What is an Occupy Healthcare post? If you’ve listened to any news outlet in the United States (and more than a few world-wide), you cannot have missed hearing at least something about the “Occupy Wall Street” movement. This is a movement that has many faces and many goals. And it is a movement of grass-roots frustration with broken systems that don’t seem to be getting any more healthy. Occupy Healthcare is a reflection of that frustration. And Occupy Healthcare is speaking to something that is deeply personal to me, both as a psychologist and as a health care consumer.
Let me say that I am not someone who normally thinks of myself as an activist. Frankly, I’m busy. I’m a small business owner, a mom, a partner, a member of a large extended family, a homeowner. My time is spoken for. So, while I financially support organizations that are working for social justice, I’m not necessarily on the front lines with my time. But, I know that unless busy people are willing to pause, to speak, to show up, then change will never happen. And I have dedicated my professional life to supporting health, not just mental heath. So now it’s time to put my time and my voice where my heart is. And I invite you to do the same.
A Little Bit of Personal History
Bear with me as I explore some of my personal history as a psychologist. During my training, I lived in a little academic bubble. Several of my practical rotations took place in university health centers. So if I had a patient who was coping with diabetes, I could consult with her primary care physician to help support healthy behaviors. If I was worried about another patient’s medication, I could walk down the hall and check in with the psychiatrist. We were able to work with our patients as whole people, not as separate body parts. I had no idea what a rare utopia that was.
Flash forward to my entry into private practice. Not only is there not a psychiatrist down the hall, but some won’t even return my phone calls when I try to coordinate care. I had to learn a new language to help my patients navigate insurance policies that placed mental health care in its own “benefits Siberia,” with separate deductibles, inexplicable co-pays, and confusing authorization regulations. Instead of working with a team that is focused on my patients’ whole health, I am on an island of “luxury” care. Patients who can afford to pay that separate deductible, or pay for out of pocket service, are allowed to ferry over.
Whole People Deserve Whole Health
This artificial separation of “regular” health needs and health insurance and “behavioral” health needs and health insurance is not simply a professional frustration. I have lost patients, folks who really needed service, because their insurance was so confusing or uncooperative that they just gave up. Let me say that again: many people who truly need mental health treatment are not receiving it because they either don’t have insurance, or they have insurance policies that create an unnatural separation between medicine that treats their physical bodies and medicine that treats their minds and spirits.
I was inspired to write this post when I read Dr. Ben Miller’s post exploring the idea that we have the power and potential to make treatment fragmentation a thing of the past. Because as I read his post, I remembered all the times that my patients have expressed frustration about having to be their own walking medical record. I remembered that a single question and answer session about the mental health effects of breast cancer generated nearly 1500 views in one day. I remembered tweetchats with moms facing post partum depression who had never been given an overview of PPD warning signs.
And as I remembered each of these situations, what hit me was this. We are whole people, with minds, hearts & spirits that are affected by what is happening in our physical bodies. Not only that, but the things that are going on in our minds, hearts & spirits are affecting our physical bodies. And when mental health is treated as a luxury health item, or a fringe issue, we all lose. We deserve better than that. We deserve whole health, in a system that integrates specialty providers with primary care providers. We deserve whole health, where mental health is recognized and discussed as regularly as diet and exercise. We deserve whole health, where seeing a psychologist is no more difficult than making an appointment for primary care.
So Now What??
I can hear someone reading this saying, “But I’m busy too. And changing the healthcare system is big and scary and frustrating. I think you’re asking too much.” And to that person, I would say, read this post by Dr. April Foreman and tell me that you’re not inspired. And once you’re inspired, I want you to find something you can do.
If you’re a health care professional, reach out to someone outside your office. Go out for coffee. Collaborate on patient care. Familiarize yourself with common mental health outcomes connected with your specialty. Know the warning signs of depression or anxiety. Make sure you have a trusted referral source for mental health (back to getting to know one another). Cross-train. I went to a patient-centered medical home conference for primary care physicians. I learned all kinds of things that I would have missed at a mental health training.
If you’re a health care consumer, ask your treatment providers to collaborate. Tell your internist that you’d like her to talk to your therapist. Ask your gynecologist for a referral to a psychologist. If that makes you anxious, don’t be hard on yourself. Treating our whole health has been stigmatized for a long time. But don’t let the anxiety prevent you from getting what you need either. Poke around this site or other mental health sites for some tips and suggestions on approaching mental health.
And for all of us, it’s time to reclaim our voices. Time to use our platforms. Time to make this a priority–even though we’re busy. I hope you feel free to share your action steps in the comments.