Two big stories in recent weeks have put the spotlight on mental health issues.

Last month the Oregon Justice Department issued a scathing report on the state hospital. And just last week the latest school shooting at on the campus of Northern Illinois University claimed seven lives, including the shooter’s.

It seems mental health care only enters the spotlight when some horror comes to light.

Shootings in schools or by police officers are often the subject of what attention is paid to mental illness.

Friday, OPB begins a month-long look at the state’s overall mental health. ‘On Our Minds’ will run Fridays on Morning Edition and All Things Considered.

We start now by examining a much-ballyhooed law that went in effect just over a year ago, that told insurers to cover mental health care the same way they cover physical health care. Ethan Lindsey reports on promise of “mental health parity.”

Ed is a successful architect. And although he and his family live in a neighboring state, his wife telecommutes to a job with an Oregon employer. So they use her BlueCross insurance to get health care.

An unusual wrinkle, he used to think, but not a critical one. That was, until his son was diagnosed with a mental illness.

Ed: “It started with a suicide attempt. That was our big wakeup call.”

Ed has asked to use only his middle name in this story to protect his wife’s identity from her employer. The suicide attempt was followed by hospitalization and then a diagnosis of mental illness.

Under his home state’s law, Ed believes his son’s medical bills would be covered. But not so in Oregon.

Ed: “And since then it’s been years and years and years of therapy and everything else. Weekly trips to the psychologist, to the psychiatrist. And basically we’ve financed his health care by refinancing our home, cutting back on our lifestyle to a lower middle-class lifestyle. And just making it work.”

Ed is not alone.

The American Psychological Association estimates that the treatment of mental illness in this country costs $55 billion a year. By way of comparison, the total cost of all cancer treatment amounts to $80 billion annually, according to the National Institutes of Health.

The state of Oregon estimates that 160,000 state residents need mental health treatment.

So, in 2005, after years of political wrangling, the state legislature did something about it.

State lawmakers voted for mental health parity, and Democratic Governor Ted Kulongoski signed it into law, effective January first 2007.

Gov. Ted Kulongoski: “The reality of it is, when this is all washed out, there will be no difference between mental health coverage and physical health coverage.”

The state law basically forces insurers to pay for mental health care the same way they pay for all other health care.

Ed, whose son tried to commit suicide, says the Oregon law looked like it was going to provide tens-of-thousands of dollars in critical treatment for his family.

Ed: "But the loopholes were huge, and we fell through them.”

The loopholes built into the law include exceptions for individual plans, and corporations that are self-insured. Ed’s wife’s employer falls into that second category.

By some estimates, more than 60 percent of Oregonians are left out of the parity law.

The Governor says that’s unfortunate, but that’s the way the law was written.

Gov. Ted Kulongoski: “Change is always difficult. And the insurance industry is no different than any other institution, and what they said is that this is going to be such a cost increase.”

But now, he says studies have shown that the costs are reasonable – and he hopes that means the law can be expanded.

As for insurers, they say one-year isn’t enough time to judge the effectiveness and cost of mental health parity.

Kaiser Permanente, one of the state’s largest insurers, says under parity, patients admitted in serious crises tend to stay one to three days longer than before. Also, patients visit the hospital for outpatient treatment more frequently. But, Kaiser says the costs increase accordingly.

Kaiser and the governor both agree that mental health parity is really just a first step to changing people’s perceptions of mental illness.

Ted Kulongoski: “That’s what people are going to have to come to understand: their lives will be made better by dropping the stigma, and trying to get in and see mental and physical health as all one piece.”

Pat and Dave Shackleton live in Eugene. When their son was a teenager, they discovered he was bipolar.

The family’s insurer has a mental health loophole also. But that isn’t of primary concern to Dave anymore.

Dave Shackleton: “It’s a good idea, in transition. And hopefully that would help to diminish some of the stigma but unfortunately, not enough people are being treated. It’s about dollars primarily, and the dollars frankly aren’t being spent in Oregon.”

To the Shackletons, mental health parity is a good thing if it changes perceptions of the mentally ill and redirects more resources to them.

And, finally, Pat Shackleton says, the law could be considered a success if those reforms eventually allow people like her  son to reenter society as equals.

Pat Shackleton: “I think he will get out there, but that last step is really hard. And don’t know how to help him, I’m hoping that I will learn. But that’s the biggest problem that I have right now.”

Instead of finding loopholes, or differences between the groups, Pat says programs need to be designed to bridge the gap between mental health care and physical health care.

And between the mentally ill and the rest of the population. Mental health advocates estimate that one in four Americans are directly affected by mental illness.

In reporting his story on Oregon's mental health care, and mental health parity, correspondent Ethan Lindsey sat down with Governor Ted Kulongoski for close to a half-an-hour in mid-February. In their interview, the Governor discussed his thoughts on the insurance industry, the stigma of mental illness, and Nurse Ratched from 'One Flew Over The Cuckoo's Nest.' We've posted an extended version of that interview here.

Also, we got help reporting this story from our Public Insight Network . People in the Public Insight Network are helping us cover the news by sharing their knowledge and experience.   If you'd like to contribute your knowledge, go to our web site - opb.org/publicinsight .