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Eye On Illinois: Small steps toward improvements in mental health care

It’s never a bad time to address mental health.

There are times when the topic demands front-page attention, such as in the wake of a killing spree or when a community reels from individual tragedy, but for many the issue is just a factor of everyday life, one that doesn’t manifest itself in headline-grabbing trauma, but nonetheless hangs over every aspect of existence.

The National Alliance on Mental Illness reports one in five American adults experiences mental illness each year – for one in 20 it’s classified as “serious” – and the rate for a mental health disorder is one in six for U.S. youths ages 6 through 17.

Such statistics certainly informed the work on Senate Bill 471, which Gov. JB Pritzker signed Friday. Among the provisions are a requirement that health insurance companies “provide their beneficiaries with timely and proximate access to treatment for mental, emotional, nervous or substance abuse disorders,” according to Capitol News Illinois, and another making insurers “maintain an adequate network of mental health care providers” such that Chicago area residents will be able to access providers within 30 miles or 30 minutes of home, with higher limits of 60 miles or minutes elsewhere in the state.

If a network doesn’t have providers meeting those limits, the insurer must make exceptions to typical out-of-network copay requirements.

As expected whenever insurance is involved, there are limitations. Primarily, the law doesn’t apply to policies regulated under the federal Employee Retirement Income Security Act. Beyond that are questions applicable to everyone: What if the provider in your town is out-of-network, but your carrier’s network includes a provider 45 minutes away? What if you can get approved to see someone but don’t have a way to get to the office? What if you and your provider aren’t a good personality match? What if within the entire 60-mile radius there’s only one provider? What if there’s a whole list of qualified professionals but none of them have space on the appointment calendar? What if you can check all of those boxes but end up with an uncovered prescription that makes comprehensive treatment unaffordable?

These questions don’t negate SB 471, but they can inform future attempts to improve the mental health climate. Is Illinois effective training and recruiting providers? Are there effective incentives for opening new practices in underserved communities? Can our Congressional delegation work on aligning ERISA plans with state guidelines?

Pritzker signed other measures aimed at ensuring access to mental health education and care in schools and barring life insurers from using substance abuse treatment as a reason to deny coverage or inflate premiums.

We can celebrate progress while acknowledging remaining challenges. Prevailing concerns about mental health are far from resolved.

• Scott T. Holland writes about state government issues for Shaw Media. Follow him on Twitter @sth749. He can be reached at sholland@shawmedia.com.

Scott Holland

Scott T. Holland

Scott T. Holland writes about state government issues for Shaw Media Illinois. Follow him on Twitter at @sth749. He can be reached at sholland@shawmedia.com.