Let the conversation begin.
Compassion Aside, Taxpayer Cost Ramifications from A Broken Mental Health Care System Devoid of Common Sense
Post by Kerry Martin, CEO and Founder, Hope Xchange Nonprofit.
Last week, we published a post, A Hope Xchange Bipolar Mentoring and Advocacy Case Exposes a Complete Lack of Compassion by Healthcare Professionals for a Mentally-Ill Young Woman In Desperate Need of Help, speaking to the fact that mental health care system today is completely devoid of compassion.
Instead of Taking Five Minutes to Refill a Clonazepam Prescription, State-Funded "Full Service" Health Behavioral Organization Tells Me to Send Her to ER for Her Meds
But, let’s put compassion on the back burner and talk about the other “C” -- cost -- that comes to mind when a mental health care system is broken. On the same day we published the post above, I was sent the following message by someone I’ve been mentoring for the past six months in our Hope for Bipolars program:
“I still have not heard anything from HBI about my clonazepam. I am starting to freak out. This is what the system does so well: go on like a dumb machine claiming to be working, but if there's someone having trouble, someone falling through the cracks, they calmly watch them fall and go right on
Here’s a snapshot of the complete absurdity of our system: a complete lack of common sense and the resulting cost implications for taxpayers; and, how my team and I spent the rest of our day.
How Hard Do We Need to Fight to Keep Woman Diagnosed with Bipolar at Highest Risk for Suicide from Possible Psychotic Breakdown and Another Psychiatric Hold?
I had known about the situation with the clonazepam (Klonopin) prescription as she had sent me a message 10 days ago saying she was “terrified and shaking” as it was due for refill on April 19 and she feared it would not be renewed in time. Not only does she suffer from extreme anxiety she also rapid cycles throughout the day, messaging me one minute she is hopeful and then the next, there is no hope for her.
She is also at the highest risk of suicide. I had to call the police about five months ago to get her committed to a psychiatric hold after she indicated she was going to take her own life. And for that she thanked me, saying “you saved my life, and I like it.” But, she was discharged back into her same toxic living environment and rapidly deescalated into a state of hopelessness forcing me to have to call the police again. While it is not known why, people with mental illness who leave healthcare facilities are at an increased risk of suicide.
She also unfortunately lives in Nevada, which is the worst state for people with mental health care challenges, according to the Huffington Post. And, I was about to find out exactly why it receives this ranking.
Over the past ten days, I had called her state-funded "full service" behavioral health organization -- where she was assigned for health “care” -- not once, not twice, not three, not four, but fives times so I could talk to woman who as prescribing her medications (her meds coordinator). Actually getting a live body on the line, despite having two extensions for that department, is impossible.
Each time I left a message, explaining who I was, sharing that she had given me permission to talk to them on her behalf, leaving her date of birth and her social security number, and the name of her meds coordinator. I let them know that she had emailed them regarding her prescription as she was too anxious to call on the phone.
As April 19th drew closer, I left increasingly urgent messages on her behalf indicating it was imperative they renew her prescription, informing them that going off clonazepam cold turkey -- particularly given she had been on it at a high dose for many years -- would result in major withdrawals, a possible psychotic breakdown and more than likely, require hospitalization. (According to American Addiction Centers, the FDA warns taking clonazepam is habit-forming and users may become physically and psychologically dependent to the drug; therefore, users should not stop taking clonazepam suddenly without medical supervision due to the dangerous side effects, or withdrawal symptoms that may occur even when taken as prescribed.)
Each time, I asked that they call me back so I would know that they got my message and so that, if there was any questions, I could answer them.
Each time, they did not call back.
Upon receiving her message on the morning of April 19th saying she still had not got her refill, I immediately called her pharmacy to double check that they had indeed faxed in the refill request. The woman I spoke to said they had not and that it wasn’t uncommon for them to have to wait up to two weeks for a response. She said there was nothing she could do to help me.
Health Behavior Organization Responds with No Urgency or Compassion: Potential Cost to Taxpayers - Absurd
So back on the phone I go. I spent two hours just calling and calling but this time not leaving messages. That obviously was not going to work. I was determined to keep on it until I could get a live body on the phone. Finally, I did in the early afternoon. I literally begged the woman who answered the phone to not put me on hold or transfer me but rather just listen to what I had to say. I explained the situation to her and her response?
“She needs to come into our office, pick up a packet listing other facilities that take her insurance and schedule an appointment with another facility to get her prescription renewed.”
I explained to the woman that it was a two hour bus ride for her to get there and that she was having an anxiety attack because they had not refilled her prescription. I asked her if it would even be possible to get into see someone that late in the afternoon assuming she could pull herself together and come get the packet, and she responded "no, not likely."
When I asked her if she knew that withdrawals from clonazepam are awful and potentially life-threatening and that going off it cold turkey is dangerous she responded, "Yes." When I asked her what she suggested I do given the woman needing the refill was having an anxiety attack, here is what I was told, something I asked her to repeat twice, as I honestly couldn't believe what I hearing:
"You need to call an ambulance and get her to the ER to get her medications."
This, from an facility, with "we are here to help," on the home page of their website.
How Much Would Taxpayers Have to Pay to Compensate for an Incompetent Health Care System Devoid of Common Sense?
The time it would have take them to respond to a faxed request for a refill I’m guessing would be about five minutes -- as it's their job and they do it all the time -- and would cost $50, if that.
Consumerist.com states the cost of an ambulance ride is approximately $164 per mile. According to Consumer Reports, the cost of an average ER visit can be up to $2,000.
Cost to taxpayers? Absurd! Compassion aside, does any of this make common sense?
Hope Xchange Responds with Urgency and Compassion: Cost to Taxpayers - Zero
I now have to call this woman I mentor (who I now consider a friend), calm her down, and explain the situation. Thankfully, she has scurried away five clonazepam pills, as she has predicted they would let her down. She was right.
I call the Volunteer Coordinator for our Hope for Mentally Ill mental health advocacy program and, armed with my mentee's health insurance information, we are able to secure her a triage appointment the next day at 8 AM at a location 30 minutes from her house so she can get her refill.
The health behavioral organization did tell me that when we helped her find another facility, as they were currently over-capacity, I could tell those facilities she was still enrolled there. So now we are looking for an alternative location, one that can do her medications, her therapy and her case management. We are now seeking a facility closer to her home that doesn’t require a two hour bus ride.
Cost to taxpayers: zero.
The response from the woman I mentor upon learning of her appointment to get her refill and our strategy for her moving forward:
“Thank you, thank you all so so so much. I'm able to feel safe and cared for because of y'all, while my own family completely invalidates and ignores my mental illness. They are such (blip). Everything is my fault. Thank y'all for helping me. You are lifesavers, no joke. THANK YOU.”