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Figuring out how to obtain mental health care.-UPDATE post 21


sunflowerlady
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I have been dealing with what I am sure is depression for years, but I have been "okay" and functional in life.

 

It is getting worse. I have had some sort of episode that lasted a couple of days and it was.....not good. :( I almost had my dh take me to the hospital.

 

Now I know I need to try to find some help and treatment. My situation. We have insurance but the deductible is huge so basically I will be paying out of pocket.

 

I am almost certain I will need medication, so most likely a psychiatrist will be what I need, right? I do not have a regular general practice doctor right now. I have had no health care at all for several years. Yes, I intend to get a regular check up soon but I need to get this issue taken care of first.

 

I found a couple of possibilities with local clinics that offer treatment on a sliding scale. They seem to offer medical/medication as well as counseling therapy. They will be my first phone calls tomorrow morning. I am thinking there is a good possibility that they will have no openings for months. Maybe I will be wrong about that. ( I hope)

 

If that doesn't work, I will look for a private provider.

 

Also, what happens when someone goes to the hospital emergency room with a mental health issue? I have heard horror stories and have heard that they don't really do anything to help you and just tell you to go see a psychiatrist. ( Gee, how helpful. :rolleyes: )

 

BTW, I feel quite a bit better today. :001_smile: So, that is good.

 

I am open to any and all insight and advice about accessing mental health care. Also, I appreciate all prayers, good thoughts, hugs and well wishes.

 

Thank you. I know I will get better, I just need to get started navigating the maze of mental health care.

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You can also call your county mental health department and ask for an evaluation. I think they do that in 24-48 hours.

 

I would.also encourage full blood work to make sure liver and kidney function is good, blood sugars are good, thyroid, vitamin B and D, etc as those can all affect mental health.

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Thanks. We don't seem to have a county Mental Health Dept. Google just gives the clinics I mentioned. I think the clinics receive funding from health dept. (Maybe) but they have different names.

 

Yes I do need a total physical and blood work. Maybe I should start with a regular doctor. They could still prescribe meds if needed.

 

Hopefully I can get in somewhere this week.

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You definitely don't need a psychiatrist for routine meds like anti-depressants. If you go for an annual gynecologist visit, they may even prescribe them for you. Not that I'm saying to ditch the idea of therapy, but meds can often get you on an even keel more quickly than therapy alone. 

 

I saw an article recently about online counseling. That may be another avenue to explore; I would imagine that the costs and waiting lists might both be lower. 

 

 

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I recommend you start with a family doctor or general practitioner. They will be able to assess your overall health and do some tests to rule out thyroid problems, etc.. They will also be able to start you on medication if they think it is appropriate and refer you to a psychiatrist or counselor if needed. Sometimes when a physician makes a referral, you can get in a little faster than if you call on your own because some specialists save space in their schedules for emergent situations, but they have to know from another professional that it is emergent so that the appointments go to the people who are really in need of them. 

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What happens when you go to an emergency room is an emergency psychiatric assessment.  They make recommendations, and these can include involuntary hospitalization (in not very frequent cases) if they determine that you are an immediate danger to yourself or to others. They may also recommend hospitalization, if you are very ill but not a danger to yourself or others.  Finally, in probably most cases, they recommend, and sometimes help to arrange, outpatient follow up.  

 

I will also chime in to agree that a basic medical check up is not only a good idea, but any psychiatrist worth her salt will not see you or prescribe medications for you until you have had one.  *Many* medical problems can have mental manifestations.  

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Well, I have an appointment for tomorrow afternoon.  It will be a regular medical appointment.  Before I called, I looked at the website and the behavioral health clinic is only open two days a week, so I couldn't have gotten in there until at least the end of the week anyway. So I just asked for a medical appointment to be checked for some health issues I have been having.

 

Since I will be there, I will go ahead and tell them about my other problems too. Inability to lose weight, digestive issues, hormonal midlife issues. I hope they don't think I am a crazy hypochondriac.  :eek:  I might be crazy but I am not a hypochondriac. :w00t:   I would rather do almost anything than go see a doctor.  :001_rolleyes:

 

I figure if they think I should see behavioral health, they can let me know and I can get an appointment for a day when they are open.

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Well, I have an appointment for tomorrow afternoon.  It will be a regular medical appointment.  Before I called, I looked at the website and the behavioral health clinic is only open two days a week, so I couldn't have gotten in there until at least the end of the week anyway. So I just asked for a medical appointment to be checked for some health issues I have been having.

 

Since I will be there, I will go ahead and tell them about my other problems too. Inability to lose weight, digestive issues, hormonal midlife issues. I hope they don't think I am a crazy hypochondriac.  :eek:  I might be crazy but I am not a hypochondriac. :w00t:   I would rather do almost anything than go see a doctor.  :001_rolleyes:

 

I figure if they think I should see behavioral health, they can let me know and I can get an appointment for a day when they are open.

Sounds like a good place to start.  Now sure where you are age/menopause wise but a good friend of mine was and now is a very even keel person and the hormonal changes in menopause made her almost crazy she said.  When she finally did go to the doctor, they were able to help her out and very quickly she felt much better.......and wishes she would have done it much earlier.  Getting a good physical and blood work......and telling your doctor is a great place to start.

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Yes, go to a regular md for a check up and they can give you an anti-depressant.  I couldn't afford counseling so I went to my pastor at church.  He knew someone who did pro bono work so now I have a counselor that I don't have to pay!  Most counselors/psychiatrists do some pro bono work, but you have to really dig. 

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CBT is one of the evidence based interventions for depression & there are some free CBT programs online that you can work through on your own. Might not be enough & you may still need a rx or a visit with a live counsellor but it's a place to start.

https://moodgym.anu.edu.au/welcome

Good for you for getting the help you need. This too shall pass - just hang on.

Best wishes!

 

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Definitely!  Write it all down and take the list with you.  I think you should be as thorough and honest as possible so the doc has the best/most information to work with.

YES, very important.  A list will help you remember everything and being honest is important for them to decide the best course of action.

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Thanks. We don't seem to have a county Mental Health Dept. Google just gives the clinics I mentioned. I think the clinics receive funding from health dept. (Maybe) but they have different names.

 

Yes I do need a total physical and blood work. Maybe I should start with a regular doctor. They could still prescribe meds if needed.

 

Hopefully I can get in somewhere this week.

I really think that (bolded) is a great course of action. You should absolutely have blood work (in my humble opinion) before seeing a mental health care specific MD... you want to know if there is a medical reason for the depression, because that would change the course of treatment pretty considerably, I would think. 

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Good for you for recognizing that you need help and taking the steps to find it.  This is the biggest step to take!  Definitely get a physical and talk to the doctor about what you have been feeling. It is the first place to start.  Yes, most doctors will prescribe anti-depressants but make sure who ever you see is experienced with them.  My doctor wasn't and it wasn't a good experience. I knew I needed help so I finally went to a nurse practitioner at a psychiatrists office who specialized in the medications.  She worked with me over several months to help "tweek" the medications until we found the dosage that was best for me.  She also followed me as I weaned off them a couple of years later.  I would also recommend that you try counseling since you have been bothered for several years.  I have been med free for 12 years now thanks to an awesome councilor who helped me learned coping skills.

 

 

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Wishing you wellness and healing! :)

 

You are worth it. The disease of depression tells you otherwise. You need to fill your life with brain transforming stuff: maybe an Rx, exercise, correct amount and type of sleep, quality food for you/your diet, mindfulness/meditation/prayer/gratitude. Working with cognitive thinking errors helps, too.

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Update:

 

The appointment went well. :). I need to provide more documentation to continue getting services on a sliding scale. I think it may be a possibility that I may not continue to qualify, but I will have to wait and see.

 

The health care workers were really polite and treated me well. I saw a nurse practitioner and she took time and listened to me and was really professional and not judgmental.

 

My blood pressure was quite high, which I expected. I just didn't expect it to be as high as it was. So I got a prescription for meds for that.

 

She also prescribed an antidepressant. I am starting out on a low dose. She did tell me that it could take several weeks to feel a benefit.

 

We discussed diet. I told her I had lost weight in the past but was struggling. When she asked what plan I had been on, I told her low carb. I don't always use the term Atkins because people have misconceptions and some people just think it is totally unhealthy. This can be especially true for health care workers. Well, her reply was " Yes, great! Atkins!". She was all for it.! She told me she had recently lost 20 pounds with Atkins.So she encouraged me to get back on track with that.

 

She so gave me some nonprescription ideas of things to try for my other problems.

 

No blood work yet but maybe at a future appointment. Not sure about that.

 

So I am at least on the road to getting better. I feel like I have some hope,at least.

 

Even if I have to transition to a non clinic, private provider, I can at least tell them what my meds are and have more information.

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