Open Letter to My Local Mental Health Center

Prepare for some rambling…

When I first sought your  help in 2009, I was worried I would not be accepted because I was considered out of your cachement area.  As it turned out, CMHC’s could not deny Medicaid clients based  upon cachement area.  This is a good thing, because in 2009 you allowed me to start your Intensive Outpatient Program in Dialectical Behavior Therapy (DBT).  I attended five days a week, for three hour days.  I can honestly say that this formal introduction to DBT saved my life.

You brought wonderful therapists into my life, some whom I thank God each and every day for.  There are too many to mention just one, but each of the IOP therapists are very special to me.  They gave me hope when I had none and taught me the skills necessary to survive with bipolar in a unipolar world.  The IOP program was just the tip of the iceberg.

After graduating IOP, you wanted me to do weekly DBT classes.  I was working at that point again and had difficulty with coordinating my schedule.  I hopped around to a few different groups, and then I gave up.  I went back to seeing the pdoc at my county’s CMHC, and continued therapy with Goddess of Mindfulness.

For a few years, my needs were fulfilled at my local CMHC.  It wasn’t the same, though — the therapists were not as invested, it was difficult to get a med appointment where the pdoc didn’t continuously cancel.  It was a fight to get any medication change.  It was if I would just come in to get the rubber stamp and then would be sent off on my way.

In 2012, I had a major bipolar meltdown and came seeking help from you again.  I needed that Intensive Outpatient Program, I needed those caring therapists, and I needed the care that I knew my own local CMHC couldn’t provide.

I started IOP again, and stopped seeing Goddess of Mindfulness, instead seeing Marty for individual DBT therapy.  IOP was very different this time.  The classes were extremely small, participation was minimal, the therapists often didn’t keep the group under control.

The times had changed — there was no longer a ten minute break after every hour.  I don’t think the therapists realized how difficult it was to sit for 90 minutes without a cigarette or a soda or a break when you are in such a mind-addled state.

One thing for sure — IOP wasn’t the same.  It wasn’t as helpful, I didn’t feel as successful, there was not much group interaction or cohesiveness, and frankly, most of the therapists seemed bored, as if they lacked passion for the subject now.

I moved quickly through IOP this course and started just seeing Marty individually.  She was a very different therapist than what I was used to.  She called it like she saw it, and the way she saw it was often very different from my view of things.  After about a year of seeing each other, she announced to me that she would be retiring the following summer.  After that, her heart wasn’t in it.  She certainly didn’t seem to care anymore, and it was like she had given up on me.

I decided to switch tactics and go for a non-DBT therapist there at the center.  That was worse.  She seemed cold and unfeeling, judgmental even as I would describe what was happening in my life.  I started to avoid appointments, and go for long periods of time without checking in.

During a time of mini-crisis, I attended a “Building Structure” group in which you basically made plans for each day and the day after.  It was a very useful group for me and I went for three weeks, then graduated.

I ended up going back to see Goddess of Mindfulness after that.  I couldn’t afford it financially in my budget, so I had to take $15 out of each weekly allotment and put it toward therapy.  In my eyes, it was a good use of money that I may have just frittered away elsewhere.  It still didn’t add up to what Goddess of Mindfulness should really be paid, but I was beyond thrilled when she accepted my request to be her client again.  Over the moon, really.

And since my 2012 return to the CMHC, there has been Dr. Wizard.  I kid you not, the man is a genius when it comes to medication.  He listens, makes small adjustments, is encouraging, worries that I am on too much medication, and, here recently, hospitalized me when it seemed to him like I was under too much duress.

I have never had a problem getting in to see my pdoc, and I thank the wonderful front desk staff for that.  Sure, calling the nursing line works sometimes, too, but the front desk staff are better at prioritizing clients and slipping people into time slots quickly.

When I came out of the hospital on Monday, I was in a daze.  I knew they had started me on a downturn of Geodon and had started me on Abilify, but I wasn’t given any titration recommendations.  I was just told to follow up with my pdoc at my next scheduled appointment on July 9th.  That was three weeks away.  I was feeling a bit better, but as a couple days went by, it was clear I needed more  support, possibly more medication.

On Wednesday, Goddess of Mindfulness had me call the CMHC to try and get an appointment.  I called the nurse’s line first, and left a message.  They called me back thirty minutes later and tried to tell me that there were no openings and I would have to “sit tight and wait” until the 9th.  The woman I spoke to barely spoke English and I actually ended up screaming into the phone, “I hope I don’t flip out before then!” and hanging up on her.  I know, real classy, Rose.  I’m out of my mind, I guess.

I then tried calling the front desk and asked to be put on the cancellation list.  I explained my situation and I was put as an “emergency priority I.”  I told them I only needed one hour’s notice and I could be there.  The front desk girl assured me I should be able to get in soon.

Much to my surprise, I received a call at 9:15 the next morning, asking if I could be there by 10:30.  Of course I can!  I made it down and Dr. Douglas kept the Geodon the same, but bumped up the Abilify.  He said, if all goes well, we can do it again at my next appointment on July 9th.  He was very understanding and caring, and we had a nice chat.

All in all, this is a good CMHC.  I think the DBT therapy program has possibly fallen by the wayside a bit, and I can tell you that the individual therapists like my last one should be fired, but what I really need is my pdoc and Goddess of Mindfulness, and I know I will be fine.

Advertisements

5 thoughts on “Open Letter to My Local Mental Health Center

  1. What a great letter!

    I never went to the classes for DBT, which may be why I have trouble incorporating it still. Maybe I need to look at that, just to see since it seems it made the biggest difference to you (when facilitated correctly).

    ((hugs)) It’s great that you shared this, especially so people know it is Ok to look for the right fit and not to settle!

    Like

    • I’m glad there’s some value in all this babble. 😀

      If you want to do DBT, you really MUST do the classes. This stuff can’t be learned by going to therapy and it can’t be learned from a book. Yes, it’s group therapy, which can be kinda meh, but I really think it’s crucial for the experience. And then to also follow up with a counselor trained in DBT, ideally.

      Damn skippy! I’m gonna keep looking for what I need and not settle. I settled for too long with Marty and with my local CMHC. No more dicking around — it DOES damage your mental health!

      ((hugs!))

      Like

  2. Good catharsis, to get ‘er out there Rosa. Bird Woman and I bemoaned the mental health and insurance issues of the eighties. Only got uglier after that. And many formerly “good” therapists went down the tube along with it.

    Yer Goddess of Mindfulness has been rockin’ our world for coming on toward two decades. And thank you Baby Jesus for a pdoc who is hella old, and still is on game. Two very importante pieces of the puzzle I am most thankful for.

    Know it, own it, and fight it. …XOXO

    Like

  3. The right doc, the right therapist, the right meds, and the right kind of therapy all add up – and if any piece of that isn’t right, you can end up totally screwed. Been there, won’t do it again.

    Do you know if your doc’s intent is to get you completely off the Geodon?

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s