Mental Health Care Shouldn’t Be So Difficult and Expensive

There are too many barriers to care for those of us who struggle with our mental health.

I never intended to go off my meds.

And when I did stop them temporarily because I had trouble getting refills while I was living in my car, I certainly didn’t intend to be off of them for five months.

Now that I’m trying to get back onto my mental health medications, I’m having to put in a bunch of energy that I just don’t have right now to find a provider, and I’m borrowing money for the ridiculously expensive appointment I need in order to get refills.

The thing about struggling with a mental illness is that even simple tasks feel much more difficult, so it feels especially cruel to put so many barriers in place that make it hard for those of us who are the most vulnerable. It’s no wonder so many people who need it aren’t in any kind of treatment.

Where do I even start with the barriers to treatment?

Even when you have good health insurance, trying to stay in therapy and on medication is difficult, frustrating, and often expensive.

Trying to get, and stay, on medication is an adventure in and of itself. While some family doctors feel comfortable prescribing antidepressants, they won’t touch my bipolar disorder with a 10-foot pole, so I have no choice but to see a psychiatrist.

In the 17 years since I was originally (incorrectly) diagnosed with depression, I’ve only ever had one psychiatrist who was more than just a jackass with a prescription pad. Generally, psychiatrists (in my personal experience) are greedy, careless assholes who care more about money than their patients. But they are the only doctors who can or will prescribe medication for mood disorders, so they’re a necessary evil.

The best case scenario is having insurance. You typically have to pay a higher copay than you would for a regular doctor visit, for an appointment that often lasts less than 5 minutes. MAYBE 10 or 15 minutes if you’re REALLY struggling.

So, my best case scenario often looked like this: 15-minute drive across town, pay $35, spend 10 minutes in the waiting room, talk to my psychiatrist for 3 minutes, then leave with a prescription for refills, a new medication, or a higher dose of a current medication. Then, it’s another 15-minute drive across town to my pharmacy and a 20-minute wait for my medication before a 10-minute drive home.

And that’s the BEST case scenario. That may just sound like an annoying errand for a healthy person, but when you’re struggling just to take a shower more than once or twice a week, it’s A LOT.

Right now, I’m dealing with the worst case scenario. I moved to a new state, I don’t have health insurance, I’m at high risk for the coronavirus (so I’m staying home as much as possible), and I’ve been off the medication that helps regulate my bipolar disorder for 5 months (so my depression and energy are worse than they should be).

Here’s what I’ve already done, and I’m no closer to getting my medication than I was a week ago.

• Got on GoodRx to compare prescription prices at all the pharmacies in town so I could see where to get my medication for the cheapest without health insurance. Fortunately, all three meds I take are now generic. One of the antidepressants, I’ve been taking since before it went generic, and it cost $300 a month for a while.
• Set up a profile online at Kroger, the cheapest local place, on average, for my medications, so I can have prescriptions called in at some point.
• Asked a family member if I could borrow the money for an appointment to get back on my medication.
• Asked my editor at the telehealth website I do freelance writing for whether the doctors there might prescribe me refills of the meds I was on previously.
• When he thought they would, I scheduled an appointment and spent 45 MINUTES filling out health questionnaires and downloading the app for the appointment.
• Got an email that my appointment was canceled because my appointment “reason is not within the scope of our practice.”
• Spent an hour comparing online psychiatrists. The cheapest I can find is $175, but they have TERRIBLE reviews. The best-reviewed company I’ve found so far charges $284. I already borrowed $99 when I thought that would cover an appointment with a regular telehealth doctor. Do I borrow less money and hope I have a good experience at the poorly rated cheap place? Or do I borrow more money for the more reliable place?

And that’s where I’m stuck. I didn’t tackle all these steps at once, but I’m still mentally exhausted. And I have work that I should be doing. But I’m having trouble focusing because my mental health has gotten so bad.

Therapy really isn’t in the cards for me right now without health insurance. It’s just too cost-prohibitive, and until my medications stabilize me, I don’t have the mental energy to put into actively trying to get better through therapy.

That’s one thing a lot of people don’t realize. True therapy takes WORK. While you can use it just to show up and complain about your problems for an hour, it’s most effective when you take your therapist’s suggestions and try to apply them outside their office.

When I have the money, time, and mental focus, therapy really helps me become a better person. But without health insurance, and with how bad my finances are, it just doesn’t look like it’s in the cards right now.

There are some places that offer therapy on a sliding scale. If you have a low income, you may be able to find therapy at a price you can somewhat afford. That was difficult in Denver, and I’m not optimistic about my chances of finding anything like that in Texas. But, perhaps I’ll do some research after I get back on my medication.

It’s no wonder that nearly half of all homeless people struggle with mental illness. Even in the best situation, getting mental health help is difficult. Honestly, the only reason I’m not homeless (yet) is because my family has helped me out A LOT over the years. Sometimes, there’s not a whole lot more than luck and love keeping me housed.

We should really find a way to make mental health help more accessible for those of us who need it the most. How? Heck if I know.

I’m still trying to help myself.