Smaldone Arlene, Cullen-Drill Mary
Columbia University School of Nursing, Mail Code 6, 630 West 168th Street, New York, NY 10032, USA.
J Psychosoc Nurs Ment Health Serv. 2010 Sep;48(9):26-34. doi: 10.3928/02793695-20100730-06. Epub 2010 Aug 23.
Although recognition and treatment of mental health disorders have become integrated into routine medical care, inequities remain regarding limits on mental health outpatient visits and higher copayments and deductibles required for mental health services when accessed. Two federal laws were passed by Congress in 2008: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and the Medicare Improvements for Patients and Providers Act. Both laws became effective on January 1, 2010. The purpose of this article is to discuss provisions of each act and provide clinical examples describing how patients are affected by lack of parity and may potentially benefit from implementation of these new laws. Using available evidence, we examine the potential strengths and limitations of mental health parity legislation from the health policy perspectives of health care access, cost, and quality and identify the important role of nurses as patient and mental health parity advocates.
尽管心理健康障碍的识别与治疗已融入常规医疗保健，但在心理健康门诊就诊限制以及获取心理健康服务时所需的更高自付费用和免赔额方面，仍存在不公平现象。2008年国会通过了两项联邦法律：《保罗·韦尔斯通和皮特·多梅尼西心理健康平等与成瘾公平法案》以及《医疗保险改善患者和提供者法案》。这两项法律均于2010年1月1日生效。本文旨在讨论每项法案的条款，并提供临床实例，说明患者如何受到缺乏平等对待的影响，以及可能如何从这些新法律的实施中受益。利用现有证据，我们从医疗保健可及性、成本和质量的卫生政策角度审视心理健康平等立法的潜在优势和局限性，并确定护士作为患者和心理健康平等倡导者的重要作用。
