Administering Generous Mental Health Benefits:
Opinions of Employers
II. Overview and Background
Insurance coverage for psychiatric conditions has evolved continually during the past 50 years. Even after the widespread development of private health insurance in the 1930s, mental health was primarily regarded as a State responsibility until the 1950s. At that time, general hospitals began to provide psychiatric services, and employers began covering mental health in their benefits packages (Robinson et al., 1993).
Rising health care costs in the late 1980s led many employers to examine more closely their health benefits and the arrangements for providing them. Cost-containment strategies increased benefit limitations and other restrictions on mental health care. According to one study, 63 percent of plans imposed benefit limits on inpatient psychiatric care in 1990, compared with 88 percent in 1998. For outpatient care, the number of plans imposing such restrictions rose from 26 to 57 percent between 1988 and 1998 (Hay Group, 1999).
This report synthesizes the experience of several employers that provide comprehensive mental health coverage to their employees. These employers use a variety of innovative practices to ensure that employees not only have access to mental health services but also use them. Their experiences may prove useful for other companies seeking to improve mental health coverage.
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