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Would tests ensure
reimbursement?
(June 2008
Issue)
By Ami Albernaz
Psychologists hold out hope for reliable genetic testing for mental
disorders that will someday make it easier for patients to receive
proper diagnosis and treatment.
"A medically based test might give [a psychological diagnosis]
better standing," says John O'Brien, a psychologist in Portland,
Maine and president of the Maine Psychological Association.
Nationwide, organizations raising funding for research for such
tests include the Chicago-based Ryan Licht Sang Bipolar Foundation,
named for a musician with bipolar disorder who died at 24. The group's
founders want a test that would allow for early intervention and
treatment for children and adolescents.
Such a test might help ensure treatment is covered in states without
parity for mental health conditions, but it could also spare children
any ill effects resulting from misdiagnosis, says Susy Sanders,
Ph.D., a psychologist in private practice in Phillips, Maine (which
does have a parity law in place).
"I am not so interested in parity as I am in something that would
demonstrate to the medical professionals - family doctors, psychiatrists,
etc. - who are doubtful and misdiagnose children," Sanders says
via email. "It is the misdiagnosis that causes all kinds of havoc,
due to giving children medications that actually make them worse.
So a test would be great for them, so that such error might be avoided."
Having a test might not solve everything, O'Brien says. In Maine,
insurance companies must determine a condition is a "medical necessity"
before authorizing treatment. "Even with a test, that question will
remain - does the current condition warrant treatment?" O'Brien
says.
Then, of course, there is the host of ethical and psychological
questions that genetic testing raises. Among these are who has the
right to be tested and who has the right to request a test, says
Gerald Koocher, Ph.D., dean of the School for Health Studies at
Simmons College in Boston and author of the popular text "Ethics
in Psychology."
"Do you have the right to have your kids tested?" he says. "They
might want to wait until they're 18 to find out. And suppose you
have the testing done and your insurance company finds out... If
I were to have a genetic test right now, I would pay for it out
of pocket and use an assumed name."
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