IV

103D CONGRESS

1ST SESSION H. CON. RES. 52

Expressing the sense of Congress that equitable mental health care benefits

must be included in any health care reform legislation passed by Congress.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 24, 1993

Mr. KOPETSKI (for himself, Mr. BACCHUS of Florida, Mr. BEREUTER, Mr.

BERMAN, Mr. BOUCHER, Mr. CLEMENT, Mr. CRAMER, Ms. DELAURO,

Mr. DELLUMS, Mr. EMERSON, Mr. ENGEL, Mr. EVANS, Mr. FILNER, Mr.

FINGERHUT, Mr. FRANK of Massachusetts, Mr. GILMAN, Mr. GUNDERSON, Mr. HOCHBRUECKNER, Mr. HUGHES, Mr. JACOBS, Mr. LEVIN, Mr.

LEWIS of Florida, Mr. MCDERMOTT, Mr. MACHTLEY, Mrs. MORELLA,

Mr. SANTORUM, Mr. SHAYS, Ms. SLAUGHTER, Mrs. UNSOELD, Mr. WISE,

and Mr. LANCASTER) submitted the following concurrent resolution;

which was referred jointly to the Committees on Ways and Means and

Energy and Commerce

CONCURRENT RESOLUTION

Expressing the sense of Congress that equitable mental

health care benefits must be included in any health care

reform legislation passed by Congress.

Whereas mental illness and substance abuse disorders are

prevalent throughout our society;

Whereas approximately 19 percent of the adult population in

the United States have a diagnosable mental illness or a

substance abuse disorder within any 6-month period;

Whereas mental illness and substance abuse disorders can

strike at any point during a person’s lifetime;
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Whereas 20 percent of Americans under the age of 18, or approximately 7,500,000 children and adolescents, have

some type of mental illness or emotional disorder;

Whereas 4⁄5 of children in need of mental health care do not

receive services, resulting in significant costs to society as

these children become adults;

Whereas approximately 1⁄3 of homeless people have a mental

illness and approximately 40 percent of homeless people

have a substance abuse disorder;

Whereas there are more Americans with a serious mental illness in prisons and street shelters than in hospitals;

Whereas the incidence of mental illness and mental health

problems is very costly both to the individual with a mental disorder and to society as a whole;

Whereas mental illness and substance abuse disorders are

devastating to the lives of those afflicted, as there exists

a direct and close relationship between mental health and

overall well-being;

Whereas American businesses lose over $100,000,000,000 per

year due to lost productivity of employees because of substance abuse and mental illness;

Whereas annual direct costs of treatment for mental illness

and substance abuse disorders are estimated at

$68,000,000,000 and annual indirect costs due to lost

productivity, lost employment, vehicular accidents, criminal activity, and social welfare programs are estimated to

be approximately $250,000,000,000;

Whereas significant progress has been made within the last

10 years in research into the causes and treatments of

mental illnesses, and many such illnesses are now treatable;
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Whereas 70 percent of clinically depressed patients can be

successfully treated by psychotherapy, and 80 percent or

more of clinically depressed patients can be successfully

treated by combined psychotherapy and

psychopharmacologic treatments;

Whereas pharmacologic intervention for schizophrenia and bipolar disorders, coupled with appropriate rehabilitative

services, can dramatically reduce the rehospitalization

rate for those afflicted with these disorders, improving

the ability of such individuals to live productively in the

community;

Whereas the success rate for the treatment of panic disorders

is between 70 percent and 90 percent;

Whereas significant numbers of persons with mental illness in

the United States find it difficult, if not impossible, to secure needed health care;

Whereas only approximately 30 percent of those in need of

mental health services actually receive them;

Whereas mental health care is treated differently from care

for other health conditions in both public and private financing systems;

Whereas 99 percent of insured individuals and their families

have private health coverage for some inpatient mental

health treatment, but only 21 percent have coverage that

is equivalent to their coverage for other illnesses, and

only 2 percent have coverage for outpatient care that is

equivalent to their coverage for other illnesses;

Whereas many private insurance programs continue to discriminate against individuals with mental illness or substance abuse disorders;
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Whereas although recent changes have improved the treatment of individuals with mental illness or substance

abuse disorders under public insurance programs, such

programs continue to discriminate against these individuals, as evidenced by the fact that the Medicare program

has a 50 percent copayment requirement for mental

health care services but only a 20 percent copayment requirement for all other services; and

Whereas businesses, consumers, and Federal and State governments are already paying for mental health care for

the uninsured and underinsured in an inefficient and inequitable manner, resulting in much unnecessary pain

and suffering for those afflicted with mental disorders as

well for their families: Now, therefore, be it

1 Resolved by the House of Representatives (the Senate

2 concurring), That it is the sense of Congress that any leg3 islation enacted to reform the health care delivery system

4 of the United States must ensure that every person has

5 access to coverage for medically and psychologically nec6 essary treatments for mental disorders that is equitable

7 to the coverage provided for treatments for physical ill8 nesses, and should contain the following provisions:

9 (1) Provisions providing for coverage of a broad

10 array of mental health and rehabilitation services for

11 individuals of all ages.

12 (2) Provisions guaranteeing that mental health

13 services will be available based on medical or psycho14 logical necessity, including provisions prohibiting dis-
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1 crimination through the imposition of arbitrary bar2 riers to mental health services.

3 (3) Provisions to ensure that services are based

4 on individual need and informed choice, with

5 consumer participation in treatment decisions.

6 (4) Provisions providing financial protection for

7 individuals and their families with mental health

8 needs to prevent these individuals and families from

9 spending a disproportionate share of their income

10 and resources to obtain services.

11 (5) Financing policies that guide service deliv12 ery to the lowest cost settings consistent with appro13 priate care, including provisions ensuring that any

14 managed care techniques used limit financial con15 flicts of interest and promote real efficiencies while

16 protecting the patient’s right to quality care, access

17 to necessary care, and confidentiality.

18 (6) Provisions to ensure that mental health

19 services will be coordinated effectively with existing

20 systems and programs of medical, income, residen21 tial, and social support at the Federal, State, and

22 local levels.

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