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Mental health parity

AFSP supports uniform implementation of laws requiring mental health parity in insurance coverage.

About the issue

Between 1999 - 2018, suicide rates across the country rose significantly at an increase of 35%.  While these statistics point to a serious public health problem, we do know that suicide is preventable.  Upwards of 90% of individuals who ultimately die by suicide were living with a diagnosable mental health condition at the time of their death, although these conditions often go undiagnosed or untreated.

Mental health parity is an important factor in behavioral health care access; “parity” means that insurance coverage for mental health and substance use disorder treatments, collectively referred to as behavioral health services, should be no more restrictive than coverage for other medical conditions. Despite the passage of major federal policies including the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008 and the Affordable Care Act (ACA) in 2010, many patients across the country continue to face several systemic barriers to care.

Our policy position

AFSP understands that assessment and treatment for mental health conditions can save lives, but only if individuals at risk can afford to obtain said care, making parity in insurance coverage for mental health critical. AFSP also acknowledges that insurers have succeeded in implementing major parts of parity law and that there has been a great deal of progress over the last decade. However, plans are often not in compliance with some of the more complex components and continue to apply managed care practices in ways that are more restrictive for mental health and substance use disorder treatment than for other medical treatment.

AFSP urges the enforcement and oversight of parity laws, recognizing that this has largely become the responsibility of the states and requires collaboration between state lawmakers and regulators. Currently, AFSP is focused on supporting the passage of comprehensive state-level parity reporting legislation to ensure federal and state laws are uniformly implemented in all 50 states and the District of Columbia.

To learn more, read our Mental Health Parity issue brief.

Additional resources

For an overview of the current state of parity implementation across the country visit ParityTrack for reports on parity-related legislative, statutory, regulatory and legal activities in all 50 states.

To learn more about the policy and advocacy work being done around mental health care in America, visit the Kennedy Forum where you can find the latest parity resources including toolkits, policy briefs, videos, and more.

The American Psychiatric Association has created State Model Parity-Implementation Legislation Adapted to All 50 states and the District of Columbia. The legislation is designed to require transparency and accountability from insurers and state regulators. Each state has legislation that is tailored specifically for that state’s terminology and formatting.

To learn more about the inequalities in insurance coverage in your area, view the updated Milliman Disparities Research Report, Addiction and mental health vs. physical health: Widening disparities in network use and provider reimbursement (2019). The report provides details on spending for mental health and substance use treatment and analysis of non-quantitative treatment limitations as they relate to behavioral healthcare services.

Visit to learn about your right to insurance coverage for behavioral health services and how you can take action if you are denied services. The Don’t Deny Me campaign aims to break down barriers to behavioral health services and create a consumer-driven movement to bring parity to insurance coverage.  

The Bowman Family Foundation provides tools and material intended to assist employers, third-party administrators, regulators, and others to determine whether a plan or health insurer provides adequate access to in-network behavioral health providers and complies with the Federal Parity Law.

Mental health parity videos (in partnership with Psych Hub)

Understanding mental health parity

How to file a parity appeal