Many of us assume that living in the United States provides us access to the best physical and mental health care in the world. Unfortunately, this is not true. One example of this fact comes from the ABC News Show 20/20 which aired on 9/11/15. An Olympic Athlete had been living with Bipolar Disorder for over 20 years even though her brother committed suicide due to being Bipolar. The family never discussed it due to shame associated with suicide and mental illness. The Athlete and her husband asked for help for 10 years and despite the fact she had all the symptoms and a family history of Bipolar, no one diagnosed her. She lives in the United States, her brother committed suicide because he was Bipolar and it still took 10 years for her to be diagnosed with Bipolar Disorder and not dismissed by psychiatrist as someone who was over reacting. Now that she is diagnosed she is dealing with the shame of being Bipolar.
We often hear parents complain that their teenager is driving them crazy or a teenager complaining how unfair their parents are to live with on a daily basis. However, there are another set of complaints that get ignored on a routine basis. The complaints that get ignored are parents begging for mental health care for their teen or a teen crying out for help by cutting themselves or running away on a regular basis. Many of us assume that if a parent wants mental health care help for their teen or if a teen needs help, all either one of them has to do is ask for help. Unfortunately, this is not how our world works. I have been working as a psychotherapist who treats teenagers for over 20 years. There have been many times I could not have a suicidal teenager hospitalized because the hospital had no beds for a suicidal teenager or the insurance refused to authorize the admission to the hospital.
It is very common for parents to ask everyone they can think of for help for their teenager and the only answer they get is, “I am sorry we cannot help you or your child.”
It is also not uncommon for teens to ask for help by admitting to someone that they are feeling suicidal and the teen is told stop being so dramatic or “sorry there is nothing we can do for you, but try calling this number.”
Some of you may assume that I must be exaggerating, but I am not. I have had many parents beg me to see their child because no one has any appointments or they don’t deal with their teen’s issues. When I interview the parents, they have been every where asking for help, but no one has offered any help or referred them to someone else because they don’t deal with their child’s issues.
For example, one Thanksgiving I had a mother have my answering service page me and she was begging me for help because her teen was suicidal. I referred her to the County hospital because based on what she said the teen needed to be hospitalized. She told me the County hospital gave her my telephone number because they had no more beds for anyone who was suicidal. The parents tell me they feel like no one cares.
Again, some people might believe this is an isolated case. Sadly this is not an isolated case. I specialize in treating suicidal and bipolar teens. There have been a number of times I have sent a suicidal teen by ambulance from my office to the County hospital only to have the teen released in less than an hour because the hospital had no beds. I had one person on the Psychiatric Crises Unit tell me on the telephone unless the person had a shotgun in their mouth not to send them to the Hospital because they had no beds for suicidal teens.
Now, some of you may assume the situation would be different if the teen had private insurance because I have been referring to the County Hospital. If you are thinking having private insurance would make a difference, you are wrong. I have had many private insurance companies deny my request to authorize additional therapy sessions for a suicidal teenager. When I remind the insurance that the teen is suicidal and needs therapy to prevent them from acting on their feeling, they often say to refer them to a community counseling center. When I remind them that most non-profit counseling centers have closed due to the economy they simply say sorry they have exhausted their benefits and they will no longer cover their treatment.
This puts the therapist in a difficult position. Do you just discharge the teen or do you continue to treat the teen for a low fee or for free? When 1 out of 5 teens have a psychological condition that needs treatment, what do you do when treatment is denied or there are no treatment options? Besides 1 out of 5 teens needing mental health care, the CDC has recently moved suicide from the third leading cause of death to the second leading cause of death for children 10 to 18 years old. Therefore, there are many teens who desperately need mental health care and can die without it. Also, when you examine the results further you find that teens who need therapy but fail to receive it are more likely to get involved with drugs, crime, are more likely to drop out of school, more likely to get pregnant or father a child and that child is more likely to become a foster child. These teens are also more likely to end up on probation, homeless and on welfare.
As a society we do not place much emphasis on mental health care. Mental health care programs are always some of the first programs cut when the budget is cutback. In fact if you look at the recent cut backs due to the Congress not balancing the budget, mental health programs were some of the first programs to be cut.
I find it very interesting that Contra Costa County had enough money to build a new Juvenile Hall, which is three times the size of the old Juvenile Hall, but there was not enough money to fund a large number of mental health services which had to be cut.
We often look at teens who are acting out and blame their parents. We ask why don’t they get their child the help they need? What stops them from helping their teenager? Why is the teen always getting involved with drugs or not going to school? The answer could be because the teen needs mental health care and the parents have been and continue to try to get their teen help but their is no help. The teen may be acting out because they are tired of asking for help and being in pain so they start looking for the easiest way out of pain.
If we want our teenagers to grow up to become productive members of society then we need to provide them with the mental health care they need. If we want parents to be responsible parents, then we need to provide parents options for how to get their teens help when they ask for it.
With the number of mass shootings, the significant increase in the number of children with anxiety disorders and the epidemic of teenagers cutting and teenage suicide, I am surprised we have not made it easier and more affordable for teenagers to get adequate mental health care. The President states we need to address mental health care, but I have seen very few changes in mental health care.
I have been treating teens for over 20 years and it is still a problem to get a teenager residential care if they need it. Also it is still difficult to get teens medication at an affordable price. I had a teen the other day who needs medication but they had no medical coverage to see a psychiatrist. The parent made an appointment but the fee for the visit was $450 and they would not reduce the fee. So what do they do?
We can write our Congressmen and Senators and demand that they fund community mental health centers. We can also demand that private insurance companies be required to offer teenagers and their families adequate mental health benefits based on what professional therapists are recommending. The professional treating the child knows what the child needs not some clerical worker with a Bachelors degree who is answering phone calls at the insurance company.
In short, if we want our teenagers to survive their teen years we all need to act together and demand that our children receive the treatment they need and deserve. Mental health care is not a dirty word. There is no difference between mental health and physical health. Therefore, they needed to be treated the same and we need to eliminate the stigma associated with mental health issues.
Finally, private insurance companies make huge profits and drive the cost of health care up based on how they do business. If we don’t start to speak up for our kids, they will never receive the care they need. Look at your next pay stub and look at how much you pay for health insurance and compare that to the benefits you receive. When you take your teenager to a psychotherapist most insurance companies only pay the therapist $75. Your copay is part of the payment. Your premiums are high, but they do not pay it out to providers they keep it.
Dr Michael Rubino has over 20 years experience working with teenagers and their parents as long as Bipolar patients. To find out more about Dr Michael Rubino and his private practice visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.