Public opinion and the mental health parity debate: lessons from the survey literature.

Research on public opinion has seldom been incorporated into the debate about appropriate coverage of mental health and substance abuse treatment services in health insurance plans. However, several surveys have been conducted to probe for voters' awareness of and attitudes toward persons with mental illness and insurance coverage of their treatment needs. Given the current debate over mandating parity for coverage of mental health and substance abuse treatment services, these data promise to be particularly useful to politicians and health policy analysts. The author reviews reports of survey research conducted between 1989 and 1994 to assess American voters' support for expansions of mental health and substance abuse treatment coverage, including their knowledge about the origins and implications of mental illness and their willingness to pay for more generous benefits. The results suggest widespread support for such benefit expansions, but voters express concern about potential increases in their taxes or in their health insurance premiums. To facilitate the passage of meaningful reforms for mental health and substance abuse treatment benefits, policy makers must present realistic estimates of the costs of such expansions and of the benefits to be delivered to those in need.