There are times I want to scream.
I have a history of depression and suicidal ideation. This isn’t particularly special or unique – almost 7% of all adults in the US have a major depression episode in any given year and suicide is the tenth leading cause of death in the US (and that’s people who actually succeed).
I’ve publicly talked about how people treat suicide as a weakeness or joke, my first experience with someone attempting suicide, my (brief) stay in a psych ward after a suicidal gesture, and how you can’t talk about it if you’re feeling suicidal.
And in this, I am only exceptional in that I write about it.
But mental healthcare is not only difficult to get, but insurance companies are making it harder.
In a recent study, researchers called 360 psychiatrists on Blue Cross Blue Shield’s in-network provider lists in Houston, Chicago, and Boston. Some of the phone numbers on the list were for McDonald’s locations, others were for jewelry stores. When the researchers actually reached psychiatrists’ offices, many of the doctors didn’t take Blue Cross Blue Shield insurance or weren’t taking new patients. After calling every number twice, the researchers were unable to make appointments with 74% of providers on the list. In a similar study among pediatric psychiatrists, researchers were unable to make appointments with 83% of the providers listed as in-network by Blue Cross Blue Shield.https://www.statnews.com/2019/06/17/ghost-networks-psychiatrists-hinder-patient-care/
But that’s not all.
Because most people in the United States get healthcare from their employer – which means that (overwhelmingly) they work during the same hours the mental health provider is available. As someone who has searched for mental health care providers who have after hours care, well… good luck with that, let me tell you. The last time I looked, I was only able to find a provider who was … well, let’s just say that he was more used to dealing with athletes with issues than with someone like me.
But wait, there’s more!
What about telemedicine? The idea that networks like BetterHelp can help you find therapists is particularly compelling, and it seems like a great idea. See a therapist from the comfort of your home, on your schedule? Hell to the yeah!
Unless you’ve got a problem that’s “too serious” – or a history of issues in the past – like me. Because this is what Betterhealth sent me after I applied:
We understand it takes a tremendous amount of courage to reach out and ask for help. Unfortunately, based on the answers given when you signed up, we determined that online counseling with BetterHelp may not be the best option for you. Online counseling is still new and is not the most effective form of therapy for everybody. However, you deserve to get the best help possible, and seeking for help is certainly a step in the right direction. We recommend considering traditional face-to-face therapy and you can find many available therapists in your area here https://therapists.psychologytoday.com . If you are in a crisis, or if you need immediate help, please look at these resources https://www.betterhelp.com/gethelpnowEmail from BetterHelp, 7 Aug 2018
Let me tell you, I felt like crap after that e-mail.
Still, it seems like telemedicine might be the way that we actually get mental healthcare for folks (though whether it’s covered by your insurance is a totally different question).
Which brings into question the limitations of internet access to lower-income individuals, and how that is de facto limiting their access to healthcare as well.
Side note: Betterhealth reached out to me with an email back in April, asking if I’d link to one of their pages – and if so, they’d pay me money. Fair dinkum, I was going to link to the page above anyway (while telling my own story about their service), so there’s that. Figure I might as well get a bit of scratch out of what I was going to do anyway, unless they figure I’m not worth it. Eh, wev. Also, they had a EULA at the end of their e-mail, to which I point them at https://ideatrash.net/anti-eula