ObamaCare: Is it really caring for the mentally ill and those in poverty ?

Ironically, the abused are often the ones who are blamed for their abuse and the aftermath that follows by humankind as well as by professions.  By friends, family, coworkers, as well as strangers. By businesses and management.  Victims are continually re-traumatized. The homeless, jobless, imprisoned… are the ones who are pointed at and mocked for things that begun – and may still reside – completely outside of their control.

I’m a victim. I know.  I am also an RN and have worked in the industry.  It’s incredibly angering and extremely frustrating for all involved – those working with the insurance companies, within all levels of social services (from the front desk to the practitioners), and those receiving services. Most everyone’s hands are tied. Most everyone in the process is frustrated. Meanwhile society – and those learning the system – believe that there is help, that there are solutions, that there is something being done.  I beg to agree in yet also loudly differ.

The article within the series The Cost of Not Caring shares: “You can only get care at the very end stage of your illness. The way we pay for treatment of addiction and mental illness, you would be waiting until you have Stage IV cancer before you begin chemotherapy. But that is often how we reimburse for mental health and addiction treatment….”  This is so very, very true.

And then the article writes:  “By the time she was 16, she was addicted to crystal methamphetamine, and homeless. “My depression and anxiety were so extreme, and I had no idea that’s what it was,” says Puckett, 34, a certified peer support specialist in Houston. “And nobody was talking about mental health in the mid-’90s. Every single therapist I went to, the question of a mental health diagnosis never came up. I was always treated as if there was something missing with my character. I was a bad kid or rebellious.”

I’ve witnessed a minimum of three mental health hospitals as being nightmarishly scary and have heard of more from other locations I will never visit.  Mental health hospitals can easily become prisons in and of itself.  And, while they try to help, they often won’t or can’t.  People recycle in and out as “frequent flyers,” there aren’t enough beds for the demands, the workers (management down) often don’t know what the hell they’re doing and inadvertently perpetuate the cycle of violence.

Speaking of prisons, the article shares that 90% of incarcerated women are victims of abuse.  That means 90% of the population of women in the prison system could have had the opportunity to not be in there should they have gotten the help they needed when they needed it.  That means many who are in there do not deserve to be there.  They are there because there was no one willing to help them some way, some how, in the way they needed it when they needed it.

This means that there are people who are stuck in the system of mental health, poverty, and those within healthcare and prison systems who do not deserve – nor do they need – to be there.  There are people in the streets, who are homeless, who can work and are ready and willing to work, but can’t because they don’t have their needs met in the way that is needed for them to become functional.  They either can’t work or hold down a job because their medical and/or mental health needs are not being met.  Sometimes this is by choice, and sometimes it just plain isn’t.

Sometimes all they need is the right combination of medical care and social services.  But, there is not enough money, time, resources, interest, and the set-up is so messed up that the whole process becomes a cyclical problem.  Spiritual sources of help are most typically the most un-helpful and non-helpful methods of helping for a myriad of reasons.  There are so many sources, solutions, and ways about going about things that the filtering and information-gathering know-how is lost, overwhelmed, and just not there.

Let me tell you straight up. This ObamaCare system that is in place is not helping. How our medical system is run via medical insurance companies is literally killing us as humans as well as a nation. The best social services that are in place are still unable to help in the ways people desperately need.  The worse off a person is, the least likely it is that they are able to get back on their feet.  Especially with how we help each other via our thought processes, actions, non-actions, and resources.

Ironically, the ones who can help, choose not to. What are you going to do to help and stop the cycle hindering help for the victims? Please, I beg you, help in some way, shape or form. Even if it just means opening your mind to the concept: The abuse, their current state of wellbeing, their diagnosis of mental illness, their status as homeless and/or joblessness just might not be their fault after-all.

If you have a coworker who appears to be suffering from blatant or subtle mental health issues, please help them out.  Either listen, guide them to resources that will help, and give them opportunities that will meet their needs to maintain or retrieve their sanity — even if it means an extra 5 minute bathroom break or a 30 minute extension for lunch from time to time.  Work with each other.  There is a time where you are going to need a favor.  By helping someone gain or re-gain their sanity, you are literally saving a life on many, many levels.

Better yet, pay for someone’s medical bills so that they truly can get the help they need. Good therapists and psychiatrists charge for their services. You can’t get services without the right insurance unless you pay out of pocket. An excellent psychiatrist in the area will only take out-of-pocket or out-of-network insurance options.  Each visit is somewhere between $200-300.  It’ll take a minimum of 2 or 3 back-to-back sessions to start the process of understanding which diagnosis might be going on then to figure out a med to try.  From here, weekly to bi-weekly visits will ensue, tapering off to monthly or bi-monthly visits, then from there it’s best handled through maintaining what is referred to as “maintenance visits.”  If you have a doctor who knows what he or she is doing, the success rate is much higher and at a much quicker rate as he’ll likely know what meds to try first.

But, meds are not the only solution.  It’s a huge step in the right direction, but not the end-all, be-all.  The brain houses the functioning ability of all of who we are as a human: spiritual, physical, social, emotional, and mental functioning all happens as the result of how that structure functions and how well it functions.

Finding the right mental health therapist (psychologist or social worker) is a tricky one.  You have personality differences, biases, opinions, and experiences that are unique to each therapist.  You have different modalities of treatment and each therapist takes a unique approach.  There are times for novices and there are times for experts.  There are times to ignore hick-ups and there are times to find someone who truly is a good match.

Even some psychiatrists and mental health workers despise concepts surrounding mental health as well as the concept of being a mental health client.  Some despise alcoholics, some believe the victim “asked for it,” some believe the patient “is crazy” and thus subhuman.  I was shocked when I learned this, but it’s true.  I heard it from their lips and watched their actions behind closed doors.  It’s hard-pressed to get good help with that sort of mentality going on.  I highly value excellent therapists and providers.  I am more than willing to give you a list of my favorites (smile).

Victims often have a difficult time being able to afford what they need. Doctors who know what they are doing don’t take ObamaCare options – or at least Coordinated Care. Coordinated Care options and social services utilizing this method of payment inadevertently help you become stuck, stay stuck, or get re-stuck. The more complicated a case is, the least likely the professional within those systems knows what is needed to rectify it.  Or, if it’s rectified, the person gets a job and loses the ability to receive follow-up, continued services due to a myriad of reasons.  And so the person stays stuck or gets re-stuck.  It’s a whole process of damned if you do, damned if you don’t.

I’m praying that we are going in the right direction, but the whole experience of desperately needing help and not being able to get it is fucked-up and wrong both from the patient’s perspective as well as the service provider.

In the spirit of giving, please consider opening your mind, concept, and understanding toward the dynamics of what all is involved in mental illness, poverty, and abuse.

What you see is not what you get.

You truly cannot get the care that is desperately needed from those who desperately need it solely through ObamaCare.  It’s a good start, but it’s definitely not an answer to the problem.  If you don’t get the help when you need it, how you need it, that is where you’ll land – unless you are supremely lucky – again, no fault of your own.

So, please, if you’re a victim, get the help you need when you need it how you need it before you desperately need it.  If you’re a friend or family member of a victim, please help that person get the help they desperately need.  They might be able to articulate it, they might not.  They might refuse.  But, please try.  And if you try, take the perspective of the victim not the abuser.  Do not perpetuate the cycle of violence in your attempt to help, not help, or deny helping.


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