Justice Denied

By Dr. Catherine Zahn, President & CEO of CAMH

Recently, the Emmy for best drama series went to Breaking Bad, a story featuring a high school teacher in the US who reverted to criminal activity to pay for his cancer care. When a loved one is struck by cancer in Canada, there’s plenty of worry and heartbreak. However, one thing we aren’t burdened with is concern about how to pay our healthcare bills. If that same person becomes disabled by a mental illness, care by a psychiatrist is covered, but there are many financial obstacles on the path to recovery – like access to psychotherapy provided by a psychologist or other care provider.

In September, the New York Times featured stories of people with mental illness who struggle to pay for their health care – even when they have insurance. One story featured Melissa, age 13, suicidal and cutting herself. Her family’s insurance carrier refused to pay for recommended hospitalization on the grounds that “she had not been getting better in a significant way.” A second featured an executive whose insurer declined coverage for his anxiety disorder as “he was generally functioning well …and should be able to manage his condition on his own.” In a third vignette, a teenager with depression was denied coverage as “there was no expectation of further improvements in the shorter term.”

Who says things like this?

The director of the California Department of Managed Care summed up these obscene examples saying “insurers seem to continue to view mental health as secondary to all other health.” How would these comments sound if Melissa had severe acne that was not responding to usual treatments; if the executive had arthritis but was still able to go to work; if the teenager had relapsed after a course of chemotherapy for leukemia?

It’s time to accelerate our messaging. There must be no room in our society for care “secondary to all other health” for those with mental illness. We will be embarking on a new awareness campaign with the CAMH Foundation in the near future. We need to be heard in a crowded media space, and many of the people we serve have very soft voices.

We intend to be very bold in our message, amplifying the voices of our best storytellers – our patients and their families. During our Strategic Plan consultations our stakeholders unanimously confirmed an expectation that CAMH lead the way in driving social change by offering the promise of a different future for people with mental illness.

It’s only fair.