Fight for Your Right to Behavioral Health Benefits

By Carol McDaid, Co-Chair of the Parity Implementation Coalition

In 2008, Congress passed a law that requires health plans to provide benefits for addiction and mental illness that's equal to other medical benefits. Unfortunately, many people still don't know about this law called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (named after two bipartisan senators who experienced addiction/mental illness in their families).

Parity is personal to me. Did you know that 23 million people have a diagnosed substance use disorder but fewer than 10% receive any help for that condition? I am one of the lucky ones who got the treatment I needed to recover. When my insurance failed twice to provide the coverage promised in my employer-provided health benefit package, I got support from family and employers to help pay for the care I deserved.

When my insurance company refused to pay for any of my last residential treatment (after years of failed attempts at outpatient programs), I fought back. I used all of my internal and external appeals rights. It took me three years and a blizzard of paperwork, but one day a check for half of my treatment appeared in the mail.

Sadly, the average American family with a loved one suffering from addiction or mental illness lacks the resources to fight a three year battle with their insurer to get benefits they are entitled to - by law. Often afraid to discuss their illness with employers, they suffer in silence rather than using their behavioral health benefits promised by insurers. These victims become sicker and even unemployable – causing the burden of paying for their treatment to be shifted to the public sector, where taxpayers like you and me are forced to pick up the bill for health plans that simply will not pay their fair share.

Today, I use my skills as an advocate and former employee benefits analyst to fight for the rights of those coping with addictions and mental illnesses. I'm driven by the passion of my personal parity experience with insurance discrimination and my sense of justice and equality. Help for these conditions should not be limited to those who can afford to pay out-of-pocket or have the fortitude to fight long battles with insurers.

If you or a loved one have been unable to get your insurance to pay for addiction or mental health treatment, please share your story. 

I've been in the halls of Congress fighting this fight since 1993. I realize that laws and regulations are complex and often take many years to be fully implemented. I intend to fight this fight as long as it takes to end insurance discrimination against people suffering from addiction and mental illness. But, to be successful, we need your stories and a collective sense of outrage.

Join me. Share your personal parity story by sending an email to hsf@psych.org. Fight for your rights. Every 15 minutes in the U.S., someone dies from suicide. The clock is ticking.

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Living in the Moment with Mindfulness

By Brandon Cornejo M.D., Ph.D.

I hope your first week of 2012 was a good one! How are those New Year's resolutions going? If your goal is to exercise more, my "Mindfulness" two-part blog post should help you stay motivated. In part-one of my post, I discussed the concept of "mindfulness" or living in the moment.

Now I will share how you can use mindfulness to stay focused on a particular goal like exercising. Since exercise and mindfulness enhance mood, decrease stress, and improve negative thinking, these tips will benefit us all as we enjoy 2012!



Tips for staying in the present moment while exercising:

·         One of the most basic tools that you can use in mindfulness is your breathing. By focusing on the sensation of air traveling in and out of your body (just like you do during meditation), you can be grounded in the present moment.

·         You may also try a mantra to stay in the "now" (for example, runners often count out their footsteps – “1, 2, 3…1, 2, 3” – or a mountain biker or skier may constantly remind themselves to “relax”).

·         Applying either technique will keep you in the moment rather than thinking about negative thoughts and feelings that influence behavior in a non-productive fashion during your exercise.

·         Paying attention to physical feelings of your body and your surroundings as you exercise will prevent you from going into “automatic pilot” (when you act and react without conscious awareness).

·         By learning to stay present, you can accept physical discomfort as a temporary state that will soon pass.

·         As you continue your workout, you can “label” both positive and negative thoughts that occur while exercising. Labeling these thoughts will help you understand which thoughts and feelings are limiting your success and need to be changed.

Try out some of these tips and see how you start removing unwanted negative thoughts to overcome challenges that may have held you back in the past. Mindfulness matters when it comes to achieving that New Year's resolution this year.

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Keeping Your New Year's Resolution with Mindfulness

By Brandon Cornejo M.D., Ph.D.

How many of you are trying to get yourselves back into a regular gym and exercise routine for your New Year's resolution? When it comes to exercise, one of the biggest challenges is staying motivated and consistent. I hope I can help you with this two-part blog post on "Mindfulness."

What is Mindfulness?

• Mindfulness is a nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises is acknowledged and accepted.

Mindfulness as a Therapeutic Approach

• Mindfulness based stress reduction means to focus your attention on the "now."

• People practicing mindfulness work on not judging or evaluating the present moment but focus on simply “being” present.

• People in a formal mindfulness class engage in daily meditation along with skill-building homework that ties them to the “here and now.” 

 How Does Mindfulness Work?

• Mindfulness allows a person to pause calmly and reflectively before reacting to things.

• Mindfulness may prevent relapse of clinical depression by allowing a person to have some “space” between who they are and their emotions.

• Mindfulness based cognitive therapy (MBCT), a form of therapy that combines elements of mindfulness with cognitive based approaches to treatment, can be an effective approach for the treatment of anxiety or depressive disorders.

• Mindfulness may enhance mood as well as help eliminate negative thoughts associated with depressive states.

So why is "mindfulness" important to keeping that New Year's resolution of daily exercise? Next week, I will post part two with my tips for staying in the present moment while exercising. Happy New Year's!

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How to "Bully-Proof" Kids

By Gariane Phillips Gunter, M.D. 

Do you think October's national anti-bullying campaign was successful in stopping bullies? The Washington Post recently blogged about our country having a hard time defining bullying among kids. So, what can we, as parents, do to protect our children and teens? Here are some tips for "bully-proofing" your kids:

Distinguish between events and feelings - It is important to teach your children the difference in their interpretations of life situations. This helps kids learn to understand and relate to the feelings of others. They will be able to determine if someone is treating them appropriately - or if they are, in fact, being bullied.

Develop a sense of self - Another great way to bully-proof your child is to help them develop a sense of self. Encourage them to learn about and understand who they "are" because children who struggle to identify self-awareness or constantly strive to be their "hero" are never going to be able to live up to those expectations. This can be detrimental for their self-esteem - making them a direct target for bullying. Kids with low self-esteem are less likely to stick up for who they are which makes them prime targets for those looking to pick on someone (bullies often bully due to their own low self-esteem).

Monitor their online lives - Parents or caregivers should have access to online accounts and cell phones to ensure their teens' safety over the Internet. Cyberbullying continues to be a nationwide epidemic.  

Positive activities - It is also important to encourage your kids to explore activities that make them feel good about themselves. Find something that they are really good at because it will help increase their overall self-esteem and feeling of self-worth. Encouraging courageous behavior is another great way to guide children. You can teach them to stand up for themselves and for their peers and other friends. When groups of kids or teens stand together to put an end to a bullying situation, the bully is more likely to back off and won't mess with your child again.

Following these tips when your kids are young is the best way to show them how to establish early on that they will not tolerate bullying. 

Sources: http://www.makebeatsnotbeatdowns.org/, http://www.olweus.org/
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Female Athlete Triad: Sport Gone Bad

By Claudia L. Reardon, M.D.

Psychiatrists encourage nearly everyone to participate in sports and exercise. Sports not only improve physical health but also can greatly improve mental well-being. However, if girls and women take involvement in sports too far, they can suffer a well-described triad of symptoms. The so-called female athlete triad consists of the following three inter-linked health problems:

1. Insufficient caloric intake/disordered eating
2. Menstrual problems
3. Weak bones

Girls and women who participate in “leanness sports” that emphasize thinness (running, ballet, gymnastics, figure skating, and others) are particularly at risk. If they receive the message that being thinner could result in greater athletic success, they may try to cut down on their caloric intake to levels too low to support their levels of physical activity. This can result in full-blown eating disorders, irregular menstrual cycles, and weak bones (including osteoporosis at young ages).

Some common myths about the female athlete triad include the following:

• If an athlete’s performance has not started suffering, then she must not have a problem. FACT:  Even if an athlete’s performance has not started suffering, it eventually will.  Not taking in enough calories to match activity level is not sustainable in the long-run.
• It is normal for female athletes to stop menstruating. FACT:  It is never normal for a female athlete to stop menstruating. There are serious health risks, especially bone loss, to not menstruating. Studies show that after three years of not menstruating, bone loss is likely to be permanent. Loss of future reproductive function could also occur.
• If an athlete is not eating enough to match activity level, she is aware of what she's doing. FACT: Denial is powerful. Athletes will very often feel that they are being as healthy as possible, and that meticulous attention to diet is a sign of dedication to sport. Coaches, parents, and professionals will need to help the athlete see the problems with the behaviors.
• An athlete who eats “healthy," is a top performer on the team, and excels in class is unlikely to have an eating disorder. FACT: Traits that are desirable in an athlete can make them more at risk of developing an eating disorder. Mental toughness, pursuit of excellence, performance despite pain, commitment to training, and being a team player are very similar to excessive exercise, perfectionism, denial of discomfort, and being self-less.

What can you do if someone you know might be suffering from the female athlete triad?

1. Share your concerns with the athlete.
2. Talk with the coach, athletic trainer, or school counselor.
3. Encourage the athlete to see a physician and dietitian. Not all health care professionals are familiar with the details of the female athlete triad; to help them out, you can send along this brochure with the athlete to the appointment.

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