Saturday, December 16, 2017

OCMA Blog

Mental Illness and the ACA — Expanding Behavioral Health Benefits and Fighting Stigmas

By Donald Sharps, M.D.
CalOptima Behavioral Health Medical Director

The phrase, “people fear what they do not understand,” is true when dealing with the stigma that surrounds mental illness. In the media, behavioral health is often blamed for irrational behavior and acts of violence. In schools and offices, you can hear name-calling using words like crazy, insane or psycho. A lack of awareness continues to spread this stigma and it can be a barrier for people to get behavioral health services to improve their quality of life. 

Just as diabetes is a disease of the pancreas, mental illness is a disease of the brain. People are not their diseases. Be aware and do not label a person as schizophrenic or bipolar. A person can have schizophrenia or a bipolar disorder, just as a person can have diabetes. It is important that people increase their awareness of mental health and wellness to reduce the stigma of mental illness. To accept and cope with having a mental illness is difficult enough. It is even harder when a person feels there is a stigma associated with mental illness. Treatment is available for behavioral health issues and it is possible for people to achieve and maintain recovery.

How has the Affordable Care Act changed the way people access behavioral health services and treatment for mental health disorders?

As of January 1, 2014, the Affordable Care Act (ACA) expanded health care benefits to include behavioral health services. However, many people still do not access services for reasons ranging from lack of awareness, to the fear of being labeled and being treated differently. By reducing the stigma of behavioral health issues, we can assist people in getting the needed treatment that is available to them.
With ACA, Medi-Cal has expanded so that more people are eligible, by providing coverage for people who earn up to 138 percent of the federal poverty level (about $15,800 for an individual). It has also increased coverage among non-elderly adults by extending Medi-Cal eligibility to childless adults and increasing Medi-Cal eligibility for parents who lose access when their income fluctuates and slightly exceeding the poverty level.

The ACA also ensures that all health plans offer a comprehensive package of services, known as essential health benefits, which includes Mental Health and Substance Use Disorder Services. 

These Behavioral Health Services are now available to all Medi-Cal members:

  • Individual and group psychotherapy
  • Psychological testing to evaluate a mental health condition
  • Psychiatric consultation and ongoing treatment, that cannot be managed at the primary care level of health care
  • Screening, Brief Intervention, and Referral to Treatment (SBIRT) provided in a primary care setting for alcohol misuse
  • Drug Medi-Cal Services

Members can call the Orange County Mental Health Plan Access Line at 1-800-723-8641 for screening and referral to services. Primary care providers, network providers, community-based organizations and county programs can also call the Access Line. This line is available 24 hours a day, 7 days a week.

To get information regarding the Drug Medi-Cal County Alcohol and Other Drug Program (AOD), call the OC LINKS behavioral health services and referral line at 1-855-OC-LINKS (1-855-625-4657).


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