A million hours a year are being spent waiting for approval from insurance companies before doctors can hospitalize suicidal or mentally ill patients, according to the Annals of Emergency Medicine.

Unlike medical emergencies, psychiatric emergencies require permission from a patient’s insurance company before an individual can be admitted. Dr. Amy Funkenstein, a child and adolescent psychiatry resident at Brown University, coauthored the study that produced this number after becoming increasingly frustrated with the amount of time she was spending on the insurance approval process. The study found that the approval process takes 38 minutes per patient on average – meaning that the 1.6 million psychiatric admissions per year translate into 1 million hours of time described by Dr. Funkenstein as “wasted.” Although half of the insurance approvals were obtained in less than 20 minutes, 10 percent of authorizations took longer than one hour, and one authorization took five hours. The patients in need of admittance most commonly presented with suicidal ideation, though a few were diagnosed as being homicidal.

Despite the amount of time spent on the authorization process, very few cases are being denied (just one case of the 53 included in this study was not authorized by the insurance company). The study evaluated a sample of 53 patients at the Cambridge Health Alliance Psychiatric Emergency Department in Massachusetts over a three-month period.
While federal and state mental health parity laws have seemingly made access to mental health services easier for individuals, a new study released in the April issue of Psychiatric Services, the journal of the American Psychiatric Association, says that many of those surveyed were not aware of their extended benefits.

Researchers studied the results of Timothy’s Law, New York’s state mental health parity law, by conducting telephone interviews with 54 employed individuals who had private insurance. Of the 54 respondents, 32 were adults diagnosed with mental illness and 22 were parents of children diagnosed with mental illness.

Most of those surveyed had been informed of their insurance coverage benefits before the state parity law went into effect in 2007, but were not aware of the extended coverage as a result of the law. Individuals also reported that their health plan provided unclear or incomplete information about their benefits, they had more difficulty obtaining information on mental health benefits than on medical/surgical benefits, and they felt their insurance companies were managing their mental health care benefits more aggressively than their medical/surgical benefits.

Those surveyed also reported difficulty finding a high-quality mental health care provider in their network as well as problems with health plan provider lists, such as outdated provider lists and long waits for appointments.

Forty-nine states have passed mental health parity legislation. What can be done in other states to educate individuals on their mental health benefits? What do you know about your state’s benefits?

To read more about this study, click here.