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Optimism Over Mental Health Coverage

November 20, 2000

Bob Rosenblatt's news about comprehensive mental health coverage among certain health plans in California ("Treating the Mind as Well as the Body," Nov. 13) makes me cautiously optimistic that we may finally be confronting the problem that no one wants but that won't go away. Imagine if health plans refused to cover treatment for lymphoma, both initially and when it recurred after a period of remission. Brain disorders are biologically based diseases that are increasingly treatable. If untreated they may lead to death. Treated, they go into remission and their victims can lead viable lives.

I just set aside a month of my time and $1,000 out of pocket to assist a close relative with obsessive-compulsive disorder whose HMO did not provide adequate treatment. Now this relative's illness is coming under control, but not until it led to a potentially life-threatening accident, which the HMO treated immediately. Both the HMO and the patient would have been better served if the HMO had treated the mental illness adequately before the accident.

In addition to treating brain-disordered patients with therapies, doctors need to bring their close relatives into the treatment loop. Close communication among physicians, patients and family can make the difference between life and death.

--JEAN ROSENFELD

Pacific Palisades

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Having spent the past few years working in community-based drug and alcohol/mental health services research on grant funds from the federal government, I find the passage of Proposition 36 and the increased coverage of mental health care described by Bob Rosenblatt to be extremely encouraging developments.

However, additional steps need to be taken. The present legislation does not cover addictive disorders or numerous widely prevalent mood or anxiety disorders. In terms of costs to society and to health-care providers, these may be critical oversights. All of these disorders are associated with staggering costs that are often passed on to taxpayers, including crime and associated criminal justice system costs, lost work days and reduced productivity and overuse of hospital emergency rooms. To overlook these illnesses might prove a very expensive error.

--NICHOLAS EMPTAGE

School of Social Ecology

UC Irvine

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