NCPA - National Center for Policy Analysis

Does Mental Health Care Really Work?

August 12, 2002

Antipsychotic drugs make it possible for schizophrenics to lead reasonably normal lives, but critics of mandated mental health parity question the benefit of spending more than $100 billion a year on mental health care in the United States.

Analysts say there is no objective biological test to identify a mental disorder -- not even schizophrenia. Furthermore, the decision about whether a set of behaviors qualifies as a disorder is subjective. The efficacy of some psychological therapies is also questionable:

  • Although many mental health providers are Freudians, a recent survey of the scientific literature found no evidence that Freudian psychoanalysis does any good.
  • Numerous studies have found that patients on their own improve as much and as often as patients in therapy; other studies have found that mental health professionals are no more effective than nonprofessionals, such as school counselors with minimal skills.
  • Carnegie-Mellon University Professor Robyn Dawes found that the therapists' credentials -- Ph.D. or M.D., for example -- are completely unrelated to the effectiveness of therapy. The type or length of therapy is generally unrelated to its effectiveness.
  • Reviewing 52 studies from the U.S. Food and Drug Administration database, psychiatrist Arif Khan, of Northwestern University's Clinical Research Center, found that a placebo was as effective as commonly used antidepressants (including Paxil, Prozac and Zoloft) in just over half of the studies.
  • A study conducted at the Stanford University School of Medicine found that patients in Alcoholics Anonymous and Narcotics Anonymous were significantly less likely to relapse into alcoholism than patients in professional programs that cost $4,729 per patient per year.

A parity mandate will not solve the uncertainties of mental health care, say analysts. Instead, it should be financed in a different way than health insurance -- such as a Medical Savings Account (MSA) -- that would allow individuals and families to choose their treatment.

Source: John C. Goodman and Wess Mitchell, "The Case against Mental Health Parity, Part III: Does the Care Really Work?" NCPA Brief Analysis No. 412, August 9, 2002, National Center for Policy Analysis.

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