Mental
Health Bill Of Rights Project
A
Joint Initiative of Mental Health Professional Organizations
Principles
for the Provision of
Mental Health and Substance Abuse Treatment Services
A Bill of Rights
Our
commitment is to provide quality mental health and substance
abuse services to all individuals without regard to race,
color, religion, national origin, gender, age, sexual
orientation, or disabilities.
Right to
Know
Benefits
Individuals have the right to be provided information
from the purchasing entity (such as employer or union
or public purchaser) and the insurance/third party payer
describing the nature and extent of their mental health
and substance abuse treatment benefits. This information
should include details on procedures to obtain access
to services, on utilization management procedures, and
on appeal rights. The information should be presented
clearly in writing with language that the individual can
understand.
Professional
Expertise
Individuals have the right to receive full information
from the potential treating professional about that professional’s
knowledge, skills, preparation, experience, and credentials.
Individuals have the right to be informed about the options
available for treatment interventions and the effectiveness
of the recommended treatment.
Contractual
Limitations
Individuals have the right to be informed by the treating
professional of any arrangements, restrictions, and/or
covenants established between third party payer and the
treating professional that could interfere with or influence
treatment recommendations. Individuals have the right
to be informed of the nature of information that may be
disclosed for the purposes of paying benefits.
Appeals
and Grievances
Individuals have the right to receive information about
the methods they can use to submit complaints or grievances
regarding provision of care by the treating professional
to that profession’s regulatory board and to the
professional association.
Individuals
have the right to be provided information about the procedures
they can use to appeal benefit utilization decisions to
the third party payer systems, to the employer or purchasing
entity, and to externalregulatory entities.
Confidentiality
Individuals have the right to be guaranteed the protection
of the confidentiality of their relationship with their
mental health and substance abuse professional, except
when laws or ethics dictate otherwise. Any disclosure
to another party will be time limited and made with the
full written, informed consent of the individuals. Individuals
shall not be required to disclose confidential, privileged
or other information other than: diagnosis, prognosis,
type of treatment, time and length of treatment, and cost.
Entities receiving
information for the purposes of benefits determination,
public agencies receiving information for health care
planning, or any other organization with legitimate right
to information will maintain clinical information in confidence
with the same rigor and be subject to the same penalties
for violation as is the direct provider of care.
Information
technology will be used for transmission, storage, or
data management only with methodologies that remove individual
identifying information and assure the protection of the
individual’s privacy. Information should not be transferred,
sold or otherwise utilized.
Choice
Individuals have the right to choose any duly licensed/certified
professional for mental health and substance abuse services.
Individuals have the right to receive full information
regarding the education and training of professionals,
treatment options (including risks and benefits), and
cost implications to make an informed choice regarding
the selection of care deemed appropriate by individual
and professional.
Determination
of Treatment
Recommendations regarding mental health and substance
abuse treatment shall be made only by a duly licensed/certified
professional in conjunction with the individual and his
or her family as appropriate. Treatment decisions should
not be made by third party payers. The individual has
the right to make final decisions regarding treatment.
Parity
Individuals have the right to receive benefits for mental
health and substance abuse treatment on the same basis
as they do for any other illnesses, with the same provisions,
co-payments, lifetime benefits, and catastrophic coverage
in both insurance and self-funded/self-insured health
plans.
Discrimination
Individuals who use mental health and substance abuse
benefits shall not be penalized when seeking other health
insurance or disability, life or any other insurance benefit.
Benefit
Usage
The individual is entitled to the entire scope of the
benefits within the benefit plan that will address his
or herclinical needs.
Benefit
Design
Whenever both federal and state law and/or regulations
are applicable, the professional and all payers shall
use whichever affords the individual the greatest level
of protection and access.
Treatment
Review
To assure that treatment review processes are fair and
valid, individuals have the right to be guaranteed that
any review of their mental health and substance abuse
treatment shall involve a professional having the training,
credentials and licensure required to provide the treatment
in the jurisdiction in which it will be provided. The
reviewer should have no financial interest in the decision
and is subject to the section on confidentiality.
Accountability
Treating professionals may be held accountable and liable
to individuals for any injury caused by gross incompetence
or negligence on the part of the professional. The treating
professional has the obligation to advocate for and document
necessity of care and to advise the individual of options
if payment authorization is denied.
Payers and
other third parties may be held accountable and liable
to individuals for any injury caused by gross incompetence
or negligence or by their clinically unjustified decisions.
Participating
Groups:
American
Association for Marriage and Family Therapy (membership:
25,000)
American Counseling Association (membership: 56,000)
American Family Therapy Academy (membership: (1,000)
American Nurses Association (membership: 180,000)
American Psychological Association (membership: 142,000)
American Psychiatric Association (membership: 36,000)
American Psychiatric Nurses Association (membership:
3,000)
National Association of Social Workers (membership:
155,000), National Federation of Societies for Clinical
Social Work (membership: 11,000)
Supporting
Groups:
Mental Health America.
National Depressive and Manic-Depressive Association
American Group Psychotherapy Association
American Psychoanalytic Association
National Association
of Drug and Alcohol Abuse Counselors
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