29
votes
How US insurance companies fill their networks with ‘ghost’ therapists
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- Title
- Out of 400 therapists in Washington, why just 32 confirmed openings for new patients
- Authors
- Michelle Baruchman
- Published
- Oct 3 2023
- Word count
- 2302 words
Yuck. Right when someone might be the most vulnerable too.
In my personal experience making dozens of calls, only one therapist sent a warm "so sorry even waitlist is full" email. I still think about that super nice lady and how fortunate her clients are. Maybe it only took her a few minutes but I really needed that at that point in time to keep trudging through.
I hope we all encounter kindness like that when we need it, and that we could be a source of it for someone who might be in need.
This was my experience as well when I was still with Kaiser. I technically could get a therapist, but I would either be seen once every 8 weeks, when I have a condition that requires much more work than that, or I could suffer/try their "partner therapist program" and see a therapist that's contracted with them. I called every single therapist on their contracted list that even remotely handled my needs, and one got back to me and told me they weren't accepting patients and didn't understand how they even got on the list.
I have different insurance now, and it pays the therapists much more, but I still only get 40 minute sessions, at least I can see a therapist/psychiatrist weekly, however, it's all virtual now, and my doctor isn't in CA so I am struggling getting my medications filled now, because of the Adderall shortage. And there aren't any partner therapists/psychiatrists who can write for her to get me my medication.
Kaiser is terrible for mental health. There were strikes of Kaiser mental health workers because of it.
They meet my complex physical medical needs effectively for inexpensive cost but I have a diagnosis.
They wouldn't diagnose me with obvious medical issues because they're expensive to treat, and as a result, I got a lot sicker.
Yeah, I was fortunate. They did diagnose me but I understand that that doesn't always happen.
I'm glad they diagnosed you. I think it's important to celebrate the wins.
I am so sorry that happened to you. I hope you're doing better now.
Your story is just another reason I'd rather go into medical debt than die waiting for Kaiser.
I am doing better, I finally have a chronic pain management team that is doing their job.
That's actually better than when I needed help through Kaiser, though to be fair, that was something like 20 years ago. Back then I think the only options were group therapy and psychiatrists who would just prescribe you pills. They also had all of their mental health offices in separate buildings which were inconveniently located.
I haven't really looked into them but I know they have definitely made improvements since they have been doing a lot more holistic health inititives. My local clinic has mental health offices in it, and they offer some more lightweight tools like life coaches and free subscription to mental health apps. I couldn't tell you about access to therapists, though.
To be honest, if things don't get better soon I'm probably going to be doing a lot more looking into it....
A lot of the free tools they provide are very invasive with your phone privacy, just be aware of that.
The #1 thing insurance companies could do to improve mental health accessibility is to raise their reimbursable rates for therapists. They pay a pittance compared to private-pay patients, usually under $100/hr and sometimes well under that level. This severely diminishes the number of therapists willing to see clients paying via insurance; any given therapist will usually prefer to fill their timeslots with higher-paying clients than lower-paying ones, and making an equivalent amount on insurance rates can mean longer hours, less time dedicated per patient and extra billing hassles getting that reduced sum in their pockets.
I assume that also means that the population receiving therapy are people with more income and less problems that need fixing.
More income, sure, but money only solves some problems. When you take away stresses from income issues, overwork, etc, you're left with various sorts of trauma that remain problematic no matter the income level of the person experiencing it. Plenty of screwed up rich people out there, the worst of which think that material success is a demonstration of how they've overcome all their issues.
Could you expound on this for us? Presumably there is a relationship between income and happiness, but I’m unfamiliar with a relationship between income and problems that need fixing.
Are pediatric oncologist immune from anxiety or depression? Public defenders? Offshore oil rig workers?
Yeah I don't really know - I've only lived one life. And perhaps the problems that come with poverty aren't addressable through therapy?
I've been to therapy before - even when making much more money than I need. But I always wondered about my small problems vs. the problems other people are facing. Still, I kept going because I wanted the problems fixed. Problems that get severe enough impact your income and then you're priced out of most therapy.
Therapists always kind of assumed by default that my anxiety was financial in nature. I'd ask why I felt so anxious as an adult and they'd respond with how now I need to pay bills, secure food and shelter, etc. But that's not an issue for me at all. I'm now pretty sure it's largely genetic and have realized my mom's behavior is indicative of persistent anxiety.
I'm just another untrained idiot on the internet, so take this for what it cost you...
Mental health care lags far far behind physical health care. For the most part we're still in the dark ages when it comes to identifying and treating mental issues. Some mental health care modalities work for some people some of the time. My biggest learning thus far has been to keep an open mind and be honest with myself and my therapist du jour when it is and more importantly when it is NOT working for me.
Your brief post resonated for me re: anxiety and being the child of parents suffering from anxiety. I'm definitely reading things into your post from my own experiences and almost certainly some of that is way off base.
What's been helping me of late has been "Parts work" (see "No Bad Parts" by Schwarz - tons of great youtube videos too). The basic gist as I currently think I understand it is that when (especially as children) we experience an event (more frequently repeated events) that is sufficiently painful and overwhelming in that moment, your brain kinda fractures and creates 'parts'. Many people are living with these parts in varying degrees of obliviousness. I think a pretty common 'part' is The Critic - that voice in the back of your head telling you're doing it wrong and you're a bad person for doing it wrong, and seriously? you should be ashamed. Terribly terrifically ashamed. My Critic part is a pretty big source of my constant anxiety issues. Parts work encourages you to identify, engage with, and ultimately empathize with these 'parts' as though they were separate individuals from your "Self". From there you can learn to recognize when they take over in any given situation, develop skills to engage with them with kindness, and reduce the negative aspects of their engagement.
Somewhere in all the above real, significant change has been possible for me, and now I want that for everyone else on the planet too. YMMV, but I wish you as much peace and joy as you can wrap your arms around in this life.
Thanks! I've actually made a lot of improvement on my own inner critic. I also do plenty of exercise, something my parents never made a priority, and that helps a ton. Add on some magic mushrooms and cognitive behavioral therapy and I'm much better off today than I was 10 years ago.
They don't want to do that. Undermines their business model: Charge as much as possible, pay as little as possible. You're not their customer, your employer is. They don't want you to see a doctor, that's part of the reason co-pays are a thing. To add just enough of a barrier to discourage someone from seeking help for a non-emergency.
They're not in the business of actually providing care.
Medicare pays doctors more than almost every insurance company. It really highlights how much of a sham the whole private insurance market is.
Honestly we'd be so much better off if health insurance was illegal and everything was just the raw cash price with a margin on top.
I'd prefer government healthcare but pure capitalism would be such an upgrade over this shit.
I mean, proper health insurance, say covering cost of a cancer treatment, makes some degree of sense. For the same reason auto or home insurance makes sense.
But yea there's no reasonable excuse for the state things are in. The quickest route to fix would be the simple public option...let everyone choose to opt-in to Medicare. That'll be the kick in the ass insurance companies need to reform or die.
But that's exactly why that had to be gutted from the ACA. Would have undermined the entire rest of the bill lol.
I agree, but I feel like the tradeoff would be better. If somehow it was politically viable I'd vote for it.
And then once you end the regime you can sneak health care back in as a government service without any incumbents to lobby against it.
I recently went through the process of finding a counselor and it took me 5 places to find some that had openings. They all responded to me and let me know that they didn't have any availability, and one of them actually gave me the name of the place I found to see if they were accepting patients. it only took a couple weeks to get a call for an appointment..that we booked a week out. Certainly not the same experience other parts of the country have.
It's also so hard when everyone is going virtual because they can't afford to continue practicing in person.