Today my good friend sent me a picture of an article posted in our nearest big city's newspaper stating that the giant HMO that our insurance provides to us for our health care, is under investigation by our state for either denying care altogether or not providing care in a timely manner to their mentally ill clientele.
They were quoted as saying they offer "brief problem solution-focused individual counseling. Research shows that many of their clients improve after a single visit. In general, we do not begin treatment with individuals whose problems are of such a long-standing nature....such as chronic mental illness, lifelong personality problems, etc. We will refer such individuals to an appropriate non-nameless HMO facility, although this treatment will not be a HMO covered benefit and will not be paid for by HMO."
The state report concludes that these statements are in error because the plan is required to provide coverage for serious mental illnesses under the same terms and conditions as medical conditions. Distributing such material may have discouraged some enrollees from seeking and accessing medically necessary behavioral health services.
Dealing with this facility has often felt *impossible* for ME and I am relatively high functioning. I can't even begin to fathom someone who has anxiety, depression, or God forbid delusional disorders trying to find their way through these services. I often found myself, true to my co-dependent self wondering if I was wrong. Was I expecting too much? Am I asking too much of them? It didn't seem like I was. Our requests seemed reasonable, humane...but *every* thing resulted in long waits, calling a myriad of departments only to be sent to another department. Crucial information like "you are entitled to visits with our staff psychiatrist" or "you are entitled to 60 days of residential treatment" are left out and the whole program being based on failure to finally wind your way around to the department where you really needed to be from the beginning, but by now you have failed numerous times and *IF* you have managed to keep hanging in there, you feel like shit and walk in hanging your head in shame feeling worn out and defeated with an even higher mountain to climb looming in front of you.
After reading this article today, I at least feel validated. I wasn't crazy or over reacting. It is an imperfect system dealing with imperfect and ill people. There are follow-up investigations scheduled thank the Lord. I can hope for change and reading this motivates me to keep walking forward for some sort of change that will benefit my girl and others like her.