This study examines M/SU parity laws and their potential effect on out-of-pocket mental health treatment costs.  The study found modest yet important variation in out-of-pocket burden across states but note that prescription drugs account for nearly two-thirds of out-of-pocket spending and fall largely outside the scope of federal M/SU parity laws.  The authors conclude that M/SU parity laws will do little to reduce the observed burden or inter-state variation.  

Zuvekas, S. H., & Meyerhoefer, C. D. (2009). State variations in the out-of-pocket spending burden for outpatient mental health treatment. Health Affairs, 28(3), 713-22. DOI: 10.1377/hlthaff.28.3.713 http://content.healthaffairs.org/cgi/content/abstract/28/3/713 

Authors: Samuel H. Zuvekas, Chad D. Meyerhoefer.

This perspectives article considers the Mental Health Parity and Addiction Equity Act of 2008 and highlights the need for clear regulations and education regarding the costs of untreated M/SU conditions.  The authors suggest using the new law to reinforce the centrality of mental health care within the overall health care system and as a curricula piece of health care reform. 

Shern, D. L., K. K. Beronio, et al. (2009). After parity--what's next. Health Affairs, 28(3), 660-2. DOI: 10.1377/hlthaff.28.3.660 http://content.healthaffairs.org/cgi/content/abstract/28/3/660 

Authors: David L. Shern, Kirsten K. Beronio, Henry T. Harbin.

This white paper by Milliman Inc. analyzes the Mental Health Parity and Addiction Equity Act of 2008, focusing on effects of the parity legislation on individuals, health care plans, managed behavioral health care organizations (MHBOs) and other key stakeholders. 

Download the white paper from Milliman: http://www.milliman.com/expertise/healthcare/publications/rr/pdfs/preparing-parity-investing-mental-WP05-01-09.pdf 

This perspectives article examines implementation challenges surrounding the Mental Health Parity and Addiction Equity Act of 2008.  the author notes that unique features of M/SU care will pose challenges in aligning benefits with general health care.  

Dixon, K. (2009). Implementing mental health parity: the challenge for health plans. Health Affairs, 28(3), 663-5. DOI: 10.1377/hlthaff.28.3.663 http://content.healthaffairs.org/cgi/content/abstract/28/3/663 

Author: Keith Dixon

In 2004-5 two-thirds of primary care physicians (PCPs) reported being unsuccessful at obtaining mental health services for patients at a rate twice as high as for other services.  PCPs cited shortages of mental health care providers, health plan barriers, and lack of coverage or inadequate coverage.  The author concludes that implementing mental health parity will reduce some but not all of the barriers to care. 

Cunningham, P. J. (2009). Beyond parity: primary care physicians' perspectives on access to mental health care. Health Affairs, 28(3), w490-501. DOI: 10.1377/hlthaff.28.3.w490 http://content.healthaffairs.org/cgi/content/abstract/28/3/w490 

Author: Peter J. Cunningham

The following link provides a selected bibliography of articles and reports examining behavioral health parity through 1999. 

The bibliography is available from SAMHSA here: http://mentalhealth.samhsa.gov/cmhs/ManagedCare/Parity/Bibliography.asp