Monday, December 17, 2012


People are talking about mental health in this country. That is something I, for better and much worse, know a lot about. Get Well Soon, my first novel, was about a teenage girl hospitalized for depression. My newest novel, Have a Nice Day, follows that girl back to high school when she gets released. Get Well Soon is closely based on my own experience with depression and hospitalization in high school. The book was one of the recipients of the National Alliance on Mental Illness Ken Book Award in 2008. I was flown to New York City to accept the award in front of mental health professionals and the other award winners, all of whom were best-selling, award-winning, high falutin' scholars. I felt like an out of place child at the ceremony, not to mention the fact that I was eight weeks pregnant and could barely keep any food down. At the time, I didn't understand why my little YA novel would receive such a prestigious award. After years of receiving letters from teenagers about their own struggles with depression, or their friends' or siblings', I am starting to understand.

Mental healthcare in this country is complicated, expensive, and abstract. My stay in a mental hospital in high school cost $25,000 from my parents insurance plan. For some reason, all of the teenagers in the ward were aware of their parents' insurance plans. Most covered a standard $25,000 for inpatient help. That amounted to approximately three weeks, twenty-one days. Somehow "helping" me cost over one thousand dollars per day. There was a joke with the kids that one guy, the "lifer," had million dollar coverage. Ha? As an adult, I was occasionally told by those in the know that I made the mistake of using my health insurance to pay for my mental health care (anti-depressants, trips to my therapist or psychiatrist). I eventually found out that it was a mistake. When I left my job as a teacher, with comfy group health insurance, my family had to apply for individual care. I was grilled over the phone for hours by Blue Cross Blue Shield, the same company who covered me while I was employed for ten years, and emotionally stripped naked by some asshole who asked me question after question about my physical and mental history. I was told that withholding information would lead to automatic disqualification for insurance. What I was not told was that ANY admission of mental healthcare-- I'm talking your weekly chat with your social worker about how your boss is annoying-- was an automatic insurance red flag. No one would give us insurance because of it. We finally found United Healthcare, a very high deductible plan, to cover us, but with the clause that we could not use it for mental health care. We are grateful for the insurance.  But what happens if down the road, someone in my family needs more? Needs to go somewhere that costs $25,000? And that was twenty years ago. Who knows what the cost is now?

Good mental healthcare is important. I have received both good and bad care, met with quacks and idiots, those who wanted to help and those who wanted to bill me $200 for ten minutes and a slip of paper. It is hard finding trustworthy, talented, responsible mental healthcare workers. I am probably more cynical on that front than most; it's hard not to be when you've seen the number of incompetents I have in my life. It's just a damn shame that so many people can't or won't get help when they need it. A huge part of the problem is financial. Now, my family pays out of pocket when we want to talk to someone to keep stability in our home. If I am in a place where I need more, I visit my general practitioner or my OB/Gyne, both whom I trust immensely, to give me my prescriptions. I have yet to find a psychiatrist who fits that bill. My last one typed the entire time I spoke with him and still had important details of my life incorrect. I am glad to know friends and family that have found ones they can trust.

But this is all coming from a person who has gone through her life under the eyes of therapists, from parents who accepted mental healthcare as a necessity. Annoyingly, I still sometimes need a lot of help. And it's a shitty kind of help to have to ask for. Why would I want anyone to know the horrid places my brain goes to when it's not working right? If I'm scaring myself, what impact would that have on someone who loves me? It is even harder now that I have a child; every sick, selfish, deathly thought is reflected back at me through her innocence. Several years ago, a colleague of mine killed herself. After our staff met about the suicide, a teacher friend of mine came up to me, ripping with anger. "I can't believe she did that to her sons," she seethed. I didn't say anything. I knew how she could. I knew what she was thinking: that her kids, the world, would be better off without her. Moments later, one of the feelier teachers came up to me, hugged me, and thanked me for keeping going (referring to the depression I've dealt with in my life). It was touching and terrifying, so much to live up to.

I have unfortunate mental health genes; my family, both sides, is filled with bi-polar disorder, anxiety, depression, and suicides. I grew up in a complicated house, one that was at times very scary, and often unpredictable. Mental healthcare, when used wisely, changed that. Everyone needs help sometimes, whether it's a antibiotic or an anti-psychotic. If we don't admit that as a society, there will continue to be people walking around, bubbling inside with confusion, self-loathing, and fear, looking for some way to release it. I don't know what the answers are. But it doesn't sound good when someone who wants help, who has asked for it, has a red flag. Those who may need it even more don't stand a chance.


Anonymous said...

Julie, thanks for being so candid about your experiences. We have family members and friends who have been affected by this and it's important to discuss.

At the risk of getting political, I'm hopeful that the new Affordable Care Act will prevent experiences like yours when you looked for insurance.

I was so moved by this, I shared it on FB--hope that's okay.

Teenage Librarian said...

I know I've mentioned before how much I appreciate your openess in writing and talking about your experiences.

My younger brother is bipolar and a recovering drug addict (I don't know if I've ever mentioned it before, or if I have, you remember, because why would you remember what some commenter said on the interwebs..). Anyways, he's been hospitalized many times and, I'm sure, has quite a big file of mental health related issues attached to him. I worry about it. I worry about it following him throughout his life. I worry about how he'll be able to get insurance on his own, even though he has through his job and it makes me really thankful (that and he's still on my parent's insurance until he's 26, whew!). I worry about his medications not working anymore. I worry about him A LOT. But the biggest thing that I worry about is him being taken advantage of. The people who are trying to help him, aren't really and are just there for the money. I feel that way about mental health professionals and rehab centers. I feel like they've scammed him, my parents, and my entire family. But what other choice do we have? He NEEDS the help, so we keep looking.

Not sure why I wrote all this, but again, thanks for sharing. I honestly feel that if we talk about mental health (and drug addiction) more, the more we can help other people. :)

Julie H said...

Shari, I'm happy you shared it. "Happy" never sounds like the correct response to this stuff, though. TL, that was a brave story to share. I didn't quite know why I shared my story either, but I guess part of it is just normalizing the abnormal. Or something like that.

Megan said...

Thank you, Julie. Thank you for sharing your story, for keeping going even when it's tough, and for helping the world know what it can be like. I never understood until I had a situation-based anxiety problem that now makes me worry any time I start getting nervous, and makes me wonder if I'll be able to handle a full-time teaching job. Thank you.