Earlier this year Seattle reporter Jonathan Martin met the family of a 12-year-old girl who had been diagnosed with schizophrenia. The girl needed to transition from inpatient care to living at home again, and her parents decided it would be best for her to live with her grandparents for the safety of the parents' other children.
When the inpatient facility recommended the grandparents observe the girl's care in the hospital for two weeks, the insurance company declined to support it, saying the girl had to be discharged immediately.
"I compare that to someone who had just broken his back and needed additional time to set up treatment accommodations at home," said Martin. "I don't think there would be much question about it." The struggle of this family illustrated the problem of insurance parity in mental health for Martin, who had received a Rosalynn Carter Fellowship for Mental Health Journalism from The Carter Center. The annual fellowships program provides stipends to journalists covering issues in mental health.
Martin, who works for The Seattle Times, began his fellowship in September 2013 and planned to cover the Affordable Care Act. He was one of six U.S. and four international journalists selected for the annual program.
Over the course of his fellowship year, through dozens of articles, blog posts, and columns, Martin not only looked at how the Affordable Care Act implementation was affecting mental health care in Washington state but also addressed parity and denial of care. In addition, he followed a lawsuit related to mental health care sparked by a column he wrote and eventually appealed to the Washington state Supreme Court.
"The fellowships are incredibly valuable for journalists," Martin said. Fellows come to The Carter Center in Atlanta at the beginning and end of their fellowship year for an annual meeting where they learn about mental health issues from professionals and hear what other fellows are doing. "The exposure to experts and the opportunity to mix with other journalists who are highly motivated are transformational experiences. I always leave the meeting with about 15 new story ideas," Martin added.
Not that there was a shortage of mental health stories for Martin to cover back home. The lawsuit that made it to the Supreme Court was based on Martin's column about a practice in hospital emergency rooms known as boarding. "It's essentially short-term detentions in ERs for people who had been involuntarily committed or held there because there was nowhere for them to go," Martin said. The patients would often be strapped down in an ER hallway, unmedicated so that they would be completely lucid for a court hearing. A judge who read the Seattle Times column called a hearing and declared the practice unconstitutional. After many appeals, Washington state's Supreme Court agreed.
Considering the Supreme Court ruling, the Affordable Care Act, and parity legislation that has been on the state's books but not enforced, the time seems right for a reform of the mental health system in Washington. "We cannot have a narrow response that means a few more hospital beds," said Martin. "You're looking at the preventative system that's been starved during the recession. It's a stars-aligning moment for mental health change."
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