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A stupid mental health parity manifesto

Mental health parity is the updated law of the land. Payers are in an unenviable position. They need to reach “parity” in mental health services, which means they’re supposed to be paid in the same manner as general medical care. Let’s dig into this idea and one proposed solution that, be forewarned, is dumb.

This is an absurd and terrible standard, to be excruciatingly clear. The reason is similar to the statistical principle of rejecting the null hypothesis. The null hypothesis is a core science concept in statistics, the math we use to test our biomedical science. The null hypothesis (in the figure below, H 0) says: “There is no difference between these two things, and any difference is due to chance and measurement error.

When we ask: “is this drug different from placebo?” we assume something crucial. It should be different and BETTER than a placebo. We don’t want interventions that are worse than placebo. No matter how hard the marketing firm leans in, it’s hard to sell:

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