So tomorrow will make it two weeks since I’ve been here. I am scheduled to be discharged. I’m not sure how many times I have told my ‘team’ that I still do not feel safe, they are treating me like I’m a baby. We have check in teams and the nurses say “No, you have to tell them, they can’t let you go if you still feel unstable – we love you, you’re a lovely woman, a pleasure to have as a patient.” It isn’t up to the nurses though. And this the most respected psychiatric facility in the United States.
Sure we have all kinds of health care drama in the US – my position politically is that I am lucky to have employment-based private insurance but that I pay taxes and prefer that those tax dollars help fund the care for those less fortunate. I will pay for their health care. I wish we got to choose how our tax dollars were allocated in this country. There are so many wealthy liberals in this country, no one would go without care ever.
Meantime, I have a highly trained team telling me to “not think black and white” when suicidal impulses come. Clearly you ladies have never experienced even the most basic of traumas. I bet all of your grandparents still run the Boston Marathon too.
Me: It doesn’t work that way. I do not feel safe. I feel no different than I did when I checked into the hospital.
Team: We understand, but we have to push you. We’re here to support you too, but we have to challenge you.
Right, because I’m being fucking lazy. If I wanted to be lazy I would have taken my life already, that’s the easy part. Healing is the hard part. And when Clooney is President, maybe we can work it so that only victims of trauma or people who have personal experience in individual disease/disorder areas be allowed to study and enter these professions. Because most psychiatric clinicians are useless and/or lazy. And this from a fairly educated lunatic who has seen at least 50 practitioners in 30 years.
SO that’s Part 1: STATISTICS BASED CARE: Insurance companies come up with statistics-based figures. Those figures say (roughly) women aged 30 and above tend not to kill themselves after a check in. They say that young women, particularly those of college age, have a higher likelihood of suicide. Ergo, I get kicked out & treated like an asshole for wanting to be safe, the 19 year old who has been here for 6 weeks stays on.
Team: This is a short term unit. Yeah, unless you’re 20.
So what’s Part 2? I’ve actually forgotten, give me a moment…oh right, the HIGH RISK BIT. I’ve mentioned that one. HOW can it be ethical for a practice to refuse to work with patients who are most in need of them??? Seriously, it makes no sense. In my profession, I LOVE difficult, challenging cases. LOVE THEM. Thrive on them even, they make the rest of the mundane work bearable. But turning someone who is suicidal away? Last summer when I left McLean my Team had made 3 appointments with the practice I was with – 1 with my pharma, one with a therapist, and a third for marriage counseling. When I called to find out which was which the receptionist, who I had a fairly good rapport with, went all quiet on me. It took me a few minutes but finally she told me that she had a note saying I was no longer a patient. Ultimately my clinician told me she would have kept me on but the head of the practice doesn’t want his name on the bottle of anyone who kills herself. I have run into that looking for follow up care too. These practitioners are useless – they want easy cases. Plain and simple. It’s fucking unconscionable.
Part 3: WE DON’T TAKE PRIVATE INSURANCE (not to be confused with WE ONLY ACCEPT MEDICAID BECAUSE THE GOVERNMENT WILL PAY WHATEVER AND THE INSURANCE COMPANIES WON’T. QUIT YOUR JOB AND GET ON MEDICAID AND CALL US BACK). This one is not entirely new to me either, but it is every bit as surprising. Apparently Blue Cross Blue Shield puts the breaks on runaway clinician and facility bills (as well they should). So if $200 an hour is all my insurance company is willing to pay, and a highly qualified/skilled clinician wants $400 (fair enough I guess, I’ve worked with attorneys who bill at $600 an hour, and no corporation has the luxury of an insurance company to foot the bill, or do they?), then highly qualified clinician ends up accepting only clients who carry very heavy checkbooks.
I have called lots of places today – trauma services-specific places – and the clinicians “are not set up for Blue Cross Blue Shield.” It’s only the biggest insurer in the Northeast! I don’t know, it’s just not patient friendly. The clinicians win, the insurance companies win because the patient is left with no legitimate services, and the wealthy psych patients win. For me, they roll out the red carpet across the bridge.
I know one of the last ‘Saw’ movies was based on the lack of ethics within the healthcare system. For me, today, it definitely feels like a game designed by Jigsaw.