Reading Time: 13 minutes

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.

Background

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. 


FEATURED STORY
Lisa Norris stands hugging her daughter Hannah. Lisa has long blond hair and is wearing a blue sweater. Hanna has short brown hair and wears glasses and a purple hoodie.
(Joshua A. Bickel for the Center for Public Integrity)

Families take drastic steps to help children in mental health crises

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)

(Brendon Derr/AZCIR)

Patients, advocates describe ‘pure chaos’ in state response to AHCCCS fraud

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)

Students walking in school hallway in front of an office that says "Mountain Family" on the doors. A boy wearing a black hoodie and black shorts and a plaid backpack walks one way. Three girls walk the other way
(Leigh Paterson/KUNC)

One answer to the youth mental health crisis? Asking Colorado students how they’re feeling

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)

The stretch of Deepstep Road in Washington County where Eurie Martin fatally encountered Washington County Sheriff's deputies in 2017. A pickup approaches. Green grass on trees on both sides of the road.
(Grant Blankenship/GPB)

Overwhelmed with mental health calls, six rural sheriffs make their own plan for better response

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)

A portion of a stack of 2022 phone screens sit on the desk of Program Manager Darlene Jackson at the McAlister Institute's Adult Detox in Lemon Grove.
(Ariana Drehsler/Voice of San Diego)

Getting drug treatment beds is so hard for poor it’s like winning the lottery

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)

This illustration shows a young blond woman in a hospital bed with an oxygen mask over her fact. A woman with long dark hair leans over her. In the background is a line drawing of a young woman being held by two men. Another drawing shows the county Public Safety Center.
(Todd Pendleton / The Oklahoman)

Cover-up Alleged in Pottawatomie County Jail Deaths

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)

A photo of a hand holding a phone. On the phone is a picture of a woman sitting on a couch and smiling. A smiling boy wearing a red graduation cap and robe lies across her lap.
(Marie D. De Jesús / Houston Landing)

This Harris County program serves the most vulnerable. But it won’t bail them out of jail.

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)

In the drawing a person, colored blue, stands with arms folded facing two options, a window with bars like a jail cell and an open door with fluffy clouds and rolling pink hills.
(Zach Raw / For The Frontier and Curbside Chronicle)

People with mental illness are more likely to die in jail. A new Oklahoma County program puts them in treatment instead

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)

Maddie Maes and her mother, Kristin Vera, pose for a photo on their couch at home in Fort Collins. Maddie is smiling and wears a brown t-shirt, faded jeans and is holding a flowered ball cap in her hands. Her mother also is smiling and has her arm around Maddie. Her mother wears a patterned tank top and black jeans. Kristin also has her hand on a small brown dog on her left that looks like a small Doberman pincer. Next to Maddie is another dog that is pinkish with brown spots and has a brown head. Behind the couch are two french doors and on the wall is a framed picture that says: "If there's love in a house It's a palace for sure.
(Leigh Paterson / KUNC)

LGBTQ+ kids in Colorado are struggling. Finding the right therapist is yet another hurdle

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)

A person in dark clothes stands with their hands folded in front of them. Their head is obscured by trees in the foreground. They stand next to a brick pillar.
(Joe Orellana / California Health Report)

Mental Health Care Is Critical for Survivors of Violence. Access Is Another Story

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)

This shows the San Diego County administrative building. It is a long beige building with windows on the front. Palm trees grow in a line next to the building. A taller part of the building is in the center. A person wearing darn shorts, a dark t-shirt and a red visor walks by.
(Brittany Cruz-Fejeran / Voice of San Diego)

How San Diego Is Rolling Out CARE Court

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)

Drawing of a woman with long dark hair reaching to a shattered reflection.
 (Anna Vignet / KQED)

Proven Schizophrenia Treatments Keep People in School, at Work and off the Street. Why Won’t Insurance Companies Cover Them?

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)

Two women talking. Woman on right has dark shoulder-length hair. She's wearing a denim jacket and white shirt. The other woman has blond shoulder-length hair and is wearing a blue sweater. They are outside on green grass with trees in the background.
(Submitted)

Jails fail to accommodate people with mental illness. In some cases, it’s a civil rights violation

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)

21 chairs, flags and crosses are displayed in front of local businesses on May 30th, 2022 in Uvalde, TX. They each honor the 19 students and two teachers killed in a mass shooting at Robb Elementary School in Uvalde, Texas.
(Joshua Guerra / Sipa USA via Reuters)

Uvalde prompted Texas to start taking mental health in schools more seriously. Is it enough?

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)

A man wearing black and a ball cap stands in a doorway talking with a woman sitting on the floor. She is wearing a sleeveless top and has tatoos on her left arm. In the foreground is a CPR dummy.
(Annie Mulligan / The Texas Tribune)

Texas bans many proven tools for helping drug users. Advocates are handing them out anyway

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)

Man wearing gray shirt and white pants reaches up to close blinds. Behind him is a bed with a brown headboard and no linens.
(Robert Gauthier / Los Angeles Times)

California is trying to house the homeless through a health insurance program. It worked for this man.

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)

(Laura Bargfeld / Cronkite News)

Healing through culture: Increasing access to Native American practices to treat mental health

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

Woman sits at desk with folders and papers on it with her head in her hands.
(Kylie Cooper / The Texas Tribune)

“It’s destroying me”: Storm after storm, climate change increases strain on Texans’ mental health

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)

Drawing with pink background with drawing of head with mental health provider profile.
(Dan Carino / LAist)

There’s Free Mental Health Help For Crime Victims, But Providers Say Bureaucracy Gets In The Way

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)

Combination locks hang on beige metal lockers in school. Two students talk in the background.
(Brandon Quester / AZCIR)

Youth access to mental health care improved under Jake’s Law, but persistent barriers hamper its reach

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)

A woman sits in front of a lab top while she talks with a headset. She wears a tan cardigan with a blue and white shirt.
(Bobbi Wiseman/Submitted Photo From Memorial Health)

A new national mental health crisis line launches soon. Some states aren’t ready

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)

Woman with dark shoulder-length hair and sunglasses on her head smiles. Her arms are folded and she wears a coral top.
(Terrence Antonio James / Chicago Tribune)

Why is it so hard to find therapists who take insurance in Illinois?

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 woman with dark shoulder-length hair is speaking in front of a podium with a laptop on it. She has her right hand raised.
(Riley Bunch / GPB News)

How researchers are getting farmers to talk about mental health

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)

Man in blue short-sleeved shirt reaches up to pick a peach from a tree. He holds a basket of peaches in his other hand.
(Riley Bunch / GPB News)

Farmers have silently struggled with their mental health for years. Are they ready to talk?

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)

Man with beard in blue polo shirt and blue cap stands in front of a painting of a tree. The tree has orange leaves.
(Ellen Eldridge / GPB News)

It’s the most important part of addiction recovery — and often the most difficult to access

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)

An illustration shows a person looking into a mirror that has a cloud over the person in the mirror.
(Alborz Kamalizad/LAist)

CARE Court Aims To Help People Living With Serious Mental Illnesses.

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)

(Alborz Kamalizad/LAist)

Why The Pandemic Took An Especially High Mental Health Toll On New Parents

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)

(Isaac Stone Simonelli/AZCIR)

Permanent funding solution elusive as mental health provider shortage plagues Arizona schools—and students

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)

(Roswell Gray/Kera)

For trans youth in North Texas, finding affirming mental health care can be a challenge

Texas leaders have targeted trans youth, their families and gender-affirming care practices for months. (From KERA)

(Ellen Eldridge / GPB News)

With few other resources, people with behavioral health issues find treatment in jails and prisons

Jails are the state’s de facto mental health facilities. (From Georgia Public Broadcasting)

(Carter Barrett/Side Effects Public Media)

Amidst a lack of mental health services, the ‘Living Room’ approach aims to plug gaps

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)

Assets via Adobe Stock. (Photo illustration by Natasha Vicens/PublicSource)

PA’s controversial mental health law on involuntary treatment stands to get a test run more than 3 years after its passing

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)

Latha Wright stands beside a window.
(Arvin Temkar / arvin.temkar@ajc.com)

Georgia students’ private battle: Anxiety disorders in the classroom

“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)

(Riley Bunch / GPB News)

Law enforcement enlists mental health experts to help save lives — ‘a paradigm shift in policing’

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)

(PublicSource / Clare Sheedy)

PA eased telehealth regulations during the pandemic. What happens if the waiver expires?

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)

(Brian Cassella / Chicago Tribune)

In a pandemic, people might know they need food or housing. But how do you help them realize they also need therapy?

During the pandemic, many Chicago organizations began rethinking how to provide mental health help as the virus swept into the city. (From Chicago Tribune)

(Trevon McWilliams / KERA)

The Girl Scouts of Northeast Texas are tackling mental health, one patch at a time

The COVID-19 pandemic worsened stress, anxiety and depression for young people—especially young girls. (From KERA)


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