I have bipolar disorder type NOS. Basically what this means is I do not cycle like a person with Type I or Type II does. Essentially my type of bipolar means I cycle through various levels of mania all the time. Depression, for me, is incredibly rare, though it does happen. What is even rarer for me (having only happened once since I started exhibiting this type of bipolar, and that was because it was mania and post-partum depression) is dual cycling, which means precisely what you think: I am manic and depressed at the same time. This last month has been the first time in ten years that I have started dual cycling. I have the lovely problems of mania (inability to focus, racing thoughts, an insane amount of trouble sleeping) with the fun parts of depression (no desire to do anything, wanting to stay away from the people I’m close to, loss of interest in the things I usually love). People, it’s scary as hell when you dual cycle. Just trust me on this.
Now, under normal circumstances I am on medication. I have access to a psychiatrist if things get especially dicey. This is not the case right now. See, I was paying for health coverage under the Covered California plan. But in December I realized I could no longer afford it, between the monthly payments for my insurance and the doctor visit and prescription copays. Since I knew I made so little money as to qualify for food stamps I also applied for MediCal, which is the state insurance. I was approved in December 2014 and began the wait for my benefits card and insurance information. It is now February 24th and I still haven’t received them. Why? Because they’re sending them out in batches because so many people qualified. I honestly have no clue when I’ll get them and can take care of my non-psychiatric needs. But the one upside is because it is evident I have MediCal I qualify for psychiatric services now.
They day I found out I actually had MediCal I called my old county clinic to transfer back to them. This was the 27th of January. I was told that because I had moved I had to go to a new clinic. I called that clinic and was told the earliest they could do an intake was today. Now, an intake means I talk to someone who gets me into the system, and then at the end of the visit I am given an appointment with a psychiatrist. When I made my appointment I was told the entire process could take up to six weeks. That was fine; I just wanted to get help because I know I need it.
I arrive for my appointment today and lo and behold, it’s not an intake appointment like I was told because the clinic is short staffed. It’s simply an assessment. I’m seen for five minutes before I’m told to come back in three weeks for my intake. Which is what I was supposed to have today. I told two mental health professionals that I am doing something I never do and that I am scared. I am told to go to a hospital if I have thoughts of hurting myself. I am also told to go to a walk-in clinic to get my medication, which is dangerously close to running out. I say it’s not working and I need something for the depression, and I ask if the clinic can give me something to treat my actual problems. The response? “I don’t know. Maybe.” I am then told that after my appointment in three weeks they will then schedule me an appointment for a psychiatrist, which can take an additional six weeks. So this is two months I may go without psychiatric care on top of the month it’s taken me to get this appointment.
So I go to the walk in clinic. They, too, are short staffed today. I’m told I’ll be there for five hours total waiting to have an intake there. They don’t answer my question as to whether I can get any medication to treat the depression which is currently making me very scared. After two hours of waiting I’m told if I come in first thing tomorrow morning they’ll prioritize me, so I leave, completely unsure if I will actually get the help I need. I’ll find out tomorrow.
This is not a solitary experience. My story happens daily to way more people than you would expect. Clinics are underfunded and understaffed all the time, and for those cities not lucky enough to have a walk-in clinic that’s primary existence is to keep medicated patients medicated then you have people with serious mental health problems and no treatment. And the sad part is once you get into treatment there can always be complications. One of my medications is no longer covered by a Patient Assistance Program so if I tried to buy it without insurance it would cost me $500 a month. And that’s not counting the fact that the other two medications I require are also very expensive (I tried buying a ten day supply of my Ambien without insurance and I was told if I took my full dosage it would be $15 and if I took half my dosage it would be $12, which doesn’t seem like much, but it’s only ten days). This is just to stay stable. And then if I end up having an emergency and need to see my psychiatrist before my next scheduled appointment? Good luck with that. It’d be better for me to go to the emergency room and pray I can get a bed in the psych ward.
When people talk about mental health issues and say that everyone should get help, I just want to show how hard it is to get help if you aren’t paying for your own insurance. Yes, absolutely, everyone should get help. I think taking care of mental illness should be a priority for anyone who has one, but it is so much easier said than done when you have to do it without being the one paying for it. This is an issue that needs more funding and more attention and until it does there are going to be so many people who could leave normal productive lives who are going to slip through the cracks for a time, or worse.