be covered for physical therapy, she would not be covered for treatment for a mental disorder. In the eyes of the insurer, mental illness is not really an illness.

Back in 1973, the Massachusetts Legislature passed a law which required insurance companies to provide mental health coverage (to a limited extent) in order to remedy such a situation. People were entitled to at least 60 inpatient hospital days and $500 for outpatient services. This law was a first step in refuting the claim that mental illnesses were not medical conditions.

Times have changed since then, however, and the field of mental health has expanded significantly. More illnesses can be diagnosed, and with them, more expensive treatments have been necessary. Amazingly, these cures are often more effective than those for physical ailments. Obsessive-compulsive disorders and schizophrenia have treatment success rates of about 60%, while bipolar and panic disorders have rates of 80%. For comparison, cardiovascular disorders have treatment success rates of about 55-60%. Thus, when people receive the proper care for mental disorders, they do indeed get better.

Unfortunately, the cost of these treatments far exceed the basic coverage mandated back in 1973. More and more folks are finding it next to impossible to foot the bill for these much-needed treatments. Not many families can cover out-of-pocket expenses for treatment, which sometimes amount to over $10,000 annually.

Over the years, the Legislature has considered a number of bills to remedy the situation. Recent advances in the treatment of mental illness and improved methods of cost management, however, have rekindled the debate around a concept known as "mental health parity." Mental health parity essentially mandates that insurance companies cover mental illnesses just as they would physical ailments.

This month, the Massachusetts House of Representatives passed a Mental Health Parity bill (H. 5008) that would drastically improve the provisions established in 1973.

H. 5008 would give full parity for both adults and children with biologically based brain disorders, as well as those who have been traumatized by sexual assault. Adults would have the benefit of 24 days of outpatient coverage (in addition to 60 days of inpatient), an incredible improvement over the current $500 limit. Those seeking treatment for alcohol and substance abuse would also receive full coverage when undertaken in conjunction with treatment of a mental disorder.

H. 5008 would expand coverage for children under the age of 19 so that they can get treatment at the onset of the illness. This is especially important because children are often hard to diagnose, and frequently fall between the cracks. Left untreated, mental illnesses in children stunt growth and development and make conditions even worse. The bill in question would enable us to give kids the help they need to prevent problems in the future.

Mental Health Parity legislation is long overdue in Massachusetts. Every other New England state has enacted legislation that would provide some kind of benefit for mental illnesses, and now it is our turn to do so. Although we cannot do everything in state government, there are times when our actions can truly help people. Passing this bill will take down some of the barriers preventing people from achieving their full potential, and help them lead happier and healthier lives. What better reason for the existence of government is there?

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