How do I get SSI/disability for mental health?

November 5, 2009 11:32 AM

How do I navigate Social Security to qualify for Medicaid, SSI and disability for mental health services? How do I find an advocate to guide me through the walls of paperwork and decisions? Sub-question: what are current mental health institutions like for in-patient treatment?

I qualify for an array of symptoms for mental health disability - namely marked social dysfunction, severe anxiety, depression (most likely rapid cycling bipolar), persistent ideations and the inability to function normally and keep a job, set or keep goals or otherwise function at life. I have trouble maintaining all kinds of relationships. I also have an unhealthy relationship with alcohol and tobacco as self-medication.

In case it needs to be said - I also qualify financially. I have no job, no money, no property and as much as I hate to admit it I'm basically indignant and losing my housing.

I'm having a hell of a time finding services, doing my homework and wrestling with the bureaucracy while in the midst of these symptoms. How do I find an advocate, case worker or guide? This process is daunting enough without struggling with the symptoms at the same time, and dealing with the bureaucracy is aggravating the symptoms and often sending me spiking off into severe manic or depressive territories.

Also what can I expect these days if I sign myself in for in-patient treatment at a mental health facility in Los Angeles? I'm considering this as an option to get the process kick-started, as I'm more or less on the edge of crisis territory. What's the process like? What can I bring with me? What can't I bring? How much control can I expect to have over the process?

(Paging The Straigtener)

posted by loquacious to health & fitness (13 answers total)

The Straightener, even. /OCD
posted by loquacious at 11:44 AM on November 5, 2009

I work for a nonprofit that does something similar to what you're looking for. I'll be MeMailing you some Los Angeles resources in just a little bit. In the meantime, if you want to look around a bit at national resources, there's NAMI. They offer some great workshops and support groups and can help you with self-advocacy. There's a list of local NAMI offices here, and there are quite a few in Los Angeles County.
posted by infinitywaltz at 11:47 AM on November 5, 2009

Start here maybe, for help with getting into the system where you are.

I don't know too much about the SSI process, but AFAIK you have to have a diagnosis from a physician to even begin the process. I have heard from people that where I live they reject many applications on the first try and then let many people in on appeal. I would say that should be something that you should think about once you are on your way to getting help.
posted by jefeweiss at 11:55 AM on November 5, 2009

I spoke to a co-worker and sent you some resources via MeFi Mail. The coworker, who is pretty experienced in this kind of thing, said that checking yourself into an institution voluntarily will get the ball rolling (via the instution's social worker) but highly recommended against doing so until all other avenues have been exhausted.
posted by infinitywaltz at 12:23 PM on November 5, 2009

Googling shows that you can get information about community mental health services in LA by calling 800-854-7771. Previous advice about SSI applications (including my advice) here.

If you're not already in out-patient treatment, I would recommend getting started ASAP. You're going to need medical records to do a successful application.
posted by Mavri at 12:45 PM on November 5, 2009 [1 favorite]

First of all, know that this is a long process. From start to finish, we used to tell new clients that they could expect a three year period before any final determination is made. That was not to scare them off, but instead to show exactly what type of a process this is. Your disabling conditions are the type that we most often represented, and I can guarantee that you fall into the very murky middle category that will encourage scrutiny and difficulty.

For one, you will probably face an uphill battle due to your relationship to alcohol. If you were my client (which you aren't), I would encourage you to seek treatment for your alcohol problem immediately, without delay. And this is because disability claims based on mental conditions are often derailed due to issues of substance abuse. ALJs often will disqualify an applicant because the proof as submitted does not prove that ABSENT SUBSTANCE ABUSE, the applicant would be similarly disabled. Save yourself this denial by seeking treatment for substance abuse now. Get sober and remain in contact with your medical professionals in order to be evaluated once you have achieved and maintained sobriety. As others have said, this is a medical record intensive process, and your medical records will need to indicate the limitations that you have discussed above.

Remember, this is a process that is designed to disqualify people (with ridiculous tricks like including "careers" like Elvis Impersonator in the Dictionary of Occupational Titles), and you need to be on top of it - you've taken a big step just by asking for resources, and you are right to seek an advocate to assist you in this process. MHALA looks like a great place to start. But don't get discouraged if/when someone says "no." Trust them and follow through on the services that they recommend you connect to. It WILL sometimes feel like a wild goose chase, as you've already found.

It is important to remember that because an accepted SSD application is RETROACTIVE from your time of application. So while it may take several years to process, it will ultimately provide retroactive benefits - which can be used to leverage attorney representation. (For a little more information on why attorney representation can be so beneficial in these proceedings.)

If you have any questions along the way, please feel free to MeMail me. I'm not an attorney, I'm not licensed in California, but I AM happy to help in any way I can.
posted by greekphilosophy at 1:58 PM on November 5, 2009 [1 favorite]

Here you go. We just had a great thread on this where basically everyone on the site who has expertise on this chimed in, tons of great info in there. (On preview, Mavri's got it already) If you can get an intake appointment at a community mental health treatment site before getting to a crisis stage where you need to go inpatient, I would recommend engaging in an outpatient program instead of going straight to inpatient. Inpatient psych stays are primarily for observation and stabilization, not so much for ongoing treatment so if you're not at the point where you need that level of care you will likely find the experience off-putting. Go to your county assistance office ASAP to fill out an application for medical assistance, food stamps and cash assistance. The medical assistance will cover your outpatient treatment and getting the application started now will make your intake process at a community mental health facility go more quickly, which will shorten the amount of time between now and your seeing a psychiatrist for a psychiatric evaluation, which you will need to have done prior to being prescribed any medication.

You caught me on my way out the door so I apologize that this is a little rushed, I will try tomorrow to help you locate a community mental health provider in LA that you can schedule an intake appointment.

If you feel like you are going to hurt yourself please go to the emergency room and tell them that.
posted by The Straightener at 3:03 PM on November 5, 2009 [1 favorite]

Try calling Didi Hirsch tomorrow, it's a big community mental health treatment provider. I can't vouch for its service quality as I am unfamiliar with services in LA but it's a place to start. Tell them you need an intake appointment, when you go for an intake tell them you would be interested in receiving case management services in addition to outpatient mental health treatment. If they can't provide you with a case manager who can help you with your SSI application ask them to refer you somewhere that can.


If you need to talk to someone about housing drop into Beyond Shelter, explain your situation and tell them that you might need to apply for permanent supportive housing. Beyond Shelter is a housing first program for families but they would know where to refer an individual. If you feel Beyond Shelter's staff isn't being helpful let me know and I will try to put you directly in touch with someone there.

Familiarize yourself with the Legal Aid Foundation of Los Angeles, specifically their Government Benefits Unit. Contact them immediately if you have any hassle getting your welfare benefits activated or if you receive a denial letter from Social Security.

To review:

1) Go to the welfare office tomorrow. You can look up the nearest location here and also print out a Medicaid application to fill out in advance.

2) Call Didi Hirsch an schedule an intake appointment.

3) Call or better yet walk into Beyond Shelter and ask them what your housing options look like.

4) Follow up with me via MeMail after you've done all this and we'll take it from there.

Good luck.
posted by The Straightener at 7:00 PM on November 5, 2009 [3 favorites]

You're down in LA now? So sorry you're having a hard time!

If you're near Long Beach, I'd stongly suggest you call Mental Health Association of Los Angeles (mhala). They run one of the premier community mental health treatment organizations anywhere, called The Village. I can't say enough good stuff about those folks. Give them a try and let me know whether they're helpful.
posted by jasper411 at 12:40 PM on November 6, 2009

From a social worker who used to work in LA:

"Didi Hirsh has a number of programs throughout the city. I went to one where the clients went there everyday and spoke highly of the program. I had a colleague that interned at the Village and liked that program as well. I think the village offers services specifically for gays and lesbians. That's really all I know. Both organizations have websites so he can check it out. He may want to call ahead of time because sometimes they have waiting lists. "
posted by The Straightener at 11:49 AM on November 7, 2009

Sorry I haven't replied yet - I've been busy acting on advice and it's kind of hard to talk about all this and work on it at the same time. I've been acting on stuff. I qualified for "General Relief" and have a referral to mental health services.

All I can say so far is that our public social services are... difficult to navigate. It seems pretty dysfunctional and ovewhelmed.

Did you know it's a loan from the county? If I get a job I get garnished and have to pay it back, or if I qualify for SSI.

I have some off-thread responses I need to edit and paste into the thread for the record too, because they contain good advice.
posted by loquacious at 10:19 PM on November 10, 2009

Wish I had some actual assistance, but I'm glad you checked in and happy the process is underway. Good luck - a lot of us are pulling for you.
posted by Space Kitty at 9:50 AM on November 11, 2009

If you find yourself with the luxury of time, please keep us updated.

"All I can say so far is that our public social services are... difficult to navigate."

I could tell you some stories that would make your hair stand on end, but I don't want to seem like I'm discouraging you. Glad to hear you're getting through it, and come back if you can fill us in on your status or what you discovered from pursuing the various avenues of assistance.

Feel free to write me personally if you just need someone to do generic legwork, someone to BS with or whatever; I've got some time on my hands for the next week or so.
posted by majick at 6:35 AM on November 16, 2009