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:
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.
All user-generated information on this site is the opinion of its author only and is not a substitute for medical advice or treatment for any medical conditions. Members and guests are responsible for their own posts and the potential consequences of those posts detailed in our Terms of Service.
Add a Comment6 Comments
I made the comment on 10 November, and would be interested in knowing the other therapist's experience - specifically what insurance company it was. My call was also from a "clinical review counselor". Was it the same company? I have never received a call like that from another company and am still taken aback that they would think it was ok to pressure the therapist to push the client towards meds. I think it is not only inappropriate, but unethical and possibly illegal.
November 13, 2009 - 5:22pmThis Comment
Kristin, this is fascinating (and worrisome) to me. Especially because depression medicine is not cheap!
I never understood before what the mechanism might have been that had so MANY people on anti-depressants. I am fully in favor of medicines for those who need them and I have taken anti-depressants in the past with good results. So I'm not at all against them. But I just never understood the statistics before this.
Sadly, they make perfect sense now. If putting people on medicines cuts costs and thereby increases their profits, of course insurance companies would push it as a solution. I hope anyone who feels that they truly need psychotherapy but have been given a brush-off on their way to antidepressants will be able to have another talk with their doctor, or even seek a second opinion if that's called for.
November 11, 2009 - 9:47amThis Comment
I am a mental health professional and just today got a call like that from Aetna, wanting to know why my depressed client isn't on meds. I stated not everyone wants that. It's also not in my scope of practice to tell a patient they need to be on meds. I can refer them to be evaluated for the possibility of medication, but not say, "you need to be on meds". He lost interest when I stated my client was done with therapy. Clearly, he was interested in saving the insurance company by pushing depression medication!
November 10, 2009 - 2:44pmThis Comment
It sometimes is easy to read the wrong type of emotion into comments - a good lesson for all of use!
May 17, 2009 - 2:33pmThis Comment
I am sorry anonymous I misunderstood what you were saying an am quite embarrasses. Sorry
May 23, 2008 - 12:53pmThis Comment
Kristin don't ever stop being advocate for your clients, It is only because of people like you that set the standards higher and changes happen. I have a doctor, my OBGYN who I first met due to a miscarriage that I had. The way she showed how much she really cared provided me with the comfort that I needed at the time. So needless to say she became my permanent doc. She worked with my husband and I for a year to get pregnant,(funny how when you don't try it happens right away). The day that i was to start clomid I had a urine test that came up negative, but I asked her just to be safe could she do a blood test. Low and behold I was about 3 days along per my HCG levels. It doesn't stop there though because when I was in my last trimester I kept cramping and feeling fluid leaking, but the other doctor (more experienced no bedside manner) kept sending me away. Finally my Doc had me go to the hospital did test and by her listening to me not her supervisor, she delivered our 8 month old 3 weeks early. The umbilical cord was so tight around his neck that she could not get her fingers under it to cut the cord, not to mention they almost lost him because he became stuck in my pelvis, But the blessing of all thus us that there was only about 1/2 oz of amniotic fluid left in my womb. If he would have gone full term like the non bedside manner doctor wanted my son would not be here today.
May 23, 2008 - 11:16amAlso since I am on a role,I am so tiered on my doctors always pushing anti-depressants on me when I know that I clearly do not need them. I personally believe that in a lot of cases doctors use anti depressants as a band-aid rather then digging to the root of the problem and healing from the inside out. I absolutely also believe that medical professionals are hero's to their patients and they are much more than that when they listen to the patient and how they are feeling. I myself deal with acute anxiety disorder caused from ADHD. So no instead of have two pills to control my symptoms I am required to take Wellbuterin just so I can take a medical that controls my anxiety. Oh an this is the best part it isn't even Xanax (spelled wrong) it is a prescription that can be refilled with out having to get a new script every time due to it being a narcotic. So instead of her just listening to me and giving me the meds that I have always taken she was to experiment on me. I truly do not know if this even relates to this post, but what struck me as rather rude is the way she almost accused Kristin of not caring about her patients as she stated, "The author gets irritated because she was not to
advocate for her clients, then she have been persuaded
by this and felt squeeze to take the patient in that direction."
To Anonymous, I want you to know that I do not even know Kristin but I felt impelled to fight off the bully meaning you. I do not want to sound rude, but since you can dish it you can take it. You should really keep other people's feeling in mind when posting
This Comment