May 17, 2008

Insurance company wants to push meds on depressed woman due to cost effectiveness

A mental health provider was kind enough to leave the below comment on my blog. I found it so unsettling that I want to put it front and center as a post. I personally feel that this mental health provider is an absolute hero for standing up for her patient the way she did. If only every woman with depression or PPD had a patient advocate like her!!! Please read and let me know what you think. (I just wish I knew what insurance company this was.....)

Anonymous said:
I am a mental health provider and very interested in the topic of postpartum depression/perinatal mood disorders - I have two children and struggled w/ postpartum anxiety after my first child.

This topic struck me today specifically because I "had it out" with an insurance company and their "clinical review counselor" today....

I have a client who is a 35-year-old woman who is moderately depressed, and trying to get pregnant. She is responding nicely to psychotherapy and wishes not to start medications because of her desire to become pregnant, and I support this as do her physicians. The "clinical review counselor" from her insurance company disagreed with me because meds would make her treatment progress faster and therefore cost the insurance company less -- he cited this new literature that you cite here in your blog -- I hadn't read it yet but told him that it was ridiculous to medicate someone who is responding to psychotherapy and who wants to become pregnant just to speed things up. It's not worth the risk, no matter how small. His only response was that it was afterall the patient's decision.

What annoys me is that if I were not one to advocate for my clients or one who was up on the research, I may have been swayed by this and felt pressured to lead the patient in that direction. In this case, I totally feel like I won though, especially when he asked me for the expected length of treatment; I said "6 months and if she gets pregnant she'll need to be monitored throughout the pregnancy and the postpartum period because her risk of postpartum depression is increased." He said "ok" -- NEVER do they say "ok." Their job is to limit benefits to save money - he clearly had no clue about perinatal mood disorders.

7 comments:

Pete Rahon said...

hi Kristin,

am sad to learn about your divorce, am a very sentimental person and I could hardly imagine why people have to break up after such long-long years of being together. People change and it is true you get fed-up. Even the Filipinas I talk to they would always tell me that they would always prefer to be away from the in-laws. Familial piety is one of those strong values systems of Koreans. Indeed cultural differences is such a big factor in the dynamics of relationships.

I hope you and your children are managing this situation well.

All my good wishes, and positive thoughts to you and your kids.

good wishes,
pete

camahdavi said...

Wow, thank you so much for posting the comment. Even though I live in Europe and have public healthcare (France and the UK), medication was always thrown at me first, rather than long term therapy, as it was easier and cheaper.

Kate said...

hi,

i was the original poster on that comment, i just wanted you to know which insurance company it was - Magellan - which actually handles the mental health benefits for a lot of major medical insurance companies -

thanks for thinking i am a hero ;) - your work makes you a hero too in my book - advocacy and education are so important in helping women overcome perinatal mood disorders (and prevent their re-occurrence)-

keep up the good work!

Kristin said...

Hi, Kate!

Thanks so much for your comment!

Hmmm ... Magellan, huh? I think I should get a group together from our PPD community and barrage them with letters ... It's really scary to think that they impact so many lives.

You keep up the good work too! You're awesome!!

Warmly,
Kristin

Kate said...

Hi Kristin,

I'd be happy to write letters, I am thinking, if I can ever get my act together (I have an 8 month old and a 4 year old that take a lot of my creative energy away from work right now) that I would like to start a psychotherapeutic group for PPD and letter writing could be an exercise that we could do towards the end (once the women have regained some strength), it could be a very empowering exercise.

:) Kate

ALilPixieDust said...

Doesn't that always seem the fact that pharaceutical companies would want to drug everyone because it's 'cost effective'. On the other end of that spectrum, some won't give us drugs because they want to run up exorbitant hospital and medical bills we can't afford. I am apart of a support group for mothers and it the subjects range from depression and anxiety to the worse bi-polor with schizophrenic tendancies. It's just sad how the suit coats and the white coats can't come together and just treat us. We don't want to be like this and we love our children like everyone else. We just need help. Thanks

Kristin said...

Thanks for your comment, alilpixiedust! I'm so glad to hear about the support group of moms that you're in. I think the more we talk about these issues in our moms' groups, on the internet, etc., the more we can create change.
Thanks for stopping by my blog,
Kristin