Updated Oct. 18, 2023
The Mental Health Parity Collaborative is a partnership between The Carter Center’s Rosalynn Carter Fellowships for Mental Health Journalism, The Center for Public Integrity, and news outlets in Arizona, California, Colorado, Georgia, Illinois, Oklahoma, Tennessee and Texas. More than 40 reporters and editors from more than 15 news outlets are working to produce data- and solutions-driven stories that examine access to mental health care in their states and why mental health parity hasn’t been achieved. Check out the latest stories below, along with those from the previous collaborative cohort.
In 1996, the breakthrough Mental Health Parity Act was passed — the first legislation to require that certain insurance providers cover mental health benefits the same, or on parity, with medical benefits.
By the numbers
- More than 1 in 5 U.S. adults experience mental illness each year
- More than half of U.S. adults with a mental illness — 27 million people — don’t receive treatment—a number that has been on the rise since 2011
- Roughly 1 in 10 people who struggle with mental illnesses have no health insurance
- 60 percent of children experiencing major depression are not receiving care
Yet even after the Mental Health Equity and Substance Abuse Parity Act passed in 2008, expanding the reach of the 1996 law, along with the Affordable Care Act in 2010, parity between mental health care and medical health care is far from being achieved. Millions of people struggle to find, receive, and afford appropriate mental health treatment and, as a result, are forced to pay out-of-network costs or not receive care at all. The 2018 State Parity Implementation Survey gave 43 states a grade of D or F on mental health parity.
Though stigma still shrouds awareness of mental health issues, they are pervasive and have serious implications, putting people at high risk for suicide and crisis. This situation was exacerbated by the Covid-19 pandemic, with data indicating increased rates of depression, anxiety and suicidal ideation. At the same time, we face a national shortages of counselors and therapists.
An insufficient mental health care system pushes some families to give up custody of their children for care. States look for better solutions. (From the Center for Public Integrity)
Arizona’s failure to adequately anticipate the impact of widespread suspensions among behavioral health providers due to fraud has put members of an already susceptible population at further risk of relapse, abuse, homelessness and even death as operators shut down. Advocates—and the providers left standing—are struggling to meet the increasingly urgent need for services among displaced tribal members and other victims. (From AZCIR)
Rates of anxiety and depression among young people are the highest they’ve been since 2013, when Colorado first began collecting this data. Driven by the urgent state of youth mental health, an effort is underway in Colorado to identify kids who need behavioral health help before they are in crisis. (From KUNC)
Law enforcement are often the first and only ones who respond to calls when people have a mental health crisis, especially in rural areas where behavioral health providers are lacking or completely unavailable. (From GPB News)
Low-income and homeless San Diegans often can‘t quickly access residential treatment for substance use disorder. Only two detox beds for Medi-Cal patients are in the city of San Diego, which until recently had no beds for these patients. (From Voice of San Diego)
Pottawatomie County jail officials apparently defied state laws and a judge’s order when they concealed information on the unexplained deaths of seven vulnerable detainees. (From Oklahoma Watch)
The Harris County Jail has continued to struggle with caring for an influx of inmates with mental illnesses. Many of the inmates who died in custody hadn’t received desperately needed care.(From Houston Landing)
There have been nine suicides at the Oklahoma County jail in three years. Another six people with documented mental health issues died of other causes. One woman’s death has helped jumpstart a diversion program. (From The Frontier)
Colorado’s LGBTQ+ youth are living with high rates of depression, stress and thoughts of self-harm, but finding treatment in Northern Colorado can be a challenge. (From KUNC)
Californians in general struggle to find and afford mental health treatment, but the access difficulties are magnified for survivors of domestic violence. (From California Health Report)
San Diego County is up against the clock to implement a new state-mandated system that compels people with certain mental illnesses into care. It’s a herculean task, and one with many obstacles. (From Voice of San Diego)
Treatment programs recommended by the National Institute of Mental Health as the gold standard of care for early psychosis rarely have enough slots available for the people who need them, and health insurance companies typically refuse to cover the full cost of these programs. (From KQED)
Conditions in some corrections facilities are a moral failure that also costs taxpayers millions.
WITF found that nearly one-third of so-called “use of force” incidents with pepper spray, stun guns and other distressing methods of control involved a person with a serious mental health issue. (From WITF)
The May 24 shooting at Robb Elementary school in Uvalde, Texas, that killed 19 children and two teachers pushed several important issues into the national conversation, including the availability of guns, school security, and mental health access. (From Texas Public Radio)
As overdoses skyrocketed amid the pandemic and the fentanyl crisis, advocates across the state are working discreetly to distribute these supplies as part of a practice to combat substance use disorder known as harm reduction. (From The Texas Tribune)
At the beginning of the year, California began rolling out extensive reforms to Medi-Cal, the state and federally funded healthcare program which serves low-income adults and children. (From The Los Angeles Times)
Researchers have long pointed to the importance of incorporating cultural practices into behavioral health care for Native Americans, but there is an ongoing struggle to ensure those services are accessible and affordable. (From Cronkite News) Related Indigenous healing: A documentary
Tens of thousands of coastal Texas residents have survived repeated extreme weather events including Hurricane Harvey. For many, it has taken an emotional toll, and researchers warn that climate change could be “catastrophic” for our mental health. Related podcast. (From The Texas Tribune)
Therapy sessions were covered through a program administered by the California Victims Compensation Board, which reimburses crime-related mental health expenses with dollars that come in through restitution from perpetrators and federal grants. But process changes and ongoing bureaucratic slowness with CalVCB has made serving crime victims more difficult than ever. (From LAist)
In March 2020, Gov. Doug Ducey signed into law a sweeping set of measures designed to help curb rising rates of suicide and expand access to mental health treatment for Arizona residents with and without insurance.Yet, two years into the program, more than half of Arizona schools haven’t referred students under the law. (From Arizona Center for Investigative Reporting)
The new crisis line is expected to send call volume soaring, and that means states like Illinois have a tough hill to climb. (From Side Effects Public Media)
- Listen to a discussion about the new mental health crisis line on NPR’s Morning Edition.
Many mental health professionals no longer take health insurance because they say they’ve grown frustrated with insurance companies not paying them enough, taking too long to pay and making them jump through hoops to give patients the care they need. (From Chicago Tribune)
A survey of farmers and farm workers in Georgia painted a startling picture. Farmers living a brutal reality of isolation and loneliness. A persisting dissatisfaction with their jobs while struggling to manage stressors like extreme weather and hiking supply prices. (From GPB News)
The fallout of Hurricane Michael in 2018 and the chaos caused by the pandemic shed light on a problem that, until recently, has only been discussed in hushed tones behind doors: the deteriorating mental health of Georgia’s farming community. (From GPB News)
Medical detox, inpatient rehabilitation and ongoing counseling are often not paid by insurance, even when patients have coverage. Many substance abuse counselors don’t even accept insurance. (From GPB News)
There’s a bill making its way through the state legislature that aims to create new avenues for people living with a serious mental illness to get life-saving treatment. (From LAist and KPCC)
Between February and July of 2020, one in three birthing parents experienced postpartum depression, up from one in eight before the pandemic. (From LAist and KPCC)
The state ranks at or near the bottom on several key indicators of youth well-being, such as the percentage of kids with untreated depression. (From Arizona Center for Investigative Reporting)
Texas leaders have targeted trans youth, their families and gender-affirming care practices for months. (From KERA)
Jails are the state’s de facto mental health facilities. (From Georgia Public Broadcasting)
Living Rooms offer an alternative to the emergency room and jails, which often become the default providers of emergency mental health care. (From Side Effects Public Media)
- Listen to the author’s report on WBUR: Here & Now.
The law governs assisted outpatient treatment, or AOT, a court-ordered treatment plan. Standards to qualify for AOT are lower than those needed for an involuntary 302 hospitalization. (From PublicSource)
“We’re putting our kids in these incubators of pressure,” said licensed psychologist Josh Spitalnick of Anxiety Specialists of Atlanta. “(It’s) not surprising that we’re seeing more families in a clinic like ours.” (From The Atlanta Journal-Constitution)
It’s a change from previous tactics when people suffering from mental crises were often arrested, a strategy that only exacerbated their issues and resulted in jails filling up. (From Georgia Public Broadcasting)
The unprecedented access to telehealth was appreciated by many patients and doctors, like the patients receiving physical therapy without leaving home and doctors seeing more patients in a day and managing those more effectively. (From PublicSource)
During the pandemic, many Chicago organizations began rethinking how to provide mental health help as the virus swept into the city. (From Chicago Tribune)
The COVID-19 pandemic worsened stress, anxiety and depression for young people—especially young girls. (From KERA)
Want more information?
Interested in connecting with us or learning more about mental health parity? Fill out the form below.
Help support this work
Public Integrity doesn’t have paywalls and doesn’t accept advertising so that our investigative reporting can have the widest possible impact on addressing inequality in the U.S. Our work is possible thanks to support from people like you.