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Med School Mental Health Insurance Snap Shot

University Business, Oct 2011

Both employers and employees struggle with health insurance costs. While most people think of doctors' visits when they think of health insurance, mental health and substance abuse treatment fall under the same umbrella. A recent study by a group of Harvard researchers from the Cambridge Health Alliance, found treatment coverage for medical school students is on the low end of the scale. Of the 115 med schools analyzed, fewer than 22 percent provide students with complete coverage, without co-pays or coinsurance, for mental health and substance abuse treatment.

"We weren't surprised, but [were] disappointed," says lead author Rachel Nardin, assistant professor of neurology at Harvard Medical School and chief of neurology at Cambridge Health Alliance. The coverage for medical students is as bad as that for the general public, she adds.

The idea for the survey came from a colleague beginning a lecture by asking students if they knew about problems in access to healthcare. Most reported having problems accessing mental health care. According to the report, medical students have higher depression rates and comparable substance abuse rates to their peers. These conditions can negatively impact their future performance as doctors, Nardin cautions. The survey revealed a wide variety of plans, some of which had "draconian visit limits or cost sharing."

"Our goal isn't to shame medical schools. We understand they are struggling with the same cost pressures other employers are," says Nardin. "This is a case study of a larger problem with our health care system."

She said most schools are aware of the gaps in coverage and that some supplement insurance with student health clinics and confidential sessions with faculty members. However, students can be leery of getting help from a professor who might be grading them down the line.

Unfortunately, there is no easy solution. "I think schools should continue to look at the issue and improve where they can," says Nardin. "And I think schools should advocate for broader healthcare reform that will get us all out of this problem."