This fall, the Mental Health Association of Rhode Island (MHARI) is launching RI Parity Initiative (RIPI), an initiative that will raise public awareness about parity and empower people living with mental health and substance use disorders to understand and assert their right to treatment. The Rhode Island Psychological Association (RIPA) supports the initiative and is providing MHARI with assistance and resources.

“For 25 years, RIPA has shared goals and resources as a member of the Coalition of Mental Health Professionals of Rhode Island,” said Peter Oppenheimer, PhD, RIPA’s director of professional affairs. With respect to RIPI, RIPA is “assisting [MHARI] with professional input, participating in stakeholder meetings, and generally doing what we can to support them and help them do this work effectively.”

The RIPI launch will roughly coincide with the 10-year anniversary of the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA). This federal law says that coverage for mental health or substance use services must not be more restrictive or expensive than coverage for medical services. Many states, including Rhode Island, also have parity laws, though their comprehensiveness varies, according to Mental Health America. But compliance and enforcement of both the federal and state parity laws have been uneven, and a 2014 survey by APA found that only 4 percent of Americans are aware of MHPAEA.

Ruth Feder, Esq., MSW, MHARI’s executive director, said that when she started in her role three years ago, she was surprised to learn that parity is still a problem. “To me, this is blatant discrimination — a civil rights issue,” she said.

When it launches, RIPI will have three focuses. The first is to raise general awareness of parity and educate the public about their rights to equal coverage for mental health and substance use services. The second is to help patients advocate for those rights by connecting them with resources, such as the consumer insurance hotline available to Rhode Islanders. RIPI’s third focus is on eroding the stigma of mental illness in the health care system, which Feder and RIPI project manager Karen Malcolm have learned is a significant barrier to care through a series of focus groups and stakeholder meetings with community members and health care providers.

“We hear over and over that when people are in the ER for a physical problem, they sense that they’re not being taken as seriously once it comes out they have a mental health or substance issue,” Feder said. Relatedly, a sense of shame may prevent people from pushing back against their insurer when they’re denied coverage.

Malcolm said that while RIPI is Rhode Island-specific, she and Feder think the project could translate well to other states.

“By the time of the launch, we’ll have a good ‘toolbox’ to share with interested groups outside Rhode Island,” she said. This toolbox could include public awareness messaging and imagery, as well as other resources.

Both Feder and Malcolm noted that RIPI has already had one great outcome prior to its launch: getting advocates from different professions and agencies to learn about each other.

“They all have a distinct jurisdiction, and many of them had never really sat down to educate each other about what they do,” said Malcolm. “When they started talking to each other in our stakeholder meetings, they really made new connections and learned how to make more appropriate referrals.”  

Keep an eye on the RIParity Initiative website for more information about its launch, its work, and how to start a similar initiative in your state.