I have Medicaid insurance, and I have found it to be very difficult to obtain good health care. Most doctors don’t take the insurance, and the ones that do have very long wait times. The insurance company has a search utility on their website to find doctors who accept their insurance. It can be quite difficult to find medical care, but it’s even more difficult to find mental health care.
When I was looking for a mental health provider, I checked the insurance company’s web search utility. I called the first 20 providers listed. Most said they didn’t actually take the insurance. Some were out of business or the phone was disconnected. There were a couple who accepted the insurance, but they had a 1 year wait list. I called the insurance company and asked them for help. They picked up on the list where I left off and had to hit somewhere between listing #25-30. They got me an appointment only about a month away at a clinic about 20 minutes away.
My appointment was with a nurse practitioner. She opened a questionnaire on her computer and started asking me basic questions. These were the usual depression and anxiety inventory questionnaires you get when you go to a psychiatrist, but they usually have you fill them out before your visit with the doctor. This nurse practitioner used it to diagnose me. I was skeptical because of that approach.
I saw my primary doctor about 2 weeks prior and she gave me a prescription for Prozac. She thought it would be a good idea to get me started on something, anything, until I could get in to see a proper psychiatrist. I thought it was a good idea as well since it takes several weeks for anti-depressants to take effect.
I complained of symptoms of psychosis to the nurse practitioner. She gave me an anti-psychotic, but insisted I stay on Prozac. When I picked up the prescription from the pharmacy, the pharmacist was kind enough to warn me not to take those medications together as they cause a dangerous interaction. I told the NP that the next time I saw her. It was news to her, so she wrote it down. Thankfully the next patient won’t have to worry about the same interaction, but it’s something every mental healthcare provider should know. It’s not the patient’s job to educate the provider.
They ended up closing that clinic location at some point, but they had another location about 50 minutes away from home. I went for another visit, but I couldn’t make that long trek anymore, so I’m left without a provider now.
The best part of my experience happened on this last visit. I was describing the symptoms of psychosis I was experiencing to the NP, and she asked if anyone had died in my home previously. She said, “I ask because sometimes ghosts of the dead can hang around and cause these kinds of issues.” My jaw hit the floor as I held back the laughter. I wrote down in my notebook, “psychosis caused by ghosts?! WTF?!”
It is so very dangerous for a mental healthcare provider to enable a psychosis patient’s delusions or propensity for delusions. This is akin to giving drugs to someone who is addicted to drugs. Maybe just a different kind of drug. It’s also unintelligent and a cop out. Rather than help deal with a symptom or an issue, it is just chalked up to something supernatural.
Mental health is such an important part of your overall health. Mental healthcare access is terrible in the U.S. even with real insurance, but with Medicaid, it’s all but non-existent. If there is no true health without mental health, then by extension, there is no healthcare without mental healthcare. Disabled people are really on their own throughout their journey through their disabled lives. We can’t expect to be helped by the people who are supposed to help us, and we certainly can’t expect the completely broken public support systems to function and help those who need it. I can tell you it is terrifying facing these things on your own, knowing there is no help in sight. Those who make it through are my heroes and are easily the strongest people on the planet.