Why can’t mental health hours suit the mentally ill?

19 Mar

You know what really chafes my ass?

I’ve been without a psychiatrist since January-ironically enough, the last appointment that was cancelled was the day I found out my job was disappearing. My doctor had a heart attack-that happens, it’s terrible, I get that.

So I’ve had the option to go to a doctor who I’ve visited before and REALLY dislike, or nothing at all. I’ve been mostly ok, so I’ve ran with nothing.

However, starting a new job, and knowing the warm weather mania is just around the corner, and terrified that it will be even worse this year, I know I need to be seeing someone. Add in the blow to my ego, losing my job, and the fear that I won’t be able to support my family, and I know I need to talk to someone.

Feeling so completely isolated being at home with just my kids, who are slowly driving me completely insane, isn’t helping either. It’s so bloody lonely.

So I finally call, and ask, nicely, if I could see someone OTHER than the doctor who will only make things worse. I’m pleasantly surprised to hear someone callback.

“We have an appointment for you!” she says, happily

“great-I hope it’s for 4pm, since I’m starting a new job and can’t take time off unless I’m having a limb amputated.”

There’s a giant pause on the other end, then a song and dance about how the doctor doesn’t usually work that late (“She’s never here til 5″) and how, seeing as I’m a transfer from another doctor, she’s not sure….the implied message being, as always, that I should be grateful for what I’m getting.*

These doctors, they always talk about how important it is that you function as part of society, have a job, etc, but they fail to comprehend how their bankers hours can impact someone who has to be at their job. There seems to be a blatant disregard for the mental patient’s job or life. My previous doctor would routinely be late, and one day, after waiting 40 minutes (longer than I would ultimately even see her) I mentioned it. She replied “My time is valuable too.”

Like mine isn’t. Like my employer at the time allowing me what ended up being 3 hours off, with pay, wasn’t time that was valuable.

You can’t win. You want treatment? You better take our hours. But you aren’t better until you’re stable, holding a job, have some friends. How dare you try and exist as other people do. You’re sick in the head. You’re different. You’ll jump when I tell you.

It shouldn’t be this way.

*(granted, the woman said she’d check with the doctor, but come on. She only sees people til 4? Even those on disability have stuff going on during the day.)
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14 Responses to “Why can’t mental health hours suit the mentally ill?”

  1. Cynthia Page March 19, 2009 at 9:31 am #

    Had this happen so many times when I was working. Even now, I’m told when my appts with psychiatrist are, never asked. Granted, it isn’t *usually* as much of an issue since now I’m home and R can slip away, but it still bugs.

    All my call centre jobs I had to take unpaid time off. And beg in advance. And explain why I couldn’t manage my appointments to fall outside my hours. And, taking time off on a regular basis put me at a distinct disadvantage when other positions opened up.

    • thordora March 19, 2009 at 9:35 am #

      Yup. But it’s YOUR fault you can’t get promoted, or keep the job.

  2. Cerra March 19, 2009 at 9:44 am #

    Oh don’t even get me started. I’m sitting here, trying to see someone so I can establish myself as totally fucked yet again so I can put through my claim for disability and stop worrying about how I’m going to pay rent. Cause, the money isn’t there yet this month (but I’m only $40 short and child tax is out tomorrow, so I’ll make it) and I can barely leave the house to get milk on my own, let alone to try and work. My saving grace is that I do a damned good job with Clive and that I’m actually sleeping at night and spring is coming, which means that I’ll be too hyper to stay home, even though I’ll be having panic attacks the whole time I’m out. But my shrink hasn’t phoned me back since…November and I have my GP, my mom and myself phoning asking for that callback. Fuck Canada. Fuck the people who say “at least the healthcare is free”. As I’ve said before, nobody would pay for this shit.

  3. Quadelle March 19, 2009 at 11:20 am #

    Hours are definitely an issue. It’s often struck me as bizarre that clients are effectively prevented from achieving identified treatment goals because of treatment. I gather most psychiatrists here (Australia) often keep strictly business hours, although I know plenty of psychologists who work one or two evenings (or a Saturday morning) in an effort to be more responsive to client’s scheduling needs.

    On the flip side, my first student psychology placement was in an on-campus clinic where we were basically expected to turn our lives upside down to accommodate client’s schedules. For me this often meant two hours commute for one client contact hour. So it really sucked big time when a client would be a no-show, or cancel 20 minutes beforehand when I was already on-site preparing.

    My natural preference would be for working hours that did not include evenings, as I (like most people) would rather spend those with my family or friends. However, I expect that I’ll have at least one evening of work, perhaps even two if I ever go into private practice. But that’s a long way off given that I’ve only just started my third of four placements and plan to work in a team environment for my first three years at least.

    But lateness? Grr. Never a good thing. I hate being kept waiting when I have an appointment, so I work my butt off to keep my clients to time (keeping to a clock does not come naturally to me, it’s a very conscious effort). Mind you, clients sometimes drop a bombshell in the last five minutes of a session. Usually it’s something that can be scheduled for a future discussion, but occasionally some immediate measures are required that necessitate blowing the schedule to some extent. That’s where having another person available to call other clients and let them know of the delay is ideal.

    Congrats on the new job, btw! And I hope you do find a psychiatrist you click with – both in personality and availability.

  4. March March 19, 2009 at 1:58 pm #

    that is good enough to make anyone’s blood boil… and given that you have to deal with this more times than not, gosh it’s a great thing you’re not just flipping on them.

  5. la March 19, 2009 at 6:32 pm #

    Wait. She’s 40 mins late and instead of apologising she tells you to be grateful she’s here now? If her time is so valuable, she should make more effort to stick to her schedule.

    GRR.

    Anyway, hope you work something out.

  6. Jennifer March 19, 2009 at 6:34 pm #

    I don;t agree with them working banking hours at all. The psychologists I worked for several years ago, had evening appointments AND also worked either half or all day Saturday.

  7. Gwen March 20, 2009 at 7:52 am #

    The strange irony, of course, is that doctor is probably a working mother, too, trying to fit her schedule around her husband’s and their childcare needs and getting home in time to see her kids at night. Please don’t misunderstand: I feel your frustration, and when it comes to mental health, you kind of think, “Come on! This is too serious to leave be!” But it’s complicated, right?

    I really hope you can see someone, someone GOOD, soon.

    • thordora March 20, 2009 at 10:24 am #

      I suppose I look at it like this-those of us working crappy jobs are expected to work ANY hours to accomodate the customer-for silly things like phone insurance or cable. But yet, things like health, the expectation isn’t really there.

      And I”m happy with one day a week or every few weeks. I don’t need someone often. Just occasionally.

  8. EJ March 20, 2009 at 1:12 pm #

    But it’s not just about you “And I”m happy with one day a week or every few weeks. I don’t need someone often. Just occasionally.”
    Its a question about access for everyone and and everyone’s working hours.

  9. nursemyra March 20, 2009 at 8:59 pm #

    Thordora I’m sorry this is so difficult for you. Can I offload here a story that happened at work yesterday? Because I couldn’t sleep last night thinking about it.

    We admitted a new resident about three months ago who is recovering from serious complications of a leg injury. He’s a really nice guy and so helpful with some of the other residents including one old blind gentleman who he does almost everything for. He’s bright and intelligent and extremely likable and was becoming one of my favourites.

    a couple of weeks ago he began behaving strangely. He was talking too much and too fast, alternating between elevated and irritable and making plans to start a garden out the front of the building saying he needed 4000 bulbs to plant at the next full moon.

    I checked his notes from the previous hospital and there was NOTHING about a history of mental health issues. Called our doctor in and also spoke to his daughter and it turns out he’s been bipolar for years and it’s never been treated. It cost him his marriage, his home, access to his children, his career as a celebrity hairdresser….. he spent several years living on the street self medicating on alcohol. He has been involuntarily scheduled twice before for mania and after becoming stabilised he was released with NO FOLLOW UP.

    I’m so saddened and appalled that this lovely man has suffered needlessly and lost almost everything because our health system has let him down badly.

    Thora, delete this if it’s inappropriate for your comments section. I just wanted to offload and thought you and your readers might understand

  10. thordora March 21, 2009 at 3:15 pm #

    Myra-that’s exactly the problem. Instead of impacting the issue where they could help-at the outset-they wait until lives are ruined and they try and “fix” things, blaming the sick person when it’s difficult or doesn’t work.

    They don’t treat cancer like that. Why is mental illness so special?

  11. Caitlin March 22, 2009 at 1:56 pm #

    I’m not sure how the Canadian health care system works when it comes to defining a radius of how far you can go for a doctor and still be covered. The only thing that comes to mind is if you can find a good doctor with weekend hours, even if their office isn’t close enough to be feasible during weekday afternoon traffic. If you only need your doc once every few weeks, it might work better than dealing with the headache of taking time off from the new job and spending an hour in an overbooked waiting room.

    The only other thing that comes to mind would be to get in touch with a Canadian mental health advocacy group. My grandpa worked with the local and statewide chapters of NAMI and they had a resource list of providers who kept hours outside of normal business hours. He was in a fairly rural area, so his local chapter also provided transportation for people who had appointments at locations not served by public transportation.

    I hope the doctor will make an exception and see you after 4 or you can find a better doc who doesn’t allow the practice to get overbooked.

  12. West Los Angeles Chiropractor April 11, 2009 at 2:39 pm #

    I have read a few of your posts and they are all interesting and informative…keep up the good work.

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