Access to mental health care expanding

Experts: Lack of insurance did impede treatment

Editor’s note: This is the fifth in a series of stories that will explain the 10 essential health benefits required under the Affordable Care Act and explore what effect those requirements will have on patients and caregivers.

Area mental health officials say great strides have been made in recent years in terms of mental health services.

“The Affordable Care Act (ACA), along with the Parity Act (Mental Health Parity and Addiction Equity Act), are really making mental health services more accessible to the population,” said Mel Fetter, chief executive officer of Pathways Community Health.

Mental health and substance use disorder services are one of 10 essential health benefits the ACA requires health insurance plans to cover. The ACA is a health care law passed in 2010.

According to the U.S. Department of Labor, the Mental Health Parity and Addiction Equity Act requires health plans “to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical and surgical benefits.”

“Having insurance companies required to better cover mental health has really helped broaden access,” Fetter said.

Cynthia Keele, executive director of National Alliance on Mental Illness (NAMI) Missouri, said more people having health coverage for mental health services allows younger adults—who may have bipolar disorder or schizophrenia—to be treated earlier.

“It has a huge impact in terms of early detection and early treatment,” she said.

She said there’s a huge demand for mental health services in Missouri, as well as nationally.

“The need is huge nationally,” she said. “I think it’s 1 in 5 (Americans) have a serious mental health need. Missouri is no different.”

According to the Missouri Department of Mental Health, the state agency “serves approximately 170,000 Missourians each year with mental illness, developmental disabilities and substance use disorders.”

Fetter said that prior to the ACA, chances were slim that Pathways clients had insurance.

“It’s probably less than 40 percent,” he said. “We’re really a safety net provider. Even if people were uninsured in the past, we left payment up to grants and other ways.”

He said the requirement under the ACA will help, but the agency is still expecting a large group of patients who don’t qualify for Medicaid or the Health Insurance Marketplace.

“But, overall, we think there will be more access to services as time goes on,” he said.

Keele said NAMI Missouri is thrilled that people are finding affordable health plans through the ACA, and she sees a positive impact far into the future.

“People not having insurance keeps people out of treatment,” she said. “This helps instead of waiting until it (mental health) gets worse.”

Your questions

The News Tribune received one question this week about the ACA:

Q: I don’t have a computer. How do I sign up for health insurance in the Marketplace?

A: There are licensed navigators in Missouri who can help you enroll — whether online or by a paper application. Primaris, Central Missouri Area Agency on Aging and the Community Health Center of Central Missouri are three Mid-Missouri agencies who have licensed navigators on staff.


200 N. Keene St.

Columbia, MO 65201


Central Missouri Area Agency on Aging

1121 Business Loop 70 East, Suite 2A

Columbia, MO 65201

800-369-5211 or 573-443-5823

Community Health Center of Central Missouri

3400 W. Truman Blvd.

Jefferson City, MO 65109


Do you have questions?

We want to answer your questions regarding the ACA; email reporter Olivia Ingle at or call her at 573-761-0248. Also, feel free to share your experiences with the ACA or your experiences signing up for coverage in the Marketplace.


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