Parents, doctors tell Healthcare Advocate: Coverage denied for children needing mental health care

Southington mother Cathy Morrelli told a nightmarish tale of fighting to keep her suicidal daughter hospitalized. She says her 14-year-old was in and out of the hospital repeatedly over the last five months, their insurance company trying — 13 times — to cut every stay short.

Diana Leyden of Glastonbury testified about her insurance company’s denying residential treatment for her 75-pound anorexic teenager.

Other parents and psychiatrists talked about the shortage of mental health hospital beds for children because of high demand. They also complained about the lack of a treatment facility in Connecticut for people with eating disorders.

Dozens of speakers testified about their challenges during a wide-ranging public hearing Wednesday on lack of access to prevention, treatment and health care coverage of mental health problems and substance abuse.

State Healthcare Advocate Victoria Veltri called the hearing at the Legislative Office Building in response to the many complaints she has fielded from families and patients seeking help after being denied coverage.

Dr. Andrew Lustbader, a child psychiatrist and pediatrician, said the middle class has trouble getting mental health treatment.

“We have found that the upper and lower classes are, to varying degrees, able to get adequate mental health care for their children. However, the vast majority of children in the middle class — those who are insurance dependent — have far greater difficulty in getting reimbursement for much needed services,” Lustbader said.

The federal Mental Health Parity and Equity Addiction Act passed in 2008 aims to promote access to and coverage for mental health treatment. But there is confusion about the law, including how to enforce it.

During the hearing Wednesday, Sen. Richard Blumenthal made an appearance and pledged to send letters to the U.S. Secretary of Labor and the Center for Consumer Information and Insurance Oversight, asking them to clarify the law.

“In the absence of regulations, health care plans have increasingly excluded coverage. We need these regulations. I’m hoping they will be issued promptly,” Blumenthal said.

Some psychiatrists and parents testified that when their private commercial insurance policies denied coverage, they sought state health care coverage instead.

Dr. Mirela Loftus, a child and adolescent psychiatrist at the Institute of Living in Hartford, described a divorced mother struggling to get treatment for her 16-year-old daughter who has schizo-affective disorder.

The teenager began having hallucinations and delusional thoughts and was hospitalized three times. The most recent time, she was picked up by police as she walked on the side of the highway where she was looking for her imaginary “triplets.” She was hospitalized for 12 days after that, but insurance coverage stopped at four days.

Dr. Sabina Lim, executive director of Yale-New Haven Psychiatric Hospital, said the sheer volume and scope of the need for mental health services in Connecticut is part of the problem. The hospital, now merged with St. Raphael’s, had more than 8,000 psychiatric emergency department visits in the 2012 fiscal year.

“And despite our now over 130 inpatient beds, patients have to wait unacceptably long periods of time for admission due to the 100 percent occupancy of these beds every day,” Lim said.

Veltri said that the hearing would be the first step in a bold, consumer-centered effort to bring substantial reforms to the current system.

In addition to Velti’s efforts, lawmakers on the Program Review and Investigations Committee are seeking information on the whether people are wrongly being denied coverage.