Reimbursement & Advocacy
Issues in Mental Health

Reimbursement: Mental Healthcare Cost Statistics
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Mental Disorders are among the top five most costly medical conditions, according to these statistics from The National Institute of Mental Health. Note the dramatic increase in expenditures for Mental Disorders between 1996 and 2006. The cost of Mental Disorders is now equal to the cost of Cancer, according to these statistics. The National Institute of Mental Health provides statistical information about incidence and prevalence of Mental Disorders, as well as costs and usage of healthcare benefits (National Institute of Mental Health, 2011).

Reimbursement: The Latest in Billing News* Conditions of Participation: The Centers for Medicare & Medicaid Services (CMS) proposed new Conditions of Participation (CoPs) in community mental health. CoPs are health and safety standards that must be met by health care organizations in order to participate in Medicare and Medicaid programs. CoPs ensure quality care for the recipients. The exciting news is that CoPs include a prominent role for occupational therapists. If implemented, CMS would require physician-led interdisciplinary teams that would direct patient care. The interdisciplinary team explicitly includes an occupational therapist. This recognition of the importance of occupational therapy to patient function and overall outcomes is an important step towards increasing opportunities for occupational therapy practitioners in the practice area of mental health. The final rule is expected to be released this fall. AOTA members who practice in a mental health setting are encouraged to voice their support on AOTA's website under Federal Advocacy/Testimony & Statements after submission to CMS. (AOTA, 2011). See entire article online at:
* ICD-10 Transition: Effective October 1, 2013, the ICD-9 code sets will be replaced by ICD-10 code sets. This will be a new set of codes for classification of diseases (CMS, 2011). This fact sheet provides background information, guidance on preparing for the transition, and additional resources.
* Medicare Fact Sheet (Basics):

* CPT Codes in Mental Health: Need help with Current Procedural Technology (CPT) Codes? CPT Codes are maintained by the American Medical Association to describe services and communicate among various professions. New versions are released each year. AOTA provides 2011 CPT Codes for Occupational Therapy. (AOTA, 2011). Login may be required at AOTA: See CPT Codes (AOTA document)

Advocacy: Occupational Therapy in Mental Health
Advocacy: AOTA's Centennial Vision
"The World Health Organization has identified mental illness as a growing cause of disability worldwide and predicts that in the future, mental illness—specifically depression—will be the the top cause of disability. In response to this trend, AOTA's Centennial Vision has identified mental health as a vital practice area for 21st century practice. Increasing emphasis will be placed on treatment and prevention services for children, youth, the aging, and those with severe and persistent mental illness." (AOTA, 2011)Click here for AOTA's Mental Health Page

Advocacy: Specialized Skills in Mental Health The purpose of this document is to describe the specialized knowledge and skills for entry level occupational therapy practice and the promotion of mental health during prevention and intervention of mental illnesses. The foundations of occupational therapy are firmly rooted in psychiatry. The profession brings a rehabilitation perspective to mental health services in keeping with increased emphasis on recovery and functionality directed toward participation in daily life occupations. The American Occupational Therapy Association (AOTA) supports the inclusion of the profession of occupational therapy as a core mental health profession in the U.S. Code of Federal Regulations and as a qualified mental health profession as defined by state statute and regulation (AOTA, 2006a). Intended for internal and external audiences, this document specifies the knowledge, reasoning, and performance skills necessary for competent and ethical occupational therapy practice in mental health promotion, prevention and intervention.
Click the Link below to read the entire document:

Advocacy: Person-first Language
As health professionals, we must recognize mental illness as the result of physiological and environmental factors just like physical diseases, such as diabetes and cancer. It is important to use people-first language, a way of speaking legally recognized by the State of Ohio Legal Rights Service. We can become advocates for change in insurances and healthcare policy on a political level. We can address negative media portrayals of individuals with mental illness. On the most basic level, we can refer to the person first and not label them with the disability. (from: - The Stigma of Mental Illness by Carol Myers).

Person first language is when you put the person first when writing or talking about a person with a disability, emphasizing the person instead of their disorder or mental illness. Below are several examples of proper use of person first language.
Don't use
person who has a disability
handicapped or disabled person
children with disabilities
special needs children
mental health problem or challenge
mentally ill
person with or experiencing schizophrenia
schizophrenic or schizo
accessible parking
handicapped parking
congenital disability
birth defect
person with cerebral palsy
person who suffers from cerebral palsy
Down syndrome
Mongol, Mongoloid, or Downs
person with epilepsy
individual who is blind or has low vision
the blind
person with an intellectual disability or person with a developmental disability
person with a brain injury
brain damaged
Provided by Ohio Legal Rights Service for People with Disabilities. For additional information on person-first language, visit this link:

Why advocate for OT in Mental Health?

Eastern Kentucky University Students Advocate for Occupational Therapy in Mental Health