Life Happens
Sometimes I will have an idea percolating that I am planning to write about and then - life happens.
Life happened today and I found myself pretty frustrated. Travis started a new psychiatric medication a little over three months ago. After a few weeks he had a significant meltdown. Not the regular meltdown that I handle often. This one was well beyond my expertise. I called the psychiatrist because I was worried that this particular medication may not be a good fit.
The psychiatrist said that he started Travis with a low dose. He recommended increasing the dosage.
Here we are a few weeks and increased dose later and Travis had another significant meltdown. He screamed at me that it’s the new medication. And that I’m not listening. I told him that I am listening, I just don’t know how to help him.
I thought briefly about calling 911. Or about taking him to the ER myself. Then I reminded myself what a colossal waste of our time and energy. Been there, done that. Several times.
I’ve written about this before. The ER staff will contact their on-call psychiatrist. Once he finds out that Travis is seeing a psychiatrist, a therapist, and is medicated he tells the staff to release him. That there is nothing else they can do. I once had a nurse tell me that typically they will only do a psychiatric hold once the patient has made a suicide attempt. I asked her, “What if Travis gets it right the first time?”
I refused to sign the release paperwork that time, but they released him anyway. With a print-out of ideas of what to do when you’re feeling down: light a candle, put fresh flowers on your table, take a bubble bath, go for a walk…
Those are great ideas for me to do when I am feeling down. But for an individual with a significant mental illness and suicide ideation?
Travis’s nurse wondered if it was a result of the chemo medication he is on for his elevated red blood cell count. I reminded him that Travis’s last episode of extreme rage was a couple of weeks before the chemo medication, but after the new psychiatric medication.
I emailed the psychiatrist that day but did not hear back. There have been a couple of times in the past that I reached out to him by email with no response. When I do finally get a hold of him, the psychiatrist tells me he never received an email from me. I figured that may have happened again, so I emailed him as a reply to an email he sent me recently. Surely that way he would get it.
When I still didn’t hear back, I left a message at his office. It took me a few minutes of listening to a recording to get to the receptionist. Who then sent my call to a nursing message box. That would be checked in the next 24 hours.
I texted the nurse that fills Travis’s medication box weekly and asked him to have the psychiatrist call me. It worked. Apparently, he has the secret direct line number. Travis has been seeing this psychiatrist for several years and I don’t have a number to leave a message directly for him.
How did the psychiatrist respond? Let’s increase the dosage. Nope, wrong answer.
Sometimes I want to scream at the top of my lungs too.
The doctor asked if Travis was on the State of Colorado Developmental Disability (DD) waiver. Travis is currently on the State of Colorado Supported Living Services (SLS) waiver. He is on the waitlist for the DD waiver. I’m thinking this doctor should know that. One, because Travis has been his patient for around ten years, I think. And because just last week I needed him to sign the paperwork for a live-in aide. Which is not a DD waiver service. I’m actually not assuming too much here. This particular psychiatrist sees several patients receiving state services through the Larimer County Community Center Board, Foothills Gateway. Pre-Covid he actually met with his clients at the Foothills Gateway office.
But I was curious, so I asked. The typical provider for individuals on the DD waiver is a host home. I asked him if he thought there was a host home provider that would put up with a young man with anger issues. What would happen when he punched holes in their walls? Or tore their doors off the hinges.
He said he had clients that did better in host homes because host home providers had boundaries. The host home providers would call the police, and clients didn’t want to get in trouble with the law. He had clients that were angels in host homes and then when they went back to the care of their parents they regressed.
I cannot tell you how tired Tracy and I are of being judged as parents because of the behavior of our mentally ill child. How is it that Corey survived us?
I told the doctor that Tracy and I were good parents and that I felt like he was questioning our parenting. He said he didn’t mean to imply that we were not good parents. But honestly, I think he did mean to. Because I ask questions, take notes, do research. He sees me as a pain in his butt.
We agreed to try a different medication. One that I found while researching this weekend that I was surprised to find Travis had yet to try. We talked again about him receiving my emails. He actually suggested that I was sending them to the wrong email address. Even though it’s been the same all of these years. And I even sent one as a reply to an email he sent.
I suggested he get with his IT department and find out why my emails are being weeded out or sent to spam. I’m thinking a psychiatrist ought to have a wide net of email acceptance, I mean it’s important that patients can reach their doctor.
The psychiatrist emailed me a medication consent form. He mentioned in his email that he found all of my missing emails in his spam folder. Was it really as easy as that? Why not check the spam folder the last time, or the time before, or the time before?
Still working on my frustration level. As I am sure you can tell.
If you’ve been following our story, you know that just a few months ago I took Travis to see a different psychiatrist, one that provides alternative natural mental health care. After a couple of visits, she indicated that Travis should continue to see his current doctor, or to find another psychiatrist that accepts his insurance, Medicaid. She determined that Travis would need pharmaceutical medications and because she didn’t accept Medicaid, she couldn’t prescribe them.
Several months ago, Travis’s primary care physician did put in a referral for a psychiatrist. We are still waiting for an opening.
Years ago the Denver Post did an expose on mental health care in Colorado. It can be found at www.extras.denverpost.com. Per the article, “The mental health care system is in crisis. More than 50 years after states began shuttering mental institutions, the system hasn’t recovered - leaving emergency room, jails and shelters as last-ditch stops to handle the most severe cases.”
At the time of the article, updated in 2016, Colorado ranked near the bottom in per-capita psychiatric treatment beds reported by hospitals, and in the bottom half in per-capita state and federal spending on mental health.
The article also states, “Under Colorado law, if a person is not planning to kill himself or murder someone right now, that person does not fit the legal requirement for treatment. People seeking mental health treatment at the ER are usually sent away with phone numbers of local therapists. Colorado has only 15 psychiatrists per 100,000 people compared with 92 primary-care physicians.”
During my research I found the following website, www.mhanational.org. The website belongs to Mental Health America. They have several different rankings available. This data is more current than the Denver Post article.
States that are ranked 1-10 have lower prevalence of mental illness and higher rates of access to care for adults. States that are ranked 39-51 indicate that adults have higher prevalence of mental illness and lower rates of access to care.
The 7 measures that make up the Adult Ranking include:
Adults with Any Mental Illness (AMI)
Adults with Substance Use Disorder in the Past Year
Adults with Serious Thoughts of Suicide
Adults with AMI who Did Not Receive Treatment
Adults with AMI Reporting Unmet Need
Adults with AMI who are Uninsured
Adults with Cognitive Disability Who Could Not See a Doctor Due to Costs
I was shocked to find Colorado in position 51. Out of 51. Higher prevalence of mental illness and lower rates of access to care.
Colorado ranks 5th in the states for most suicides.
Insurance companies need to pay higher rates of reimbursement if we are going to attract mental health specialists. Including Medicaid.
Today while conducting research a residential facility came up in Colorado, All Points North Lodge, www.apnlodge.com.
Per their website, “Whether you’re looking for trauma therapy, addiction treatment, or mental health work, All Points North Lodge exists to bring healing to dysfunctional behaviors and their root causes. For you or your loved one, there is hope – no matter the past. Our expert team offers custom-curated treatment selected for each individual and customized for their needs and goals. With whole person care, your story matters, and you’re more than a medical chart.
We offer opportunities for physical, emotional, and spiritual health. We focus on families. Our trauma-integrated treatment goes beyond trauma-informed care to tackle addiction, trauma and mental health by addressing the root causes instead of just symptoms. With our custom curated care, your personalized treatment plan is made specifically for you - based on your needs and the therapies that are right for you.”
They also offer personal training and nutritional counseling during your stay.
While I was looking at their website a support agent asked to chat with me, did I have any questions. Ok, I’ll play. So I say, “I am desperate to help my 28-year-old son but after looking at the video I am certain our family cannot afford care here”.
Ashley responded right away, “Does your son have insurance he is looking to apply towards treatment services?”
I type, “He is on Medicaid”.
Six minutes later and I still have not received a response. Have you chatted online with a business before? A certain amount of time goes by and the chat gets disconnected for inactivity.
So I type, “Hello?”
A few more minutes go by. I type, “It appears I lost you at Medicaid”.
Finally Ashley replies, “Sorry for the delay. Unfortunately, we aren’t able to accept Medicaid. I would try findtreatment.gov, they can better assist you at finding treatment to utilize your insurance.”
Just for fun I add, “Can you send me a form that shows your cash pricing? Unfortunately, we have been working on this for years, and have come to the realization that it is extremely difficult for poor people to find good care. In the meantime, I am watching my son’s mental health deteriorate.”
Ashley types, “I understand, I am sorry it’s been difficult for you, I know the system doesn’t make it very easy to find affordable treatment. Our cash price starts at $60k for 30 days of residential treatment. Unfortunately, treatment can get quite costly without the help of private insurance.”
Your story matters - if you can afford it! If ever I win the lottery, I am sending Travis there! In all seriousness, this is a luxury facility in Vail, Colorado. But residential facilities start around the $20k per month rate.
“Life is what happens when you are busy making other plans.” - John Lennon
“You can’t control everything. Sometimes you just need to relax and have faith that things will work out. Let go a little and let life happen.” - Kody Keplinger
“Life happens, chocolate helps.”