Okay, so last Friday I talked a bit about how hard it was for me to even get in to talk to a counselor. My appointment was at 1 pm on Friday. I had high hopes for what it was going to be. I was finally in. I was finally going to get the help I need.
It sort of worked out like that.
The first thing that happened was I had to fill out paperwork. That’s why they asked me to get there 15 minutes early. No big deal, and most of the paperwork was just reading and signing the usual forms to give them permission to treat me, permission to share the information with my primary care doctor, their financial policy, etc. Nothing too strenuous.
Then I got taken back. The woman I saw was named Amalia. She took me back to her office. The first thing she said to me was, “We’re here to figure out if you qualify for our services.”
Um, what? I’m bipolar, I suffer from an anxiety disorder, and I’m off my meds. You’re telling me I may not qualify? Apparently yes, that’s what she meant. So after all the crap they put me through, there’s a chance I might have wasted my time.
Thankfully that wasn’t the case. After five minutes of very basic questions about my situation, she decided that yes I did qualify for their services. Then we got into the deeper questions about my life, my diagnosis, my overall mental health, if I was suicidal, had I ever been suicidal, etc. The big questions that they have to ask to get an idea of how to set up your treatment plan.
When we were finished, I expected she’d tell me that she was going to set me up with either herself or another therapist. I was told it could take 2-3 weeks to get me set up with a counselor. I kind of gave her a blank look. She said it was because they had to work out who was going to see me and how to fit me into their schedule. Fair enough. I can understand that. I wasn’t as worried about the counseling – though that is something I do need badly – as I was about the visit to the psychiatrist to get on proper medications to help with my bipolar.
That’s when I got hit with the whammy. “It could take up to a month or more to see the psychiatrist.” I just froze. I’m supposed to go for another month, maybe longer, with out of control mood swings that I’m fighting every day to hide from those around me because it would cause them problems? You know, the problems that made me contact the mental health services for the county I live in in the first place? That was not what I wanted to hear.
I asked her why that was. “We only have one psychiatrist working full time. We have an intern here for three months, but she’s only part time. With how small the towns around here are, we have trouble finding someone with the necessary credentials to do the work.”
Okay, I live in a fairly small town. The town that’s 45 minutes away – where I went for my appointment – is bigger, but is still definitely not a large town. But that’s one psychiatrist for the two cities. I checked. Between the two towns, we have a little over 18,000 in population. That’s both combined. Does this tell you something about where I’m living now?
So I asked if there was anything she could do to get me in sooner. I told her I was relying solely on my anti-seizure meds to keep me stable, which they’re not doing. She told me she’d try her best to get me in sooner, but that she couldn’t promise anything. I accepted that and then went to talk to their finance lady about how I’m going to pay for my appointments. If I can do one thing, I’ll manage to avoid huge co-pays. So I’m trying to do that one thing.
I realize that part of my problem could be solved moving to a bigger city. But the difficulty with that is I can’t afford to move, neither me nor my husband want to leave the farm, and really we’re where we belong and where we’re needed the most. We also live on the coast and I’m not trading that since being here has somewhat improved my mood. I’ve hated living in large cities for a while now. I feel like they’re sucking the soul out of me and my mood tanks more often there.
I also realize my post may come across as me whining. But I think this highlights yet another problem with the lack of viable mental health care in our communities. It’s the small towns and rural areas that suffer the most because they can’t get reliable doctors, social workers, counselors, etc. out to them. Then, in many areas, the nearest city that might have the services someone needs could be a 3-4 hour drive one way. Doing that once a week for counseling isn’t worth the cost of being in the car for that long and the gas. When you’re first starting to get your meds set up, you could be in to see your psychiatrist once a week. That adds another brick to the financial wall that is being built up by this.
There is also a limit to what Medicare, Medicaid, and private pay insurance will cover when it comes to mental health. Services that are needed regularly may only be covered for a short period of time. Or you may have to pay out a huge deductible to your regular doctor before you can even think of getting mental health care. I had to deal with that last one for almost two years. I could never get up to the cost of the deductible unless I ended up in the ER. So I was making payment plans and paying the full appointment cost each time I went. It got so I’d avoid going to them as long as possible just to keep from having to spend almost $200 a visit, which is something I couldn’t really afford. I would go until just before my meds ran out without seeing the psychiatrist. Or I’d ignore the fact that the meds weren’t working until I couldn’t do it anymore. That is not a healthy way to deal with mental illness, but it is a fact that many people face every day.