But I’m further into this little therapist career I’m building, and I have (like everyone) friends who take advantage of mental health services in our area, and my hospital job has taught me a LOT recently about insurance and getting services and who qualifies for what, and let me tell you something.
It’s super duper annoying and hard to get mental health services even for people who working in mother fucking mental health.
The hard extends two ways. First, it’s super hard to admit that you need any kind of help ever because we’re all about being tough and handling things, right?
But THEN I’m finding that for even the people so brave that they can say help even in the most small feels-like-too-late voice, even with all the funding and insurance in the world, that it is still hard to get help when you need it.
So we have to admit we need help. THEN we have to get some to say yes I’ll help you. THEN we have to figure out a way to pay for it. Yikes.
I had a friend recently who came to the conclusion that he needed some help. There had been a series of … episodes … involving anger and sadness and feeling so alone in the world, and finally it became too much to bear, so he decided to look for help. He has insurance! And is white! And educated! And one therapist came, and another went, and suddenly we were at a point of really needing something more than an hour per week. And so we started looking at outpatient services. You call to say you need help, the operator asks you if you want to kill yourself, NO, and that’s basically the kiss of death, pun not intended.
You see, if you’re going to kill yourself you can go to the ER and get yourself committed and be held in a facility until you don’t say you’re going to kill yourself for enough days in a row. Great! Safety. But for those people that are kind of on the edge – freaking out is happening, but they don’t really want to hurt themselves – you get the most ridiculous run-around in the entire world to be able to talk to someone about the fact that you kind of sort of but not really don’t want to always be alive.
Ridiculous. It’s like how insurance will pay to fill a cavity but not for the sealants to protect teeth against said cavities on most plans. You have to be ready to take your own life for someone to treat you in an efficient manner.
Awesome. Freaking awesome. We have this person who has gone through all of these feelings, feelings that are so hard that they’ve had to say help, and then they have to get a referral from the cruddy general practitioner who’s been prescribing them their psychiatric meds without any real knowledge of psychiatric medication, and that doctor has to fill out forms and fax them to the facility that might actually be able to help, and then said facility has to say YES WE WILL TRY TO HELP, butthenfirst they have to call your insurance to be sure they’ll pay for the services, because there’s no way on God’s green earth that you could afford them without your insurance, and IF insurance says yes and there is space and you can get off work you can go get treatment.
Maybe a few days later. Maybe a week later. Maybe longer.
Remember how this was the scenario in which we aren’t yet ready to kill ourselves but have maybe kind of sort of thought about it?
Sometimes if we aren’t yet ready and then have to wait several days for someone to hurry the fuck up and help us we get ready.
I have not yet found any way around this. The runaround is generally the same whether you need a therapist for 2 hours a month, outpatient treatment a few hours a week, or straight up hospitalization, and everything in between. Insurance and money rule the game, instead of care coming first. I get it – I sure as shit don’t want to work for free, but I also HATE it for the people that are finally feeling brave enough to at least ask for help.
I also have no answer. A huge part of it is education – I’m still learning how to navigate this ridiculous system, and it’s my effing career. I had dinner with a therapist friend the other night and was recounting this sad tale to her, and she looked at me incredulously and said “you know this is how it is!” I know. I KNOW. But that doesn’t meant I have to like it.
So here is what we have to do. If you know someone who might need help and your tendency is to just say “just call and make an appointment!” go fuck yourself, it doesn’t work that way. Emotionally or logistically. You don’t have to do anything, but you can sit there with someone who’s experiencing every hard thing in the entire world all at once and just BE there. No brilliant words or interventions necessary.
And if you’re the one ready for help but it’s taking its sweet-ass time getting to you? Help is coming. Someone will help, and it totally blows that it takes time. The most important thing is that you are being ridiculously brave for even putting yourself out there in that manner, and telling receptionist after receptionist that you’re ready for help and change and growth and KEEP PUSHING, they’ll get to you. Even if it feels hopeless sometimes.
And also someone please run for office and change the system. That would be great.