IV
104TH CONGRESS
1ST SESSION
H. CON. RES. 98
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
AUGUST 4, 1995
Mr. SERRANO submitted the following concurrent resolution; which was
referred to the Committee on 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 over 50,000,000 adults in the United
States have a diagnosable mental illness or a substance
abuse disorder on an annual basis;
Whereas mental illness and substance abuse disorders can
strike at any point during a person’s lifetime;
Whereas more than 12 percent of Americans under the age
of 18, or approximately 7,500,000 children and adoles-
cents, have some type of mental illness or emotional dis-
order;
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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 ill-
ness 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 men-
tal 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 sub-
stance abuse and mental illness;
Whereas combined direct and indirect costs of treatment of
mental illness and substance abuse disorders are esti-
mated at $314,000,000,000 annually, direct costs being
the cost of treatment and indirect costs being lost pro-
ductivity, lost employment, vehicular accidents, criminal
activity, and social welfare programs;
Whereas significant progress has been made within the last
12 years in research into the causes and treatments of
mental illnesses, and many such illnesses are now treat-
able;
Whereas nearly 85 percent of persons with depression re-
spond positively to antidepressant medication, modern
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electroconvulsive therapy (ECT), or psychotherapy, either
alone or in combination;
Whereas pharmacologic intervention for schizophrenia and bi-
polar 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 80 percent;
Whereas significant numbers of persons with mental illness in
the United States find it difficult, if not impossible, to se-
cure 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 fi-
nancing systems;
Whereas 99 percent of insured individuals and their families
have private health coverage for some inpatient mental
health treatment, but only 20 percent have coverage that
is equivalent to their coverage for other illnesses, and
only 4–8 percent of plans have coverage for outpatient
care that is equivalent to their coverage for other ill-
nesses;
Whereas many private insurance programs continue to dis-
criminate against individuals with mental illness or sub-
stance abuse disorders;
Whereas, although recent changes have improved the treat-
ment of individuals with mental disorders under public
insurance programs, such programs continue to discrimi-
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nate 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 gov-
ernments are already paying for mental health care for
the uninsured and underinsured in an inefficient and in-
equitable manner, resulting in much unnecessary pain
and suffering for those afflicted with mental disorders as
well as for their families: Now, therefore, be it
Resolved by the House of Representatives (the Senate
concurring), That it is the sense of Congress that any leg-
islation enacted to reform the health care delivery system
of the United States must ensure that every person has
access to coverage for medically and psychologically nec-
essary treatments for mental disorders that is equitable
to the coverage provided for treatments for physical ill-
nesses, and should contain the following provisions:
(1) Provisions providing for coverage of a broad
array of mental health and rehabilitation services for
individuals of all ages.
(2) Provisions guaranteeing that mental health
services will be available based on medical or psycho-
logical necessity, including provisions prohibiting dis-
crimination through the imposition of arbitrary bar-
riers to mental health services.
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(3) Provisions to ensure that services are based
on individual need and informed choice, with
consumer participation in treatment decisions.
(4) Provisions providing financial protection for
individuals and their families with mental health
needs to prevent these individuals and families from
spending a disproportionate share of their income
and resources to obtain services.
(5) Financing policies that guide service deliv-
ery to the lowest cost settings consistent with appro-
priate care, including provisions ensuring that any
managed care techniques used limit financial con-
flicts of interest and promote real efficiencies while
protecting the patient’s right to quality care, access
to necessary care, and confidentiality.
(6) Provisions to ensure that mental health
services will be coordinated effectively with existing
systems and programs of medical, income, residen-
tial, and social support at the Federal, State, and
local levels.
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