Chicago Tribune: Retirees Have Incentives to Address Mental Health Issues
Posted 02/04/2010
With all the costly physical ailments that can crop up in retirement, mental health issues can get pushed aside.
But this year, there are new incentives for addressing them under a law that ensures people with private group health insurance get equal coverage for mental-health and substance-abuse treatment.
The law —the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 — applies to employers with 50 or more workers whose group health plans include mental-health and substance-abuse benefits.
A separate Medicare law calls for phased-in parity among mental and physical health benefits by 2014.
Health officials say depression and substance abuse is a growing problem among retirees, and they are bracing for big increases as the baby boomers retire. Further, they say, a significant portion of older retirees are falling victim to alcoholism and substance abuse for the first time.
"Retirement is one of the major contributors to late-onset substance abuse," said Juan Harris, program director for the Center For Older Adult Recovery at the Hanley Center, a rehabilitation facility in West Palm Beach, Fla. "When people retire and have too much time on their hands or there's a loss of identity, the drinking increases."
Other times an older person has an illness or injury that triggers an addiction to pain medications, or there are other triggers — divorce or the death of a spouse, for example.
Think you or a loved one may be vulnerable? Here are some tips:
Later addictions
Alcoholics and substance abusers who first get seriously addicted later in life often get clean quicker, said Harris.
"Older adults have the best treatment outcomes of any group. With early onset cases, those individuals have no frame of reference for sober living skills. With late onset addicts, they can remember the recent past when they didn't have these problems and they respond very well to treatment," he said.
Don't sweep it under a rug
Family members are often reluctant to mention signs of addiction to their aging parents, said Brenda Iliff, clinical director for Hazelden, a non-profit addiction center based in Center City, Minn., with locations in several states (www.hazelden.org) and one opening in April in Naples, Fla.
"A common attitude is, 'Why take away Mom's last pleasure?''' Iliff said. Instead, she suggests adult children consider that drinking is no longer a pleasure because it is leading to other health problems and robbing parents of quality time.
Older addicts often have trouble recognizing a problem and think it might be age-related dementia, she said, so it's important to have a conversation about what may be happening.
Tailor your treatment
Particularly for older adults who have established beliefs, it may help to incorporate philosophy or religion into the treatment.
Don Coyhis, 66, won a $100,000 Purpose Prize last year from Civic Ventures in San Francisco for his work blending treatment steps from mainstream alcoholism organizations with his traditional Native American beliefs to help tribes curb rampant substance abuse. His non-profit organization is White Bison Inc. (www.whitebison.org)
Check out your benefits
If the cost of treatment has been keeping you from seeking help, check out how your plan is responding to the new legislation.
Under the law, group health plans that provide mental-health and substance-abuse benefits must provide the same benefit limits, out-of-pocket limits and prior authorization rules as required for medical and surgical benefits.
While that in theory could scare employers into cutting mental-health benefits, benefits consultant Hewitt Associates surveyed 70 big employers last fall and none planned to drop coverage in light of the law, said Kathy Mahieu, senior behavioral health consultant for Hewitt.
"Companies know they need to offer these benefits," Mahieu said, adding that mental-health benefits are a relatively small outlay when compared with others.
And they are important. Experts said dropping them can have life-threatening consequences for the elderly.
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