In rural states such as North Dakota, accessing mental-health care can be extremely difficult. Federal officials say it's even worse when someone's benefits for such care are improperly denied.

They're ramping up enforcement under a law aimed to address the issue.

The Mental Health Parity and Addiction Equity Act, in place since 2008, requires most health plans - offering coverage for behavioral health or substance use disorders - to not make those benefits more restrictive than those for standard medical care.

Lisa Gomez, assistant secretary for the Employee Benefits Security Administration, said their investigations have found that providers are still falling short in providing equal access.

"For example," said Gomez, "there were plans that were excluding coverage for nutritional counseling, if you were seeking that coverage for an eating disorder."

However, the plan in question was not restricting coverage for those seeking that type of counseling for help with a physical health issue such as diabetes.

In fiscal year 2022, Gomez's agency investigated nearly 150 plans and found almost two dozen violations.

An EBSA report suggests correcting these situations is significant because in some cases, hundreds of plan participants were affected by a single provision not in compliance.

Report authors say forcing the provider to make good on the claim can be a life-changer for those struggling with a mental-health issue.

Gomez said for underserved populations, such as rural areas, getting rid of obstacles helps that individual make their situation more manageable.

She added that the last they need is to have to wait for something like a co-pay error to be sorted out.

"We've seen what mental-health conditions and substance-use disorders can do to a person, to a family," said Gomez. "And so, it's really important that we try to use the tools that we have available to us and work together to try to address these issues."

Gomez acknowledged that while there is progress, it isn't moving fast enough to remove these specific coverage hurdles.

Various federal agencies are trying to finalize proposed rules that would strengthen provisions under the law.

Outside of benefits roadblocks, Kaiser Family Foundation data show that in North Dakota, only 19% of mental-health care patients' needs are being met due to provider shortages.




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The 2024 Arizona Alzheimer's Consortium Public Conference kicks off Saturday, where industry experts and researchers will share the latest scientific developments and ongoing advances to fight Alzheimer's disease and other forms of dementia.

David Coon, director of the Center for Innovation in Healthy and Resilient Aging at Arizona State University, will lead the conference.

Coon said experts continue to see growing numbers of people developing dementia in the Grand Canyon State, which also means increased demand for care from family and friends.

"The reality is we're still facing this," he said, "and we're facing it also with a growing number of people living alone with cognitive decline, and that is very important for us to recognize as well."

It's a growing public health crisis in Arizona, according to the Alzheimer's Association. An estimated 152,000 people 65 and older are living with Alzheimer's disease in the state.

Coon said increasing awareness about the disease is critical to not only diminish stigma but also plan for the future.

Saturday's event is free and will take place from 8 a.m. to 1 p.m. at the Memorial Union on ASU's Tempe campus. Coon said a panel of experts will share information about treatment options, but also the resources and support systems available across the state.

He added that it is critical for people not to wait until a crisis strikes, and that the sooner patients know their cognitive-health status, the better they can have a voice in their own preferences for care.

"How you get assistance, who's engaged, and I think that is really important for you to be, in part, in the driver's seat," he said, "and similarly, for somebody that's going to help you along that way to have those conservations."

Coon called Saturday's event a "family affair," and encouraged anyone impacted by dementia or Alzheimer's to bring family and friends to learn more. Topics will range from new drug treatments to reducing the risk of Alzheimer's with exercise, as well as resources for caregivers.

A new report showed a significant decrease in suicidal ideation, planning and attempts on college campuses around the nation, as well as improved levels of those suffering from anxiety and depression.

The nonprofit Jed Foundation analyzed a decade's worth of data from higher ed institutions participating in their JED Campus program. It provides colleges and universities with resources and guidance to protecting and improving student mental health.

Michelle Mullen, senior vice president and chief design and impact officer for the foundation, said in Utah, 16 institutions took part in the program.

"We work them collaboratively to be able to identify what is already strong and the ways in which we can strengthen it," Mullen explained. "Are there critical pieces that may be missing to be able to enhance mental-health and suicide prevention on campus?"

With more than 18 million students attending colleges and universities every year, Mullen pointed out academic institutions are at the forefront of bringing mental health services to young adults. Her message to academic institutions is to not wait to implement what she calls a "comprehensive approach to mental health."

The group has a list of recommendations, including preventive practices, guidelines for treatment of people at risk of suicide as well as effective postvention efforts.

Mullen noted mental health challenges have risen significantly among young people and contended it is not a surprise when you take into account the multiple stresses and challenges younger adults face, such as what she calls "today's comparison culture," brought on by social media, mass shootings, race and faith-based harassment and threats as well as decreasing protections for LGBTQ+ youths.

"The amazing thing is that we are now seeing results that are coming out of our reports, is that this group is incredibly resilient," Mullen observed. "With the right support and structure, then they do better on campus. So there is hope and there is something we can do."

Mullen added if you or someone you know is struggling, the first step is to reach out to a friend, a family member or a professional for help. She said one can also call 988 to receive free and confidential support for those in distress.


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Alzheimer's disease is the eighth-leading cause of death in Pennsylvania.

A documentary on the topic debuts Saturday in Pittsburgh. "Remember Me: Dementia in the African American Community" features individuals and families who are dealing with memory loss.

C. Nathaniel Brown, founder and CEO of Expected End Entertainment and a former Pittsburgh resident, said his aunt lives with dementia, which sparked his interest in talking with others to find out more about the disease and how it affects communities of color.

"The first thing I found out was that there are over 100 types of dementia," Brown noted. "And the more I learned, the more I realized how much it was impacting the African American community disproportionately. We're twice as likely to be diagnosed with Alzheimer's disease or some other progressive type of dementia."

The film will be shown at the Carnegie Library in Homewood, from Noon to 3 p.m. ET. It is free, but registration is required. According to the Alzheimer's Association, more than half of Black Americans believe major declines in memory and cognitive function are simply a normal part of aging, rather than symptoms of Alzheimer's or dementia.

Brown added after the screening, there will be a question-and-answer session and community organizations will be there to provide resources.

"Allegheny County Health Department will be present, the University of Pittsburgh Alzheimer's disease Research Center will be there," Brown outlined. "The Dementia Friendly Pennsylvania organization will be there, as well as several people who were interviewed for the film, including counselors, professionals."

He mentioned the documentary features the late Academy Award-winning actor Louis Gossett, Jr. Brown said Gossett emphasized the importance of leaving a legacy by educating people about living with Alzheimer's, steps to take after diagnosis, and preventive measures.


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