insanity: the journey or the destination?

Originally Posted by russotto

If you're nasty enough to deal with or have poor enough personal hygiene , there's some incentive to pronounce you cured (or incorrigable) and in no need of further therapy.

Don't forget the part where if your insurance runs out you suddenly acquire brand new coping skills over night. If you want to be crazy these days, you better have some bucks or else resign yourself to a life of sanity.

[wolf]

I'm not able to turn away the folks with the poor personal hygiene.

In fact, just this evening, I advised the incoming shift to "break out the Air King."

And we do find people not in need of treatment. Yes, It really does happen. In the real world, therapists with weekly clients do even sometimes reach a point where they are able to end treatment, and not just because the insurance company won't pony up the bucks for treatment. I'm not saying that anyone actually gets "cured" but they do get "better able to handle things on their own."

These, however, are not the folks I typically end up dealing with.

[wolf]

There is more than one way, Mari, to get treatment covered.

Many of the folks I see are uninsured, or just have medical assistance. We apply for MA for patients who don't have any coverage, and if that falls through we apply to the county. If an insurance company refuses to admit someone we feel needs admitting, we tell them we'll appeal and admit the client anyway. We also don't discharge at the behest of the insurer. They aren't treating the client. We are.

We eat about $1 Million a year in unpaid services.

We also don't bill line item for things that most hospitals do ... like medications (yes, even the really expensive ones), meals, linens, physician and psychologist sessions, medical care, dressings, popsicle sticks for activities projects, etc. Our posted day rate is around $1,000.

[ladysycamore]

marichiko wrote:

Don't forget the part where if your insurance runs out you suddenly acquire brand new coping skills over night. If you want to be crazy these days, you better have some bucks or else resign yourself to a life of sanity.

Damn I kinda feel guilty...my Medicare and Medicaid took care of my therapy visits. But yeah, I have to agree with you because if they didn't cover it, I certainly would not have gone.

wolf stated:

In the real world, therapists with weekly clients do even sometimes reach a point where they are able to end treatment, and not just because the insurance company won't pony up the bucks for treatment. I'm not saying that anyone actually gets "cured" but they do get "better able to handle things on their own."

Precisely. That's basically what happened to me. I had just reached a point where his services were no longer needed.

Originally Posted by wolf

There is more than one way, Mari, to get treatment covered.

Many of the folks I see are uninsured, or just have medical assistance. We apply for MA for patients who don't have any coverage, and if that falls through we apply to the county. If an insurance company refuses to admit someone we feel needs admitting, we tell them we'll appeal and admit the client anyway. We also don't discharge at the behest of the insurer. They aren't treating the client. We are.

We eat about $1 Million a year in unpaid services.

We also don't bill line item for things that most hospitals do ... like medications (yes, even the really expensive ones), meals, linens, physician and psychologist sessions, medical care, dressings, popsicle sticks for activities projects, etc. Our posted day rate is around $1,000.

Your facility sounds more humane than many, and if you are in the Philly area you also have the good fortune to reside in a state and a county that are somewhat more generous about funding services for the working poor/uninsured, etc. Colorado is not only an extremely conservative state (it really is, Wolf, influx of yuppies to Vail and Aspen have hardly made a dent in the political scene here), but once outside the metro Denver area, the various counties lack the population and/or the desire to fund medical services for lower income people. I, personally, have seen some tragic cases as a result.

[Troubleshooter]

Originally Posted by wolf

We eat about $1 Million a year in unpaid services.

Nobody eats anything anymore, it has to come from somewhere.

The bottom line is usually the tax payer in some way or another.

[wolf]

No, I really mean EAT. That's totally unfunded care, the leftovers after we do medical assistance apps and apply to the County for funding. Charity cases, if you will, although we don't call them that.

I'm in a private hospital, not a county or state agency, which is what you may be confused about. Some days we're just a little more not-for-profit than others.

[Troubleshooter]

Originally Posted by wolf

No, I really mean EAT. That's totally unfunded care, the leftovers after we do medical assistance apps and apply to the County for funding. Charity cases, if you will, although we don't call them that.

I'm in a private hospital, not a county or state agency, which is what you may be confused about. Some days we're just a little more not-for-profit than others.

Something that makes me wonder about is where they get the money to eat though. You can't just pull medication out of your ass for these people. It has to come from somewhere.

Of course there is credit and state/federal loans...

[Trilby]

[quote=jaguar]Serious depression and panic attacks for two years, worked though the causes and they went away.


When you have a pain attack in a natural environment, with friendly people, let me know. We've created environments that aren't good for us, we live in ways that stifle our minds and then we wonder why some crack like a fucking egg. You've been on drugs for long enough it would be hard to say whether you're really in a position to judge what normal emotions are anymore.[QUOTE=jaguar


Jaguar--I suspect you are a relative youngster? I used to feel that way, too-while in my early 20's, mid-thirties. I felt that most people who went the "depression/anxiety" way were mentally lazy or just defective. I had pulled myself up out of the Abyss-why couldn't they? I now have my comeuppance! It seems to just get harder the older one becomes and whether that is due to the brain chemistry changing even MORE or different expectations, I don't know. I have panic attacks when I WAKE UP IN THE MORNING! No fluoro lights, stress, crowds-just me and myself. Why should I freak out upon wakening? Unfortunately, I cannot take benzodiazepam's (Ativan, Xanax) so I suffer. There are some meds that help and I wouldn't want to think of where I'd be without them. They don't blunt my emotions-they keep me from sticking an axe in my head.

[jaguar]

Well, you're probably half right but I go the feeling your begin here was to do with the fact you were deeply dissatisfied and unhappy with your situation, that might be the other half. Hypotheticals are the bane of rational argument but do you think you'd be in the same situation if you were in a happier, more fulfilled situation?

[Trilby]

Maybe it would be a bit better if I were in a more satisfying job, but I was diagnosed at age 13--so, it's sorta there.

I am doing some things for myself, though. I am going to (gasp!) waitress and go back to school. You'll think this is a hoot but I want to be an (ahem) English Lit. teacher! Nurisng couldn't be further away from where my passion and talent live. I know it's supposed to be wonderful, soul-nourishng work, but after 10 years as a nurse (and 8 as an Xray tech) I am so sick of sick people I could (and sometimes do) cry. I just can't seem to build that necessary firewall anymore, y'know? I was getting supremely affected by my environnment and my patients. No perspective, ya know? I would come home and cry or sit in anxiety-ridden panic; not eating, not sleeping--just freaking. The meds are an enormous help. It has to be chemistry.

[xoxoxoBruce]

Brianna, did go into nursing because you weren’t aware of any professions that would encompass the things you really enjoyed?
Those of us that grew up before internet/400 TV channels, were pretty much at the mercy of guidance counselors , unless we were privy to specialized publications or knew somebody that knew somebody.
Also pressure from family and scholarship providers, to pick a profession they felt was socially acceptable and/or lucrative enough to support ourselves and repay loans.

[Trilby]

Yes, pressure from family. My father would pay for school but only if he got to choose the field. Being breathtakingly lazy as a teenager instead of researching my options for grants, loans, etc. I just went with it. He really did not so much pay for my education as invest in his own future--he's got three care-takers in the family and he is counting on us in his old age! Sound cynical, bitchy? It's the truth. Yes, I didn't have to take his handout (see: lazy) but I am paying for it now.