[CaliforniaPlaya]

Wow, great forum here! I think I posted this in the right place, but if a mod feels it would be better suited somewhere else, please move it.

I'm trying to get help for a good friend (yes, its really for a friend) who is having a very difficult time in her already difficult life. We are running into difficulty finding her a hospital/program that will take her because the only insurance she has is California state's Medi-Cal.

Shes been diagnosed with PTSD, conversion disorder, depression, anxiety. Also possibly opiate addiction to prescription drugs to treat diagnosed medical conditions. The addiction is questionable, she does and always has had a high tolerance to prescription pain meds. Even from the first time she took them as a child, it took many more and higher doses than it does for most people. As she has gotten older and her medical problems and need for pain meds has increased, so has her tolerance. She was addicted to pain meds a couple of years ago and did go through medical detox using Subutex. She doesn't currently have the withdrawal symptoms she had in the past if she doesn't take meds. But with all the pain she is in, she does take a lot of meds.

Where she is now - She has medical conditions that cause her a lot of pain and frequent trips to the ED for pain meds and pain control. She is on a waiting list for a primary care physician, but isn't able to get one right away because not many doctors want to take Medi-cal. Because she is in-and-out of ED so much, usually sees different doctors, gets different prescriptions, it is becoming more difficult for her to get help because the doctors want to jump to the conclusion that she is just a drug seeker. Because of the medical conditions, she is unable to hold down a job, so she has no income. This has forced her to move back in with her mentally and on a couple of occasions, physically abusive mother. Her ex-husband/baby's father and his lifestyle and the way he raises their daughter (they have joint custody) is a big source of stress for her. He is also mentally and verbally abusive and was physically abusive when they were together. She does have a psychiatrist and therapist she is working with.

Because of everything going on and some things that were said about how the child is being treated while with the father, yesterday her therapist decided to open up a case with child protective services and have both parents investigated. My friend sees this as trying to have her child taken away from her (realistically her child is one of her few reasons for wanting to live and is possibly the reason she is still alive). This, combined with a major fight with her mom for the past several days, her mom threatening to kick her out of the house, and everything else going on in her life blew things up majorly yesterday and I had to go and get her. We had a long talk, lots of tears and hugs, and has accepted that she needs help and wants to be hospitalized and have her psych meds adjusted...that is where we are stuck.

She says she has thoughts about wishing she wasn't alive, but has no plans at this time to attempt suicide (she has in the past) or hurt anyone else, so she isn't an immediate danger and can't be forced to get help. She doesn't think she needs to detox, but is willing to go as part of an overall psychiactric program, but the only one we're able to find with her insurance only does it cold turkey and she isn't willing to do that. Her psychiatrist and therapist are also trying to find her a hospital that will take her, but even with a referral from them, they can't find anything in the area because (1) she is not an immediate risk and (2) she has Medi-Cal insurance and no money and can't afford to pay for anything out-of-pocket.

We are kind of limited to what is available in her county because she is on state insurance and it is administered by the county. The county she is in kind of lacks on availability of services for people in her situation. Its been difficult getting her to admit she needs and wants help to try and get her life under control. Now that she has, it is very frustrating to not be able to find her help.

Anyone know of any resources to try and get her help? She is in Santa Clara County, but realistically we'll consider anywhere in the Bay Area and possibly the state if it is able to help her. Any other advice on how to proceed would be greatly appreciated.

Thank You!!!

[CaliforniaPlaya]

Guess I should throw in that she was hospitalized a year ago for two weeks after two suicide attempts. The hospital that she was in did help a lot and she did like it. They were able to get her overall situation under control with her mental stability and the meds she needs and everything else. They're several counties and over 100 miles away. She was only able to get in there through the referral of emergency protective services in her county and only because it was the first bed they could find. She is trying to get in there again for help this time, but they will not take her without a referral from her county because of the insurance. She doesn't want to go through EPS because it is a very long messy procedure along with the worst of the worst in the county. She could end up anywhere and it could make the situation worse.

[mightaswelllive]

Have you looked into Langley Porter at UCSF? It is primarily an inpatient emergency facility but they are known for their med management and I'm pretty sure they have a PHP program. I'm pretty sure to get into their programs you need to be 5150 or referred but sounds like she has someone to refer her? I'm pretty sure medi-cal is accepted but otherwise, I know they have financial assistance and I can give you a little more info if you want to PM me (though what I know is very limited, more of a lead than a solution).

[Gus1234U]

dear Playa,, you might try a search for the nearest Independent Living Center.. they are a great resource for people with disabilities of all kinds,,, and are free and even able to do home visits, in most cases, if that's needed. they are a federally mandated program to help people with disabilities to access supports and services needed to help them remain living in the community. best wishes to your friend, she's fortunate to have a friend like you. Gus

[ErinBear]

Hi - That would have been my suggestion also - Langley Porter at UCSF. It's a long distance from you, but they would take Medi-Cal, have very good experts on staff, and they also have an excellent pain management center at UCSF, with world-class pain treatment experts. Possibly she could get treatment for both issues (?).

I'm sorry your friend is going through so much - I hope she can find a place that can provide better treatment and support.

Take care,
ErinBear

[googley]

You might want to contact NAMI: www.nami.org They should have information on where you can get help for your friend.

[CaliforniaPlaya]

Thank you all for your responses. I will follow up on these suggestions. Being from San Francisco myself, UCSF was one of the places I looked into. Didn't go far enough into it to find Langley Porter, so thanks for that. Also will see if there is anything at NAMI that can help.

Don't want to jump to conclusions before I make any contacts. But what I've been finding is that with Medi-Cal, no place will take her on a voluntary admit and everything has to go through her 'home' county of Santa Clara. It has to be a referral through EPS, and that would only come with a 5150. She isn't there now. She was a year ago, 5150 after the suicide attempt. Was taken to St. Helena for a couple of days, released, and then within a day another suicide attempt, another 5150, back to St. Helena and they turned it into a 5250 and she was there for 20 days.

We talked about it today. She says that suicide isn't something that's on her mind. But at the same time, she isn't totally comfortable being by herself at this time (she is staying with me for a while), because sometimes when she is alone and she starts thinking too much, things get to her, and that is when she starts thinking about suicide. But still says she wants and needs help - and that's whats frustrating, someone reaching out for help, and because the need isn't immediate (yet), we're not able to find it, at least not yet. I think we can get a referral from her therapist or Psychiatrist if that is all UCSF needs, but all I've talked to so far need more, it needs to be from EPS.

Thanks again, I'll post back with my findings!

[CaliforniaPlaya]

Did contact Langley Porter. I'm going to give them a try again Monday morning, but right now I'm getting the same answers I've gotten most other places: (1) They are currently full, (2) they can't take Medi-Cal patients on a voluntary admit, it needs to be on a 5150, or possibly a referral from a Psych, depending on the circumstances.

But my friend does also have some diagnosed medical conditions (endometriosis and chronic ovarian cysts) and a yet undiagnosed medical condition that causes involuntary muscle spasms. This has her in and out of ED a lot, sometimes several times a week. I'm there with her most of these times. I think next time we need to go, I'll take her up to UCSF. Its a bit of a drive for us, but I keep getting mentions to them from different people. When I lived in the City, I saw a few doctors there and know they are good. Maybe this way I can begin to get her into their 'system'. If it helps, it will definitely be worth it. Right now, shes at the point that shes willing to try almost anything if it helps.

Thanks again!