National Mental Health Awareness Month and the Importance of Language

Every month is Mental Health Awareness Month here at a day with depression, and I’m glad to have the support of President Barack Obama’s proclamation for one month each year.

Among the topics he discusses – care for veterans, reduction of stigma, that “taking action to help yourself is a sign of strength,” etc. – I personally am most grateful for the Affordable Care Act. As a result of this legislation, Fox and I have health insurance that enables us to receive the medication and marriage counseling we need. Around this time last year I felt like our marriage was falling apart. Now we’re working together and supporting each other. Fox has held down a job for 6 months (and counting!). I am less than a week away from completing the last two classes I need for my Master’s degree; after nailing my piano final last night(!) I feel like I’m ready for internship and will be an awesome music therapist.

I have a bone to pick with President Obama, though. His proclamation begins:

This year, approximately one in five American adults — our friends, colleagues, and loved ones — will experience a diagnosable mental health condition […] and many others will be troubled by significant emotional and psychological distress, especially in times of difficulty.  For most of these people, treatment can be effective and recovery is possible.

(emphasis mine)

I wish he would use more inclusive language; that would be a great way to reduce the stigma around mental health issues. The language in this proclamation suggests that mental health issues affect other people, even if “they” are the people “we” interact with every day. It seems like the President is trying to distance himself from the people who live and struggle and sometimes even thrive with these issues. He’s practically saying: “this thing exists and we need to be aware of it – and just to be clear it doesn’t affect me, and I don’t think it affects you.” IMHO, that contributes to the stigma.

I imagine that we’re all in a room, and Mr. Obama is on the stage giving a speech, and I’m in the front row because hey, I’m the one imagining it. He’s talking to me… about me, as though I’m not sitting right in front of him and can’t hear him. I’m probably one of the people who are the happiest to be there listening to him, and yet he’s not really talking to me. I think maybe he’s talking to the person sitting next to me.

However, more than 20% of the people in this room are the population he’s talking about (as though we’re not there listening to him – probably filling the front-and-center seats). The person sitting next to me might feel the same way I do; they probably think I am a member of the President’s intended audience. But neither of us will admit it, because then we’d be marking ourselves as “other” – as not really belonging in that room where “normal” people go to become more aware of us. (How ironic is that?) Instead of connecting with each other, we each go home feeling more isolated than ever. (And the “normal” people go home unaware that we were literally sitting right in front of them.)

What about us? I wish someone would say: “This year, approximately one in five of us will experience a diagnosable mental health condition and many more of us will experience significant emotional and psychological distress, especially in times of difficulty. For most of us, treatment can be effective and recovery is possible.”

That wording makes it sound like mental health issues affect everyone, and needing help with them is normal. If I attended a speech and the speaker said that, I would feel like I belonged in that room. Isn’t that what reducing stigma is all about?

You don’t have to be one of the “one in five” – or the “many more” – to use this language. You just have to be willing to admit – to yourself and everyone else – that you could be. If you’re brave enough to do that, you can help us feel safe admitting that we are. That’s how you let us know we’re “not alone.”

Take Women’s Health Care Out of Employers’ Hands: The Hobby Lobby Problem and the Single-Payer Solution

I really love the underlying point made in this post: “healthcare is an essential and public good.” In the US there’s too much focus on individual economic growth; I find it kind of terrifying that healthcare is a for-profit sector people (well, the small percentage who still have extra resources) can invest in for their own private economic growth. This article is great because it reframes healthcare as something we all as citizens can invest in for the health and well-being of ourselves and each other. That’s what a single-payer system should ultimately be: not putting healthcare in the hands of a nameless, faceless “government” that is ultimately run by big business… but taking it out of the hands of big businesses (including private, for-profit insurance companies) and back into the hands of we, the people.

Healthcare Headache

My health insurance finally paid their share of the bill for my first visit with Psychiatrist B, which occurred 7 months ago to the day.

When I learned of this, I decided to (finally) look into options so I’ll have health insurance after my current plan – which is dependent on my being a full-time student – expires. There is an option through my current company. When I called for a quote, the person I spoke to was very nice! She asked a few questions and suggested a plan that costs – wait for it … – $400 per month! This is marketed to students who are between leaving school and receiving health care coverage from their employer, mind.

I took a look at the information she sent me and became quite concerned. One of the criteria that prompted her to suggest this plan instead of a less-expensive option was my need for prescription coverage. When she told me the benefits, I thought they included prescription coverage. But when I looked at the explanation of what the plan covers, it explicitly excluded all prescription drugs – even generic! It also explicitly excludes mental/behavioral health care.

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I thought, there has got to be something better out there! I searched for “affordable health insurance” and found ehealthinsurance.com. Through that site I was able to find a plan with a different company that costs $320 per month. Their prescription coverage includes a $15 copay for generics and coverage of 50% of the cost of brand-name drugs up to a certain limit. They also cover 70% of mental/behavioral health care, up to a certain limit. Sounds pretty good.

Except that, according to their brochure, I might not be able to switch companies and I might have to wait to enroll within a specific range of dates and I might have to go several months without coverage. I have no idea whether I’ll be able to find a psychiatrist who is in-network for both companies. “Long-term care” is on the list of services they don’t cover – I have no idea whether that applies to me or not or even what it means in terms of practical considerations.

Worst, I read a customer review by someone who said coverage was denied for treatment of a “pre-existing condition,” and ze had to fight for what coverage ze did receive! WTF?! I wouldn’t care so much about health insurance if I didn’t have a “pre-existing condition” that (likely) requires inhumanely expensive medication to treat! And there’s the nagging voice in the back of my head asking, am I really saving any money if my health insurance costs over $300 per month? That’s before the copay for the doctor’s visit, the copay for (or half the cost of) the prescription medication, and 30% the cost of any additional (limited to a certain number of visits) mental/behavioral health care I receive.

But then, I’m reminded of the first time I used my school’s insurance to help pay for a prescription. Long story short, I literally saved $100 on that month’s supply of the generic drug. Add the doctor’s visit that finally got paid for ($250, minus the $25 copay) and I’ve already saved $5. Never mind if I do need to go to the hospital, etc. And preventative health care … I have yet to compare insurance coverage vs. going to a low-cost clinic (e.g. Planned Parenthood), but there’s a decent chance I’d be saving money there, too – especially since companies are increasingly required to cover preventative care at no cost to the patient.

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Oh, I just took a look on Planned Parenthood’s website, which has a link to HealthCare.gov. Starting October 1st, I’ll be able to search for low-cost insurance options there, with coverage to begin in January. Yay, Affordable Care Act!!! Why, oh why couldn’t you be fully implemented immediately?! (I’ll refrain from soapboxing about what healthcare should look like in the US – and still won’t, come 2014 – … at least for now.)

Anyways, I still haven’t decided what I’m going to do about health insurance from mid-August (when my current plan expires) to January (when coverage begins for any low-cost plan I manage to find on Healthcare.gov). But at least I have hope that paying through the nose for whatever plan I do find (or going without insurance, as millions of Americans do) will be a short-term solution.

What’s your experience with health insurance, particularly trying to find an affordable plan? Any suggestions? International readers, how does access to affordable health insurance in your country compare to what I’ve described here?