Invalidated (again)

Told my doctor about the sui thoughts I've been having, the anxiety, the paranoia, and asked for more help. He was nice, but cool. As I feared my level of risk hasn't changed and because I can keep myself safe, he isn't able to refer me to a pdoc. So I've got to just suck this crisis up and the next and the next, or I can make the gesture and maybe get some help. This is a rock and a hard place, either way my depresion is the only winner here.

Hi, we should not have to get to the place of self-harm in order to be able to get help. It doesn't make sense. We are important and worth having our health needs met. I think it always boils down to money. If it costs too much money to treat people, the system creates huge hurdles to getting help and treatment. I am sort of in the same position right now. Its a downer, to get your hopes up that you'll get treatment and then not get it. Wish I could make it better for you.

Guess it doesn't matter where in the world you are, money is priority over human life!

so if you told him youre thinking of hurting yourself just to get a referral would your level of risk go up? this is ridiculous. I have nevr heard of such a thing. what a crappy doctor...im so sorry......

I don't think he's a crappy doctor, he's as stuck as I am, it is the rules that suck. It costs him to make a referral which he knows will be turned down, so when his budget is limited he may as well spend it on someone who is going to get help. There just aren't services for a single, white, female aged 49, without children, who has a job, who doesn't have addictions, who has never been caught the wrong side of the law (I don't mean I habitually break the law, I just mean that I drive a car and sooner or later there is bound to be some minor infringement). When such a person stays safe through a combination of twisted thinking (I'm already dead so suicide can't save me), not wanting to be a bother to anyone else, apathy and fear of failure, the level of risk can't be measured. So having suicidal thoughts, no matter how graphic isn't enough. He did ask me if I had a plan, my answer was "I have a car, I don't need a plan", wrong answer it seems.

As my primary care doc had to jump through hoops to get my latest anti-depressant which the local NHS bureaucracy says can only be prescribed in secondary care, I do know he's trying. It is just that his best and my best are nowhere near enough to get me through this, the thought of ending up more broken than I am already is humiliating and invalidating.

Sounds like the health system in England is as bad as here in the USA. If you are unemployed, a criminal in the system, or what is termed as extremely poor you can get all kinds of health services free or almost free. If you are very rich you can afford anything. Middle class and the working poor like me are either turned away or asked to pay ridiculous prices for health care. It stinks. Our lives are worth saving, and we deserve proper treatment for mental illness. Best of wishes, at least we can support each other.

Its a damn matter of money or lack of and it is a shame.

That's it exactly? I was in a crisis unit last week and because I have a home ( sec 8)the case workers couldn't really do anything for me. As for therapy and groups, if I didn't have medicare/medicade I would have been able to get in a partial program? As it is I've not the right kind of insurance for anything except seeing a Pdoc once every 3 months.....and that's not working.

If I had money to throw away on a lottery ticket I might, just might hit the jackpot and get the money for treatment.....that's so pathic. Needing to win a lottery to get treatment. That or do something criminal!

O M G

England (again)...............

I didn't realise (or remember? ) that when I read your first post in the thread, but sadly I'm not surprised

No offence intended to anyone.....

Just freaking angry at the ..... . My stuff.

peace
Fuzzy

@sidestepper. I don't know what state you are in but in Michigan I recently qualified for Medicaid under the new ObamaCare expansion of medicare. There is no asset test anymore. You are allowed to have a house and a car and some money. You have to be under 133% of the federal poverty level which I think is about 16,000 for single.

I feel guilty because the insurance is better than most private insurance these days. I know it is better than what my plumbing union is offering now a days. We used to have gold plated insurance in the union but they have cut it back so much.

I'm in Texas, which is in 49nth place for care of mentally Ill and one of the states that refused the Medicaid expansion.

I am surprised Michigan did it, right governor too, he thought it was stupid not to take all that money to help all his citizens.

That is too bad about Texas

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zinco, offhand do you know if they have anything similar in CA like they do in MI? Or what the threshold is to receive med benefits? Thanks!!!

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Rant warning:
Yeah and I forgot to mention that if I lived 10 miles down the road there would be services as it is a different County which is "more deprived" than the "rich" town where I live. My income and assets don't count either way, I could be a millionaire living in the deprived area and get a service for free or I could be working poor in the rich area and get nothing. The reality is I have a decent income after tax, but private healthcare in the UK is all about cosmetic surgery on interest free loans. Anything else that you might really need is hugely expensive, most of the private psych facilities specialise in detox or eating disorders. In my town, there is a private psych hospital full of 80s pop "stars" no-one has ever heard of doing rehab after getting caught for possession of class A substances, a referral there would cost over £400, which is more than my monthly disposable income.
Rant over.

California did choose to adopt the medicaid expansion and the thresholds should be the same. In CA it is called MediCal.

California is 138% percent of poverty which means a family of one has to make less then 16,105.
Do You Qualify?

Looks like you have to apply at this site. This site is also where you sign up for ObamaCare but it should tell you if you qualify for Medi-Cal

Covered California? | Affordable Health Insurance

Hi TheOriginalMe - I can relate to your post and live in the UK.

I got referred to secondary care as I was having sui thoughts and the medication that was tried by my GP just made things worse. I saw someone (not sure of their backgrgound) for an assessment.

She asked about sui thoughts and I told her (included some planning), however as I wasn't specific enough, her advice was to stop seeing my long term therapist, see an NHS counsellor instead (who may be a trainee) and stop thinking so much!!!

Gobsmacked is not the word - so yes it seems as if in the UK, unless you are literally on the edge, significantly psychotic requiring sectioning, or you have short term psychological health problems and can slot into one of the 6 session CBT programmes (may be working with a graduate mental heath worker and not a UKCP / BACP therapist or counsellor), then you aren't important enough.

I guess maybe because the risk to society isn't high enough and you can't then become a political statistic in terms of successful short term treatment.

I agree that the GP hands are tied, but maybe they need to shout louder.

Sorry for the rant - I think the sooner the UK goes fully private, then more people will have equal access to health services - the NHS used to be an excellent service (I used to work in it), but now it is about tick boxes and statistics not about individual patient care.

I am pretty moderate politically. As you probably know in the US 90% of the insurance market has always been private. I had private insurance most of my life and was satisfied with it. In recent years the rates have gone up by 20% a year for quite a few years or some ridicules amount. Year after year higher premiums and lower coverage. I have been forced to be on government insurance now, medicaid, and it is better than any private insurance I have recently had. Private now is pay the first 3000 out of pocket.

So I don't know what the answer is but it is a mess. Mental health is the last on the list it seems.

Is privatization in the works?

Gosh, how can anyone treat their depression and anxiety, without a referral?

So sorry, to OP, for being stuck in a quandary.

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It isn't fair that some folks get everything they need because of their circumstances, but I've found that even being stuck in that middle place - making too much to qualify for some things and not enough to qualify for other things - I've always found a way to get what I need even though I've had to work harder to find it.

Thanks zinco!!! There is so much confusion with Covered CA (Obama Plan) and the integration of Medi-Cal into that program. They have eased up on some requirements, but you are correct on the earnings threshold to qualify. Right now I don't qualify, because of my job. But I may go on a 6 month temp disability in July to work on my depression issues. If I do this, I may qualify for Medi-Cal or at least a lower costing Obama plan. Since, I'll prob lose my job if I go on disability, and Cobra is like 400-500 per month which I cannot afford. I'm hoping being on temp disability qualifies you for Medi-Cal or a least gives you a break on another plan.


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Not sure as CA state disability pays pretty good and I don't know if that would count as income or not. I have been on it before and got the max which was like 900 per week. My pdoc would only ever give me three weeks. Kaiser has this policy of get your *** back to work and you won't be depressed. Never worked to good for me.

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Thank you, I agree about privatisation leveling the playing field. Right now the money is just being wasted in bureaucracy, there are people making policies, writing care pathways, choosing wallpaper, microwaving soup in a cardiology clinic and causing all the equipment to crash, doing anything and everything other than ensuring people get treated. If GPs were totally free to purchase the services from the best provider rather than the local hospital then we would be getting somewhere. I know if waiting lists are too long for physical conditions GPs can use private services, so why not for mental health?

This also struck a chord with me:
In March, I did manage to get a CMHT assessment by a nurse (not a nurse practitioner so not qualified to prescribe or review meds), my doc had requested a pdoc appt to review my meds. The nurse said, if the meds aren't working stop taking them!!!!! Apparently, pdoc's don't see anyone in clinic for a med review, it isn't their job!!!! Whose freaking job is it then, the tooth fairy? I had to fill in a questionnaire to score my mood at the start of the appointment and again at the end, as this marked the start and end of my course of treatment, how exactly was I supposed to get better in 1 hour? I didn't get worse either because at the start I was already at the worst possible level based on the lame questions being asked. It wasn't even a proper depression screening test, it was something cobbled together on the back of a fag packet, by the cleaner probably, this was all about them meeting targets and had nothing to do with getting me the right treatment.

Anyhow, I agreed to play their game and am still waiting for my CBT. The waiting list is a minimum of three months but if during that time, anyone who ticks more boxes than me comes along they get to jump the queue, so it is possible that I'll never reach the top of the waiting list and I think after three months they'll just bump me down to the bottom anyway.

Angry just doesn't begin to express how I feel. I know I'm being my own worst enemy with this, but I just can't let go of the hurt all this caused.

Anyone who wants to rant about the inadequacies of their own system or who has experience of defying the odds and getting the right help, please continue to add your thoughts, all perspectives are welcome, unless you are that freaking nurse who told me I didn't need meds, you'd be hollering for mercy and every drug known to pharma (legal or otherwise) after just one hour in my head.

Hi there.
I couldn't resist replying, and hope I don't upset anyone.
I am in the position of being a user,and child mental health nurse in uk.
Having worked in the NHS for over 20 yrs, I have seen many changes, some good, many bad.
The model which currently dominates in both adult andCamhs, makes box tickers of us all.
As for standing around microwaves, I don't kn ow.
The profit motive underlies the private sector, which cherry picks the so called best providers, but they also need their profit.
So the business model kicks in.
The most cost effective provider is chosen. I.E who does most for less?
Mental health is difficult to quantify, and current interventions, such asIAPT, provide fairly short term help withvariations in quality. I wonder if your Cbt is IAPT.
The trick is to improve outcomes then make your service look good, and who cares about the hereafter for the family/client.
The pressure of competition, which drives private sector businesses, MAKES services into box ticking, seemingly uncaring people.
How can the ruthless profiteering model, be applied to a service which employs highly traine, experienced, and occasionally caring people, who certainly don't help people for the money!
Also, the NHS was meant to be free for all and accessible to those who can't pay, and who has the greatest need for healthcare? Yes children and the elderly.
I understand yout frustrations, but privatising has led to more dissatisfaction not less, eg outsourced cleaning in hospitals, and god forbid they now want to privatise child protection.
Who is going to be accountable when things go wrong?

I'm now off my soapbox.

Hi Spacegeek

I'm not offended by your post and I'm not picking a fight, your opinion is valid, welcome and in essence I agree, but the trouble is the system is broken.

Who was accountable when two people in my town were refused treatment and then went on to kill themsleves? No-one. The coroner quite clearly identified the failure of the system to help them, but nothing changed.

My rant was because I needed a service (I probably still do), I didn't get one despite having paid taxes and NI all my adult life. I would fully endorse a properly run NHS but, just as it is immoral for services to be available only to those who can afford them, it is immoral to take money off hard working people and then refuse them a service. All I want is a fair bite of the cherry. Like I said before if I lived 10 miles down the road, I'd get help.

Hi theoriginal.
Thanks for taking time to reply.
I missed the frustration in your post and only saw thr political.
I get defensive quitr easily,and am incrrasingly drspairinh about the future for kids today,as it seems to be a small number who don't have tostruggle.

I agree with your comment on taxes.
How about we tax the drug companies and this would pay for staff training or more drop ins etc.
I once ssif way back when i started my menyal health nurse training, that friends should let me know ig i brcomr cynical and hard about the issues i work with.
This hasn't happened,but if anything i have gone the othet way,and becomemore sensitive,and despairing of those around me who seem to see themselved as above having mental health problems themselves or their children.

I hope you find a decent therapist, it seems to be the personal style which helps most.