The Mental Health "System"

I am planning to see a psychiatrist to talk to them about my bipolar disorder. I tried to do this once before, in August of 2008, but gave up without managing to actually make an appointment. It's three and a half years later and I'm trying again in a different state.

Here is my experience this time. I started by going to see my regular doctor to get a referral, while I was there I thought I would also get a physical. What happened was that I got an extensive physical, right down to full blood work and an EKG of my heart. The doctor said I didn't need a referral to see a psychiatrist and that I should call the mental health number on the back of my insurance card. The only question he asked was whether I was very depressed at that time, basically whether I was a danger to myself at that precise time, and when I answered that I wasn't he went on with his tests. His reaction was essentially that I shouldn't be bothering him with something that wasn't in his area of responsibility.

To give you an idea of how irresponsible this is I would like to give you some statistics about bipolar disorder. 2.6% of the population (nearly 6 million in the US) have been diagnosed with bipolar disorder, although the actual numbers may be higher because many are not diagnosed (perhaps half are diagnosed). Of those diagnosed 60% attempt suicide and 20% die as a result, that's a mortality rate of 1 in 5 which is higher than that for diabetes (10-15%). A million Americans are going to die from this disease and those with bipolar disorder don't do cries for help, the rate of "success" in suicide for bipolar is about four times higher than for the general population.

However, I am not suicidal, when I started the process I was actually feeling fine. I called up the number for mental health on the back of my insurance card. After pressing button 1 for English, button 3 for finding a doctor, and so on for some time I reached a real live human. They informed me that I could go to a web site and look for doctors, and they told me not to interrupt them while they were giving me information (which I did not need).

I went to the website where I was able to search for providers near me in the area of "Behavioral Health" because clearly what I have is a problem with my behavior rather than a crushing mental illness with which I have coped heroically for twenty years. After searching through a list of 150 providers in the area I was able to narrow down the search to three psychiatrists working in mood disorders. I was able to do this because I know the difference between counselors, clinical psychologists and psychiatrists and know that only psychiatrists can prescribe medication, and also I know that I have a mood disorder rather than an anxiety disorder, or some other problem. I know the difference only because I have experience in the field of social work, if I had been a plumber I would simply have had to guess as to what I needed.

I called the closest person on the list, didn't get a human being, pressed #1 for ...(you get the picture) and left a voice mail which informed me I would get a return call within 48 hours. 36 hours later I was informed that the next available opening was nearly two months away (even though they are "accepting new patients." I said I would try elsewhere. I called the second number, hit #1 for ..., #229 for ..., #3 for... and got a human! I was very excited by this until it turned out that the number was for an inpatient mental hospital at which the psychiatrist worked and the receptionist had no idea how to hook me up with the psychiatrist for other practice, didn't even try, and didn't offer to take a message. I called the third number, hit #1...etc. through three stages and then left a message. It's been three hours now since my message without a return call.

It's almost a certainty that I am going to give up again. I am depressed now, with very dark thoughts going through my head and a strong urge to cry. Grocery shopping was quite hard yesterday and dealing with the plumber is no joke. Two weeks ago I had surging emotions of indescribable beauty. Circumstances seem to have conspired in such a way that the money we would need in order to move out of Texas has been taken away simply so that we can maintain our position, so prospects for the foreseeable future are more of the same.

I think it's important to remember through all of this that I am enormously more qualified to deal with this sort of stuff than most people with a mental illness. I have a degree in psychology. I am much more intelligent than the average person. I am no where near as sick as many people. I am not delusional. I have someone who loves, understands, and supports me. I have many years of experience in dealing with medical and social work systems. Each time I hear a recorded message I despair at what this must be like for someone who really needs help now. This is literally killing people. It's killing them in the worst way possible by demonstrating beyond a shadow of a doubt that even the people who are supposed to care for those who feel alone, abandoned, hated, held in contempt, crushed under a great weight of impersonal misery, don't care if they live or die.

"If you wish to live, press #1 now. For caring, press extension #229. Have you looked for concern from us before? Press #3 now. If this is your first attempt to find help for something that has devastated your life for press #7. We are sorry, we haven't bothered to have a human answer the telephone, leave a complete, lucid, and detailed message and if we find the time in the next couple of days we might call you back. Should we call you back it will be to inform you that we cannot manage to care for you until our schedule is open. Good luck."