[googley]

I have a somewhat complicated situation.
Background: I will be moving to go to a clinical psychology program in another state. I looked at the uni health insurance and student health center. The student insurance only covers up to $500/year for anything related to mental health. (an additional $300 for mental health medication). As compared to $10,000 for any individual physical illness/injury.

I have to decide what to do about my T and pdoc. I will need to find new ones when I move. I have two options. The first option is I can go to the student health center and it appears that treatment would just cost a co-pay for however much I need. However, the student health center is one of the practicum sites for the students in my clinical program. I would feel uncomfortable with them even seeing I have a record there, (even though I am sure they would not read it) which they could come across in their work. There is also the problem that I could need to do my practicum at that location. My dad says that I should just suck it up and go to the student health center because it would be against the law for any other students to read my file. But I feel like it could be very awkward to run into other students in the clinic.

My other option would be to do cobra for 18 mos and try to finish the program in that time as the insuarnce I have now through work is pretty good. But that would be a lot of cost.

I know that stopping seeing a T and pdoc is not an option for me right now. I want to be able to keep my mental health treatment seperate from my school work.

I was wondering if anyone had any opinions on the two options. Am I being overly sensitive to the thought of my fellow students knowing I'm in treatment? Right now I work in a psych department at a large hospital and it seems like there is a current of stigma that is rampent. I really don't want to have to run into that with my training.

I guess what is making this worse is that I really just want to take my T and Pdoc, put them in my luggage as if I were going on vacation and take them with me so I don't have to change who I'm seeing.
Any advice on this long rambling post would be much appriciated.

[sunrise]

googley, it it were me, I would not go want to go for treatment to the site that my grad program used for practicums. I would want to keep my own mental health care separate from my professional program. I would worry about conflicts of interest, dual roles, etc. Like maybe you would get one of your fellow students assigned to you as your therapist or something like that. It might be worth a call to the director of the student health center (not the director of your grad program) explaining your concerns. Maybe he/she would have advice or say, yes, they've had students in a similar situation and we came up with this solution that worked.... For example, maybe you could go to a community health clinic for low cost therapy (because your insurance covers very little and your income is apt to be low since you are a fulltime student).

The $300 for mental health medication--is that for the cost of the prescriptions? Or does it include also the cost of seeing a pdoc for prescribing? One way to save on the cost of a prescriber is to see a GP for your prescriptions. They are less expensive than a pdoc, and if you already have your meds established and they are working, then the GP could just follow suit, and consult with your former pdoc if need be. If you feel a GP cannot handle your meds, another less expensive alternative is a Psychiatric Nurse Practitioner. I see a PNP right now for meds and am very satisfied. She has much more training in this area than my GP (who made an attempt at prescribing for me but didn't do very well). My PNP costs about as much as a therapist per visit rather than a pdoc's fees. And if I go to her for the 20 minute appointment, it is even less expensive. I think for the 20 minute appointment, the cost is only $70; for an hour, the charge is closer to $130-$150--I can't remember.

An even more economical idea is to go to the PNP for both meds and therapy--then you can kill 2 birds with one stone. My PNP is a licensed mental health therapist so can give therapy if her clients need it. Some PNPs are trained therapists and some are not--so this is a question to ask before beginning with a practitioner.

So I think you have other options besides student health center and COBRA--the community health clinic, paying out of pocket for a less expensive practitioner such as a PNP, etc. I am facing losing my job soon and I looked into COBRA. It is $425/month to cover just myself. You could keep that $425 in hand instead of paying it to COBRA, and sign up for what is presumably a low-cost student health plan to cover your basic medical needs, and you could afford a few sessions of therapy a month with a non-health center therapist with the money saved from not doing COBRA.

Good luck.

[googley]

Is the $300 for mental health medication--is that for the cost of the prescriptions?

This is just for the cost of prescriptions seeing the pdoc would fall under the $500 limit. I would definitely go to see a gp at the clinic for my meds. Though the 300 for psych meds wouldn't cover more than two months.

Thanks for your advice.

[sunrise]

Hi googley, I thought of something else that might help offset the cost of meds. Some pharma companies provide their medications at a low cost to those in low income groups. Maybe you would qualify. You can find info at the NAMI website:
http://nami.org/Content/ContentGroup...e_Programs.htm

[chaotic13]

Googley,

If I were in your position, I also would not want school and personal care to overlap. Let's face it, the law may technically protect you, but...people don't always follow the rules. Your instructors are human and as much as they may try to remain completely objective in assessing student performance,their personal opinions, biases, and subjectivity affect these assessments.I would want to be in control of what information they have about me.

Do you really have to get a new pdoc? How often do you need to have follow-ups? Could you just keep your pdoc and have him/her Rx your meds to a local pharmacy. Maybe schedule your follow-up appointment during school breaks. If you require more direct MD type care, could you just work through the University's on-campus health center. At my University the health center and counseling center operate separately. Our health center is set up to provide local services for out of state students who can't be followed by their hometown MDs. Could you use an online pharmacy to have your medications filled and shipped to your school address?

The for your T services, could you do the Cobra option or find a local T that uses a sliding scale? Or maybe make arrangements with your current T to do phone sessions and maybe face-to-face sessions on breaks or a few weekends?

[Kiya]

yep - i agree about keeping care and learning separate! that could get really weird really fast... and might be detrimental to your career. best!

[googley]

Thanks everyone.
The using the mental health center at school was my dad's idea. I was totally against it but needed to make sure I wasn't just being overly sensitive. Thanks for backing me up.

Chaotic-
As for keeping my current pdoc i don't think that would work because I don't think he would be comfortable seeing me every couple of months (right now I see him every month.) While I am moving from "home" it is not where I grew up so there is no long term connection for me to return to if I were trying to see my pdoc over breaks. He definitely spoke of making sure I had continuing care wherever I went to grad school, so I don't know if that would work.

I would love to keep my T and do phone sessions forever, however, they don't really work well for me. I take a lot of time to think about my answers and what I am going to say. When we have had to talk on the phone because I have been in a crisis it makes it hard because she is always wondering if the connection has been lost.

Sunrise- thanks for the idea about the pharma companies programs. I have actually looked at them before. The only problem this time is that I would still have support for my medications (just not my psych ones). I will check, but I think you have to have no support for any medications.

I know that for undergrad my health insuarnce was bad, I just didn't realize that it would be so extremely bad for graduate school. I guess I just thought that for some reason it would have to be better because it just would.

Thanks for all the ideas. I will try and see if I can find low cost clinics in the area etc.

[phoenix7]

I would keep the two seperate - you have had some great advice here - I just wanted to wish you luck!