Dear Jigsaw, Are You Accepting Patients?

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.

Clooney 2016?

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.

Lazy practitioner’s ideal client

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.

Pay up or jump. Make your choice.

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.

His brand of therapy may be more accessible than that “offered” by degreed professionals.



  1. Dorothy says:

    I sat here reading this and then let out the big…*HEAVY SIGH* …nothing changes except the amount of time that the insurance company allows for you to be there. When I was a kid, before the days of HMOs and was kept in Glenside, now called The Arbor in JP (I’m sure you know of it) for 2 1/2 months (!!!! can you imagine??) because I was suicidal and was kicked out finally because the insurance ran out even though I was still suicidal and put on Mellaril. These were the days like in One Flew Over the Cuckoo Nest….but I shouldn’t have been let out!
    It’s as if you have to act like a raving psychopath for them to keep you in and then you run the risk of being sectioned by a judge. They have you over a barrel.
    When I’m done with my time as a caregiver I have a plan that I’m going to put into action regarding the way people with mental health issues are treated by our government and the insurers. Personally, I’m sick of being treated as less than as animal.
    Hang in and write me more if you want, I understand this crap too.
    Hugs, Dot

    • OMG, Arbor is like Cuckoo’s Nest STILL, we put my ex in there a while back. Maybe that’s what I need!!!! Honestly though, I think it’s my team, I don’t think BCBS is calling McLean saying “she has to leave now” – not after two weeks. Maybe next time I’ll slash the shit out of my arms. Then maybe they’ll keep me longer. Whatever. If I die, I die, it’s an eventuality & after talking about it now for 2 straight weeks I could give a shit about it. I have to say, my team is really useless compared with prior teams I’ve had here – it all comes down to age & experience – they are 20 & 30 somethings. I want GREY HAIRED psych professionals, not ones who just finished their “insurance and mental illness” courses at UMass Medical. Assholes. You’re right, you have to be a total raving lunatic to get their attention. I had the worst episode yet just a few days ago, into that cross-over zone, so I know I am as close as I can be to crossing over into no man’s land. And they just say it’s B&W thinking. It’s not even their fault really, but that’s why I really think it would be more useful for psych professionals to have experience in order to practice. You can’t learn this shit in school – you simply CANNOT.

      If your plan involves heavy artillery, count me in.

      Thanks for your support!!!

      Love, j

  2. Wow. I think you’re brilliant.
    (Amy at Writing Thru Complex PTSD)

  3. How are you?

    • OK, transferring to residential program tomorrow or Tuesday. How about you?

      • Good! So they didn’t send you home?? I felt myself kinda dropping yesterday, and today I’m down for the count. Not 100% ready to jump though. There’s been a LOT of crap going down though and I had 3 extra kids here so that probably contributed I’m guessing. Hopefully this low won’t get lower or stay long.
        Will you have wifi at the new place?

      • Sorry, hang in there!!! Yeah, wifi next door too, couldn’t live without it 🙂

        Big hugs & hope some of the black dropped off overnight. Kids will definitely escalate!


      • Hey! Hope you’re moved and doing better!
        Things got a little more complicated. There is SO much going on that I can’t say which is annoying. My #1 trigger (my fucking parents who I no longer give a SHIT if they find and read this) are always doing SOMETHING to fuck with me. My mother keeps posting things on facebook as if we’re all still this happy family. (no contact with them for most of the last year. You wouldn’t believe the things they have said) Today (yesterday) she changed her profile picture to one from about 2-3 yrs ago with my brother and I and all the grand kids. First, I look like SHIT. I weighed like 75 pounds more than I do now. Second, why? Just to piss me off? Then comment and have her friends comment of her family… I want to comment SO badly. I actually saw the picture because there has been a date set for my aunt/cousin’s memorial. June 29th. Which means ALL of my family will be there. I panicked! I HAAAATTTEEE that I let them get to me. I don’t CARE what they think of me anymore. I’m TIRED of crashing every time something like this comes up. I HAVE to go to the funeral, but I don’t know what kind of consequences it will have. Going to jail is one. 🙂 I want to punch a few of my family members who talked shit about my aunt/cousin 2 weeks before she died (she’s my dad’s cousin but more like an aunt) because “she’s been saying she’s been terminal for a few years now. She’s always been dramatic”. I hope they feel like SHIT now. They don’t and I need to just let it go. But it’s so fucking messed UP and I’ve believed all of their comments like that for so long. A lifetime of secrets, coverups and lies. Don’t deal with anything, just push it under a rug and it’ll go away. Or talk shit.
        Wow, I just went off there didn’t I!
        Anyways… Let me know when you get to the new place and if it’s working out any better!! You’ve been feeling like crap for too long. A change will be good.

      • Hey, oh no, family drama is the worst. Sorry! If you’re tired of letting it impact you, can you just “breathe” them out of your system? I have identical reactions to my sister. I would probably go to jail if I ran into her…bunkmates in prison?

        Can you just ask you mother to take down the pic? Weight is a legit issue for a woman. Did she tag you in it? Good lord!

        No, I won’t be transferred until the end of the week, the coordinator was supposed to meet with me yesterday but I didn’t see her, perhaps today.

        Yay, 7 am, I get to collect my cords to plug this machine in before it shuts down.

        I spend way more time on here than I do on FB these days, but if you want to add me:

        I do feel better. I don’t know what to do with the blog now!!!! Probably have a breakdown tomorrow, lol. Or a day after I go home – my spouse is my biggest “oh-god-I’d-rather-be-lifeless-on-a-river-bank”. I’m trying to adjust my attitude before I go home so I don’t launch right back down into death-mode, but I guess it’s about as effective as suggesting you breathe your family out of your system. If we have that kind of mental sway we wouldn’t be where we’re at. Gee. What a fun cycle!

        love, j

      • I was trying to explain to someone how two suicidal people could still find humor in the situation. I guess we’re just sick and twisted, but if you’re not laughing you’re crying (or in my case just doubled over in pain) and I would rather be laughing at JH jokes! I’m pretty sure I’m “unfriending” my mom. Too bad it’s not Jimmy Kimmel’s unfriend marathon. I have to see them at the memorial in a week and a half. I HAVE to go but everyone around me is telling me that it’s a really bad idea. My therapist thought it was fine before, I’ll talk to him on Thursday. Got you on facebook. I’ve never been anonymous like most of the other bloggers so it’s different for me. I’ve always been pretty much an open book!
        I slept an HOUR last night. I fell asleep and then kept waking up which is weird. Usually when I’m asleep I’m asleep. I don’t like the way weird is spelled. It’s a rule breaker. I guess I should love it. Had a complete meltdown today because Mark asked me to call about this bill but when I’m like “this” I can’t fucking think straight. I don’t remember my own birthday half the time. I had to ask about my SS#. Soooooo not me at all. Anyway, we got in a fight about it because I had the whole irrational rage come out and I have NO clue what I said. But he should know by now that that’s the BPD , not me. Nope! I should give him a break. He has short term memory loss from his cancer treatments and has a hard time putting things together. He has to make lists. If he doesn’t, he’ll only remember the first or last thing on a list of 3-5 things. Maybe he should make a to do/not to do list regarding BPD. 🙂

        Ok, here’s an awesome Jack Handey for today. If you’ve gone to any therapy or groups this will fit RIGHT in. 🙂

        “Today I accidentally stepped on a snail on the sidewalk in front of our house. And I thought, I too am like that snail. I build a defensive wall around myself, a “shell” if you will. But my shell isn’t made out of a hard, protective substance. Mine is made out of tin foil and paper bags.” – JH

  4. Jeez. So screwed up. I’m sorry you have to deal with such bullshit when you should only have to focus on getting better. Shame on them.

    And so true about doctors only wanting easy cases. I couldn’t find a single psychiatrist to take my case to the disability board. Not one. Their reason? My case is too complicated. Le sigh

  5. Today I took a walk in the lovely weather (for a change), listening to music and three songs made me think of you. They kind of lift me up when when I listen to them. Each in their own way. So here you go, 3 songs just for you hoping they’ll be of just a little help! Wishing you a great day! Lots of hugs!

  6. Let us dance away the bad things in our life… Just for a while 🙂
    I love Nina…such a wonderful wonderful voice….

  7. This really pushes my buttons and pisses me off!! I’ve had so many stupid healthcare workers over the past 19 years and I began saying, and still say to this day, that whereas I’d never wish this illness on anyone, I think every healthcare worker should have to experience this full-blown for 24 hours just so they could understand it. I’m one of those kids who was taught to smile no matter what — partly out of politeness, partly out of being southern (Texan, actually, which is more important!! HA!!) and mainly because we weren’t supposed to bother anyone with our true feelings or our true pain, etc. (Just wrote a post about being a bother where I got to rant it out.) So I cannot tell you how many idiots would see me smiling and tell me “You’re fine!!” when I’m dying inside!!! I had bloody scabs on my arms from using my blade, yet because I’m being polite and saying, “Hi. How are you?” while smiling, I’m fine???? I wanted to SCREAM!!!! But of course, that would be impolite, be bothersome, and let people know my pain — which would not only bother them but make them run screaming from the room were I to tell the whole truth and nothing but!!! ARRGGGHH!!! Most of the time I’m nice, polite, kind, etc. but inside there’s an incredibly angry person and sometimes she comes out with a vengeance. I’m a follower of Jesus, so this completely upsets what I’m trying to achieve through my faith. Yet what in the Sam Hill am I supposed to do with all this anger? If I hold it in, it messes up my body, mind and emotions something fierce. If I let it out it hurts others. If I had a gun, it’d REALLY hurt others and I’d be in jail/prison!! 😀 I guess that’s why I enjoy it when you let your feelings out — I’ve always wanted to be able to do that. I can do that with my sister on the phone (we live states apart) because she understands and its safe to do it and when I rant and rave and curse, she knows it’s not personal. Afterwards I feel incredibly guilty and have to apologize to her and to God for my hate-filled words. But sometimes I just get so freakin’ mad at how unfair everything is . . . and I also get freakin’ mad at people telling me, “Life’s unfair. Get over it!!” You get over it, you jerk!! I KNOW it’s unfair, but that doesn’t make it right!!!! Geez!! I thank God for my faith that keeps carrying me through each day and each night and I TOTALLY believe Him when He says that He will set the balance scales right one day — because as you and I and so many others know, they are WAY out of balance!!!

    Thanks for letting me rant!! I’m enjoying getting to catch up on your posts!! My OCD makes me have to start at the beginning and work my way through!!

    Take care of yourself, God bless you and yours and to heck with the idiots in the healthcare and especially in the insurance professions!!

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