An ounce of prevention
January 31, 2015 10:41 AM
Is it possible or practical for me to get immediate care for a psychiatric non-emergency? Location: Los Angeles.
I've been on SSRIs for depression and anxiety for ten years. About two years ago I weaned off under supervision of my psych. Recently I felt the old anxiety and depression coming back (nothing big or needing immediate emergency action—I am not a danger to myself and others, nor am I gravely disabled).
I'd like to get back on meds as soon as possible (since SSRIs take six weeks or so to really get going).
Changes in job, job location and health insurance mean that a new appointment to see my old psych would not be soon forthcoming, if at all. My primary care physician is booked for the next month. Other sources online indicate that hospital emergency rooms or urgent care centers will just try to 5150 me even though I may not meet the criteria. (Again, let me re-iterate: I DO NOT MEET THE CRITERIA FOR A 5150. I'm absent-minded at work and a little more mood-swingy; that is all.)
Do you have any advice for me to get back on SSRIs in the next week without getting entangled in the California justice or mental health system?
I've been on SSRIs for depression and anxiety for ten years. About two years ago I weaned off under supervision of my psych. Recently I felt the old anxiety and depression coming back (nothing big or needing immediate emergency action—I am not a danger to myself and others, nor am I gravely disabled).
I'd like to get back on meds as soon as possible (since SSRIs take six weeks or so to really get going).
Changes in job, job location and health insurance mean that a new appointment to see my old psych would not be soon forthcoming, if at all. My primary care physician is booked for the next month. Other sources online indicate that hospital emergency rooms or urgent care centers will just try to 5150 me even though I may not meet the criteria. (Again, let me re-iterate: I DO NOT MEET THE CRITERIA FOR A 5150. I'm absent-minded at work and a little more mood-swingy; that is all.)
Do you have any advice for me to get back on SSRIs in the next week without getting entangled in the California justice or mental health system?
My primary care physician is booked for the next month.
WTF? I think this is an important point. No way in hell you should have to wait a month to get an appointment with your family doctor. Get a new family doctor because when you get on SSRIs, what's going to happen if you need adjustments? If you have side effects? You are going to need a doctor you can see immediately.
In the meantime, if your doctor is aware of your history (i.e. knows that you've been on SSRIs before etc.), then just talk to them on the phone and ask them to phone in a prescription to your pharmacy.
posted by If only I had a penguin... at 10:57 AM on January 31, 2015
WTF? I think this is an important point. No way in hell you should have to wait a month to get an appointment with your family doctor. Get a new family doctor because when you get on SSRIs, what's going to happen if you need adjustments? If you have side effects? You are going to need a doctor you can see immediately.
In the meantime, if your doctor is aware of your history (i.e. knows that you've been on SSRIs before etc.), then just talk to them on the phone and ask them to phone in a prescription to your pharmacy.
posted by If only I had a penguin... at 10:57 AM on January 31, 2015
Does your insurance require you to get a referral to see a specialist? My suggestion would be to try to find a psychiatrist. You can start with ones who are in-network for your new insurance. However, in my experience in-network psychiatrists tend to be busier, more overbooked, and not always super responsive. If you can afford to throw money at the problem, it can be a lot easier to find a psychiatrist on short notice that doesn't take insurance, and you're less likely to be dealing with a dehumanizing pill-mill sort of practice.
Also, if your PCP can't schedule an appointment for a month, that to me would be a sign to start shopping around for a new one.
posted by drlith at 11:00 AM on January 31, 2015
Also, if your PCP can't schedule an appointment for a month, that to me would be a sign to start shopping around for a new one.
posted by drlith at 11:00 AM on January 31, 2015
No Urgent Care is going to 5150 you for going in and saying, "Hey, I went off this scrip 2 years ago and would like to go back on. Y'all are the only people who can see me for an ice age, because insurance."
They do this routinely. There is no SSRI request that is in any way a flag that you are a danger. At worst, they're going to be like, "Winter, amirite?" and you'll be all "So right."
Yes, if you go to an emergency room they are going to assume you are emergent. But Urgent Care is basically everyone's gap coverage now, it's fine.
posted by Lyn Never at 11:02 AM on January 31, 2015
They do this routinely. There is no SSRI request that is in any way a flag that you are a danger. At worst, they're going to be like, "Winter, amirite?" and you'll be all "So right."
Yes, if you go to an emergency room they are going to assume you are emergent. But Urgent Care is basically everyone's gap coverage now, it's fine.
posted by Lyn Never at 11:02 AM on January 31, 2015
If you know your PCP and they know your history, have their office call in a script to a pharmacy somewhere. Alternatively, take your old pill bottles (if you still have them, or hopefully some kind of documentation, if you don't) to a walk-in clinic or the pharmacy that filled your old prescriptions and tell them that you need a refill. Actually, if you can still get to your old pharmacy (assuming they're in LA) they might have your records on file so you probably wouldn't need the bottles to back it up.
posted by un petit cadeau at 11:02 AM on January 31, 2015
posted by un petit cadeau at 11:02 AM on January 31, 2015
My understanding is the Exodus is the LA County 24 hr walk-in clinic, and they can, on the spot, prescribe you a month's worth of meds.
No clicky because I'm on my phone.
They are east side and west side. Very nice over the phone, I'm sure you can ask about 5150 hold if you have concerns for that.
I called recently on a neighbor's behalf. I believe the receptionist told me it is best to come in early morning when the doctor(s) start their shift. Good luck.
posted by jbenben at 11:08 AM on January 31, 2015
No clicky because I'm on my phone.
They are east side and west side. Very nice over the phone, I'm sure you can ask about 5150 hold if you have concerns for that.
I called recently on a neighbor's behalf. I believe the receptionist told me it is best to come in early morning when the doctor(s) start their shift. Good luck.
posted by jbenben at 11:08 AM on January 31, 2015
It is very unlikely that anyone would try to hold you at the ER if you are not a danger to yourself or others. They will not get paid by your insurance unless you are suicidal, homicidal, or psychotic/gravely disabled by mental illness, so they take pains to ensure that is the case.
But the emergency department is for emergencies, not prescription refills. Go to urgent care if you must, or try to get an urgent visit with your PCP, ideally.
posted by treehorn+bunny at 11:14 AM on January 31, 2015
But the emergency department is for emergencies, not prescription refills. Go to urgent care if you must, or try to get an urgent visit with your PCP, ideally.
posted by treehorn+bunny at 11:14 AM on January 31, 2015
Just went through something similar, so you may want to look at the advice I got in this thread. HOWEVER -- be aware that Exodus will only see you if you have no insurance. However, it seems that that basically adds up to them asking, "Do you have insurance?" and if you say no, they will still treat you. My family member went there, waited for hours but saw a psych, a social worker, was prescribed meds and got a ride to the nearby pharmacy to get the prescription filled. This is only available at Exodus's downtown location, not the others. And as JBenben said, you should go as early in the day as feasible. The doc leaves around 6ish.
posted by BlahLaLa at 11:14 AM on January 31, 2015
posted by BlahLaLa at 11:14 AM on January 31, 2015
I was in a very similar situation (medicated, weaned, things got bad again) and I got in touch with my PCP's office to ask if they could write me a prescription and I'd come in when they can fit me in. They - meaning the nurse I spoke with - immediately called it into the pharmacy right down the street. I was basically just asking for a continuation of a antidepressant that I'd been on before (with a different doc, though.) They do this all the time. Call your doctor's office again and explain the situation and I'm sure they'll call in a script, especially if your charts show that you were taking this medication previously.
Good for you for being so proactive and aware about your mental health!
posted by punchtothehead at 11:33 AM on January 31, 2015
Good for you for being so proactive and aware about your mental health!
posted by punchtothehead at 11:33 AM on January 31, 2015
My primary care physician is booked for the next month.
WTF? I think this is an important point.
Welcome to California, where Kaiser has eaten all the doctors and there are none left for the rest of us.
You should be able to call your old psych and get a referral too if you think this will be an ongoing thing and you'd like a new one. You get in much faster with a referral.
posted by fshgrl at 11:43 AM on January 31, 2015
WTF? I think this is an important point.
Welcome to California, where Kaiser has eaten all the doctors and there are none left for the rest of us.
You should be able to call your old psych and get a referral too if you think this will be an ongoing thing and you'd like a new one. You get in much faster with a referral.
posted by fshgrl at 11:43 AM on January 31, 2015
Despite faaaar more pushback from my new insurance's urgent care than I expected, I managed to get a new prescription. Thank you all!
posted by infinitewindow at 2:27 PM on January 31, 2015
posted by infinitewindow at 2:27 PM on January 31, 2015
I've used ZocDoc when I've needed to get in and see someone fairly quickly. You put in your insurance, location and what kind of MD you need to see and it gives you a list with appointment times.
You can usually find an appointment within a couple of days.
It saves you lots of phone calls. I like things that save you lots of phone calls.
I've recommended this many times on the green.
posted by sciencegeek at 3:10 PM on January 31, 2015
You can usually find an appointment within a couple of days.
It saves you lots of phone calls. I like things that save you lots of phone calls.
I've recommended this many times on the green.
posted by sciencegeek at 3:10 PM on January 31, 2015
This thread is closed to new comments.
posted by roomthreeseventeen at 10:54 AM on January 31, 2015