Yesterday I wrote about what a job it is to connect with a therapist. Even if every therapist were available to you and money was no object, it is still a crap shoot and slog to find a therapist that will work for you. You may get lucky and find one on the first attempt, or you may find, several sessions in, that this therapist really isn’t helping.
The easy-peasy advice to folks to seek professional help when they are experiencing mental issues doesn’t take into account this long process of searching.
Here’s another thing, trying to find help when you’re experiencing the problem isn’t the best time to do it. If you’ve never had depression, well then looking while you’re having your first experience is the best you can do. If you have chronic issues, then you probably know you have chronic issues and the best time to look is not when you’re in a full blown melt down.
Here’s the second part of the fallacy of “simply” seek professional help: It may be impossible to find.
Since moving to New England (and before, but we’ll keep it to “recent” history), I have been on a roller coaster ride of unemployment, employment, insurance, no insurance, income, no income, housing and no housing. I knew it was affecting my mental health; I’d quip that I’d be crazy if all of that wasn’t making me crazy.
No money and no insurance in a relatively small town meant I had no options. When I got the theoretically stable job (that eventually laid off the entire department for outsourcing) and I had insurance, I began looking in earnest for that professional help.
This is what I found while looking for a therapist (and by therapist I’m making it easy on myself by meaning everything from a BS to an MD/PhD) :
I needed to use “in network” therapists.
For the humongous medical center that listed 95% of all my available therapists, there was a YEAR long waiting list. Even my general practitioner’s referral of “needs help sooner” made no dent, and she tried, even though their multi-doctor practice had a standing notice not to refer to the humongous medical center for that very reason of no one can get it. It is a well-known problem throughout the community.
That left the other 5% of in network therapists. Let’s see…
The list kept by the insurance company was woefully outdated. When I complained to the insurance company that their list was terribly inaccurate but to which I kept being referred to by the phone CSRs, I was told that it wasn’t the insurance company’s problem. It was up to the doctors to keep updated. Many of the listed therapists were no longer practicing or no longer even in the state.
Of the therapists still around, most were full. If they had openings then it turned out they only dealt with addiction. I wondered if I should become addicted to something so I could get help. At one point I even asked someone that, oddly the person on the other end of the phone didn’t find that amusing. If they had openings and saw clients for something other than addiction (or something else I didn’t have), then they didn’t deal with medications, or they didn’t deal with what I do have, or…
I looked, diligently, for months and months. After hitting the brick wall of in network options, I looked for out of network (and so out of pocket) options. Nothing. I gave up. Then I lost my insurance again.
I wondered at one point in this blog if one option to get myself into the system would be to show up at the ER claiming suicidal ideation. I wasn’t having that at the time but I had in the past and knew it was a possibility and I wanted to prevent it. I stupidly left the comment section on and got some really crappy remarks from people who don’t understand desperation or the so-called system. One useful comment was from someone who apparently figured out that we live in the same area, had had the same problems, and did go to the ER with true suicidal ideation and got nothing but a short hospital stay. There was no follow up and no referral.
I finally did get a prescription for citalopram, but only after an ER scare involving my gut. I started searching for a gastroenterologist for my IBS. I did have insurance then, but still I was hitting a brick wall in finding a GI specialist, too. Eventually I did find a really good doctor for the IBS. Since stress can be a part of IBS, the citalopram was for that treatment. I did tell her that I had stress and depression, and that I had been on citalopram years ago with no adverse effects. That was all true, but I lied through omission. I did not tell her of the possible bipolar 2, nor of the PTSD. Those conditions make prescribing antidepressants more difficult. I did tell my GP about those complications and understandably she refused to prescribe an antidepressant, so I wasn’t about to make the same honesty mistake twice.
Mental health issues have never gotten the political traction they should. They’ve always been second or third class issues compared to physical health. Considering the abysmal shape our healthcare system is in, my experiences listed above should not be a surprise to anyone. Things are not getting better out there. If you think they are then you must also think America is getting Greater Again (and you really should go to see a shrink, because you’re delusional).
Yes, I’m angry.
There are other reasons why “seek professional help” can be a superficial, near nonsensical, bit of advice. As I stated yesterday, I am not anti-therapy nor anti-medication. Sure, go ahead an offer that bit of wisdom, but don’t pretend it is going to be all that useful or even possible.
The recent events that have sent me into a tailspin of actual suicidal ideation are a situational convergence of real life issues: employment and housing. If I could have magically summoned up a qualified therapist, s/he might have been able to help me cope a little better, or sedated me to a near stupor, but they would not have been able to fix those real issues of employment and housing. I had a bit of a miracle in getting new employment so quickly, had I not, I don’t think there is any amount of “therapy” out there that would have convinced me that living out of my car was a viable option. Someone offering the hand-wringing advice for me to seek therapy would have not liked the response they would have received.
(After posting this I went back and saw even more errors than usual in my writing. My apologies to anyone who tried to read this before I tried cleaning it up a bit. I’ve been having some real problems typing and writing coherently lately—something else to worry about.)