Feeling abandoned by the mental health care system
October 27, 2015 7:17 AM   Subscribe

My therapist can't meet with me for the indefinite future, my psychiatrist quit, and I can't get an appointment with a new doctor. I am handling this badly. What should I do?

Right now I am dealing with some mental health situations that make me feel inclined to give up on the whole process. I could use advice. Here is what is going on:

1) My therapist experienced a major personal emergency (leaving out details for his privacy) that means he will be out of state for the indefinite future. He doesn't know when he can return to regular sessions but has offered to do video/phone sessions until then. I am reluctant to do this because we've done those before and I didn't get a lot out of them. There was too much negotiating wifi connection issues and I have major trouble communicating with people not in person. It did not really seem worth it for the expense. I feel bad, though, because he probably depends on the income. He is a good therapist but I just hate not meeting in person.

2) My psychiatrist left his practice a few months back with no explanation and no forwarding address. In all honesty, he was pretty dismal anyway. He often seemed distracted (my partner thought he was stoned), neglected to call in prescriptions and didn't remember even discussing them, and once canceled a session 5 minutes in because he had a headache and billed me anyway. But I can't seem to find a new psychiatrist. Literally everyone I call on my insurance is not taking new patients. I got refills on my prescriptions from my primary care doctor but it seems like I should be seeing an actual psychiatrist.

I have major depressive disorder and autism and was once diagnosed with bipolar II but don't know if that diagnosis was reliable. The autism means that change like this is really stressful. I am skeptical of all the mental health help I have received because I still feel terrible and hate the drugs, but my partner thinks the medication and therapy help. I don't want to be more of a burden on my partner since I seem to have meltdowns on a weekly basis lately but I am running out of hope for the future. Is there even any hope when I have been trying treatments for 20+ years and don't feel any better? What should I do about these two situations? My sleep schedule is all messed up and my body tolerates the antidepressants badly so it is sort of a crisis point. I wish I could check out of the world and not have anyone depend on me for the next few months but that isn't possible. Please help. Thank you.
posted by anonymous to Human Relations (7 answers total) 2 users marked this as a favorite
I'm sure other folks will have better suggestions than me, but in your situation I would start by making an appointment with your GP in person. Once you're there, focus on:

1) You need a new, better pdoc. Your GP may be able to refer you to one! Sometimes doctors can ask another doctor to take on a patient who they might not take through the regular channels. So definitely ask about this.

2) Ask about your sleep issues. It may be fully related to your pdrugs, but it could also be a separate sleep issue that is impacting your other issues badly. Ask about a referral to a sleep specialist to discuss. There may be something going on (delayed-phase, apnea, whatever) that can be handled better.

3) If you haven't had one recently, a general checkup. There may be other medical stuff going on (e.g. low Vit D) that is exacerbating the other issues.

This sounds extremely stressful and I hope things start looking up soon. Good luck!
posted by pie ninja at 7:53 AM on October 27, 2015 [6 favorites]

I can relate to this feeling. my god, can i ever. (i just had to change insurance, and thus providers, and apparently my insurance has very few psychiatrists taking new patients). here are a couple ideas. sorry if you already tried these.

- ask your therapist if he has anyone he can refer you to that takes your insurance.
- if you get really desperate before you find someone new, ask to schedule a video session.
- your old psych sounds awful and a new one could help you out a lot. call every last name on your insurance (although it sounds like you're doing that) - i've found that my insurance list is not always up to date and there are doctors who take my insurance who aren't in the directory. if your insurance lists groups or hospitals that are covered, try calling the intake lines for new patients and ask if there are any psychiatrists there that take [your insurance] who are accepting new patients.
- you might try using the "search by insurance accepted" feature on a site like vitals. then if you find someone, call and confirm if they take [your insurance].
- whenever someone says "no they're not accepting new patients" you could try asking if they are referring to anyone.
- whenever someone says "no they're not accepting new patients" you could try asking if they have a waiting list, or how long it might be until [doctor] can accept a new patient. this will (hopefully) show them that you are actually, truly in need and maybe, just maybe they can help you out with either a wait list spot or the name of a referral doctor or clinic.

it's not much, but I hope you'll have luck with something. hang in there.
posted by ghostbikes at 7:55 AM on October 27, 2015 [5 favorites]

A good therapist will have someone on-hand for emergencies when s/he is not available. Ask your therapist who that person is. (And if your therapist doesn't have someone to back them up, I'd say start looking for a new therapist.)

I would call your insurance carrier and see if they have a list of psychiatrists in your area who are accepting new patients. Also, you could check out hospitals with mental health services and see if they have appointments. Sometimes, that's easier than going provider-to-provider.
posted by xingcat at 8:21 AM on October 27, 2015

I meant to add - on your insurance directory, even if a provider is listed as currently not accepting new patients, call them anyway. in my experience those things are so out of date as to be meaningless.
posted by ghostbikes at 8:24 AM on October 27, 2015 [1 favorite]

The Find a Therapist search might be useful for you.

It's really scary when you need help and providers fall through. I hope everything works out for you.
posted by bunderful at 8:24 AM on October 27, 2015

There are hotlines available 24 hours a day that likely can help triage you to additional resources and provide emotional support in the meantime. Please review the MeFi Wiki ThereIsHelp page - it lists a variety of hotlines, guidance on finding a therapist, and MeFites offering ideas for therapists by location. Also:
The National Alliance on Mental Illness (NAMI) offers a free HelpLine at 1-800-950-NAMI (6264) for information, referrals and support for people living with a mental health condition, family members and caregivers, mental health providers and the public.
posted by Little Dawn at 9:55 AM on October 27, 2015 [1 favorite]

Ooo wee man I'm going through something very similar right now. My therapist kind of sucks and my psychiatrist (who also had an emergency and cancelled multiple appointments) definitely sucks. It adds a whole new level of stress to what you're already going through.

Here is what I would suggest and how I plan to attack this:

Call the insurance and ask them for a list of all the psychiatrists/therapists, etc that they accept. Go onto their website and find whats there.
Go to zocdoc and see who accepts your insurance.
Then call each and every one of these people and confirm that they accept because people don't update their profiles and the insurance company websites are shit. I know this is tedious but it will save you trouble down the road.
Go to psychologytoday as mentioned above. You can find a therapist and pdoc. This is how I found my therapist.
Call local hospitals and clinics who may have out patient programs. Anytime someone says no ask them if they have any idea who might accept your insurance/be accepting new patients.

I had to do this at a very difficult time and am gearing up to do it again. It got me over the hump and I got medication that I needed.

Good luck!!
posted by mokeydraws at 6:33 PM on October 27, 2015

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