The health care insurance system failed 14-year-old Jacob Edward Machovsky miserably in 2015.
An insurance company decided his in-patient treatment for a mental illness was not a “medical necessity,’’ ending the second of two hospitalizations within two months.
That decision led to tragedy when Jacob, who had turned 15, took his life at his family’s Tempe home in January 2016.
His parents, Denise and Ben Denslow – who have since moved to Gilbert – launched the JEM Foundation in Jacob’s memory, setting in motion their mission to save the lives of other teenagers suffering from mental illness.
Now, the Denslows are hoping the same legislative coalition that a year ago won passage of a landmark suicide prevention bill will help them with the adoption of “Jake’s Law’’– a wide-ranging bill designed to improve access to treatment for troubled juveniles.
At least 38 East Valley teens have taken their lives since 2017.
“We don’t want any other family to go through this. That’s why we are fighting so hard,’’ Denise Denslow said. “We definitely have momentum from last year and we are going to build on that. It’s a huge next step and I am really proud of this bill.’’
Jake’s Law would:
expand youth access to behavioral health services in schools at a cost of $8 million;
establish a suicide mortality review team that would start looking into the root causes of a death within a few days after teens take their own life;
create parity in the insurance coverage of medical and mental health conditions.
Approval of the parity measure would mean that Arizona for the first time would be enforcing a federal law, the Mental Health Parity and Addiction Equality Act, that was signed in 2008 by former President George W. Bush.
Jake’s Law would require insurance companies to demonstrate how they are complying with the federal law.
That law requires insurance coverage for illnesses of the brain – such as depression, anxiety and addiction – be no more restrictive than any other medical condition, according to the JEM Foundation.
“It’s access and having the industry treat mental health in the same manner as physical health,’’ Denslow said. “If he (Jacob) had gone to the hospital with a cardiac issue, they would not have released him until it was repaired.’’
She recalled her own apprehension when she learned the treatment center was going to discharge Jacob.
Jacob had spent five days in a treatment center in September 2015. He was readmitted in October 2015, only to be discharged another five days later after an insurance company decided his hospitalization was unnecessary.
“I’m worried, I’m not sure he’s ready to come home,’’ Denslow said.
She said Jacob’s follow-up care for treatment of bipolar disorder was inadequate. It included seeing a psychiatrist once and month and waiting months to see a counselor.
Jacob’s state of mind seemed to improve. Only after his death did Denslow learn that it’s easy to misinterpret the actions of a mentally ill person, who may only be signaling that they are comfortable with taking their own life.
Three months after Jacob’s discharge, he was found dead.
If the bill passes, his mother said, “It helps us to know that Jake is still making a positive impact on people’s lives.”
She believes with the proper recognition of warning signs and follow up treatment, that teen suicide is 100 percent preventable.
“It’s about saving lives and saving our kids,’’ Denslow said.
Katey McPherson, a former longtime East Valley educator and a suicide prevention advocate, said the mortality review team will help save lives by identifying the common factors that lead to suicides.
These factors sometimes include emotional problems related to family relationships, breaking up with a boyfriend or girlfriend, getting a bad grade in school, or having easy access to an improperly stored firearm.
“For me, whenever we have data in front of us, we can look at the protective factors, what would have prevented this death,’’ McPherson said.
“When a review team comes out and says, here are some commonalities, now we can attack the problem,’’ she said. “It’s a point of reference to start looking at the root causes.’’
Denslow has recruited some powerful allies, including Gov. Doug Ducey.
She said Ducey’s office suggested the bill seek the $8 million for addressing the mental health needs of students.
The bill is sponsored in the state Senators Kate Brophy-McGee, R-Phoenix;. Sean Bowie, D-Mesa; and J.D Mesnard, R-Chandler, and in the State House by Rep. Jeff Weninger, R-Chandler.
“Insurance companies should be covering mental health, just like they cover an annual physical. And we’re going to make sure they do,’’ Ducey said in the annual State of the State address on Jan. 13.
Natalia Chimbo-Andrade, director of community education and outreach for Community Bridges, a behavioral health agency in Mesa, said that approval of last year’s bill, the Mitch Warnock Act, was critical in prevention.
It requires that as of the 2020-21 school year, all teachers and other school employees who serve kids in sixth through 12th grade receive training within three years on how to recognize the early warning signs of suicide and what to do.
But she said prevention, while laudable, needs to be followed up with safeguards to ensure access to proper treatment.
“This whole bill is a game-changer for Arizona and for those who work in behavioral health,’’ Chimbo-Andrade said.
Chimbo-Andrade said the state funding would allow school districts to contract with behavioral health agencies to treat the mental health needs of students or to provide the services through their own counselors and seek reimbursement.
“It’s the missing piece of the puzzle,’’ she said. “You can scream from the mountain tops about prevention and education, but if you don’t provide the services, it’s all for nothing.’’
Weninger said he supports state oversight to ensure that insurance companies are following the federal parity law.
“It’s creating the ability of mental health coverage to be extended to school campuses,’’ he said. “We are trying to make sure we are all on same page and they are all covered by the same statute.’’
He said his bill in the House mirrors Brophy-McGee’s Senate bill.
“It’s a great bi-partisan bill. I think Kate’s got all but four senators on board,’’ Weninger said. “You are always going to have partisanship, but there’s no room for it on this issue.’’
Denslow, Chimbo-Andrade and McPherson all said that the bill would address a gap between the mental health coverage provided to low income students through the Arizona Health Care Cost Containment System and by private insurance.
Denslow said she receives reports every couple of weeks from frustrated parents who tell her how a child suffering from a mental health illness has been turned down for treatment.
“We definitely hear that, that folks want this coverage. They often find out they are not covered,’’ said Bowie, one of the primary sponsors of the Mitch Warnock Act and also a co-sponsor of the parity bill.
“The mental health parity piece is very important,’’ he said.
Although Bowie and Ducey are members of different parties and clash on other issues, Bowie praised the governor for his support of mental health.
He said there appears to be a consensus that problems with mental health affect everyone.
“We are trying to use our role as a legislature to be helpful’’ in the prevention of suicide and the treatment of mental illness, Bowie said.
Bowie, whose district includes Mesa, is sponsoring three additional bills aimed at addressing mental health. They include authorizing the state Department of Education to set rules for allow students an excused absence for mental health reasons, such as being victimized by bullying.
The others include requiring teaching, counseling and social worker instructional programs to teach suicide awareness and prevention and requiring school district ID cards for students in grades 9-12 to include suicide hotline numbers.