Quality Over Quantity: An Analysis of State Parity Laws and their Impact on Mental Health Outcomes Across the United States

Abstract

In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) was passed into federal law with the ultimate goal of eliminating discrimination between mental and physical health care. Despite the federal effort, fundamental differences embedded in the treatment of behavioral illnesses have acted as barriers to achieving full parity with medical care. Over ten years later, individuals across the United States continually struggle to access mental health care, leaving millions of individuals untreated. Untreated mental illness imposes a huge cost to society, impacting not only the individual, but also rippling out to drastically impact family and friends. In order to promote parity, state governments have passed various different laws that support the MHPAEA within their own borders. Through a difference in difference model, this paper uses state laws as an exogenous shock to poor mental health outcomes in an effort to analyze which state laws are effectively improving mental health outcomes. While the MHPAEA ultimately sparked state efforts to achieve parity, has it successfully lowered poor mental health outcomes? The results show that access to care is the most important tool for improving mental health across the United States, while highlighting that many of the enacted state parity laws prove to be ineffective at lowering poor mental health outcomes. While the MHPAEA set a federal standard for parity that has served as a catalyst for the implementation of laws across states, prevailing limited access to care across the U.S. has prevented the achievement of full parity between mental and physical health.