Chapter 26.

Introduction

Student Video Activities for Abnormal Psychology
true
true
You must read each slide, and complete any questions on the slide, in sequence.

Telemental Health, Crisis Care, and Insurance

Authors: Ronald J. Comer, Princeton University and Jonathan S. Comer, Florida International University

Photo Credit: Bloomicon/Shutterstock

Click the Arrow to start this activity

26.1 Telemental Health, Crisis Care, and Insurance

This video features three stories highlighting financial and logistical challenges people face trying to receive mental health care in the United States. The first segment looks at the lack of inpatient mental health services and the solution offered by one Texas county, where clinics provide urgent treatment and case management. The second segment explores the problem of access to outpatient mental health treatment, particularly in rural areas, focusing on the case of a young girl who receives telemental health treatment. In the final segment, the video shows the story of a family struggling with insurance issues and their inability to afford mental health treatment.

Telemental Health, Crisis Care, and Insurance

[MUSIC PLAYING]

NARRATOR: With a dearth of psychiatric beds across the country, the Center for Health Care Services in Bear County provides short term care for acute cases.

OK, we're just going to make sure you get help today, OK?

JESSE TREVINO: I'm a police officer with the San Antonio Police Department, and we just brought someone that was in crisis in for an assessment and treatment.

LEON EVANS: We at the Center for Health Care Services concentrate on the public safety net, assuring people that have behavioral health problems get to the proper level of care. Rather than taking people to jail or emergency rooms. Over 2,300 people a month are brought here to the restoration center.

DEMI MINTER: Tell me what's bringing you in today.

PATIENT: I've been suffering from depression for many years, and I'm at the point now where suicide is an option for me, and I need help.

JAMIE RODRIGUEZ: We provide our own medical aspects, as well, which is very unique to our center. And we're expanding that dramatically. And so they get a good workup. They gets stabilized to within less than 48 hours. And then because of the incredible wraparound services that this center has developed over the years, we're able to get them out into their proper place.

LEON EVANS: I can tell you that emergency rooms are packed with these folks who really don't need to be there—don't have medical problems, per se, but have these behavioral problems. So they end up in emergency rooms over and over and over again. Diverting somebody from an emergency room is probably going to save $2,000 to $4,000.

JAMIE RODRIGUEZ: We've been able to show that that criminal justice money—which can be readily obtained in a state like ours—can be channeled into mental health, and reduce the cost.

DEMI MINTER: I know people have a desire to live, and to go on, and they have hope that whatever they're going through or whatever has brought them to this point in their life, that there's some help. And that help us what we want to see. We see the lights come on in their eyes and it's like, oh, thank god. You know, they're feeling better and they're doing better.

LEON EVANS: You know, people are starting to understand that the mental health system—that these people need treatment, and we need to have earlier intervention and identification programs and treatment. So I'm happy that Bear County and The Center for Health Care Services has in some small part had something to do with that.

NARRATOR: More than 70% of Texas counties have no local psychiatrist. The East Texas Mental Health Authority in Burke uses telemedicine to bridge the gap between rural consumers and counselors.

KIMBERLY GREGORY: My name is Kimberly Gregory, and I'm Alicia Gregory's mom. For a couple of years, she had been struggling some with behavioral issues at school, so I came to the Burke Center to see if I can get help for her behavior and her mood issues that she was having. If we didn't have telepsychiatry at Burke, we would have to drive approximately two and and a half hours for Alicia to get the help that she needs.

MEDICAL WORKER: Hi, how are you all doing today?

KIMBERLY GREGORY: And so the Burke Center has been like a lifesaver for us.

SUSAN RUSHING: There's a real shortage of psychiatrists in Texas. Out of the 254 counties in Texas, 185 have no practicing psychiatrists, which makes telemedicine a great solution.

[MUSIC PLAYING]

Telepsychiatry, it's much like going to see a doctor in any other setting. You make an appointment and come to the clinic location, and when it's time to see the physician you go into the office, and the physician's there on a TV screen.

SRIDEVI VEMULAPALLI: So any mood swings?

ALICIA GREGORY: No, ma'am.

KIMBERLY GREGORY: They're still there, but you know, nothing where she's out of control. Actually I'm bragging oh her, because she really has been doing better.

SRIDEVI VEMULAPALLI: So a big change from a few weeks ago.

SUSAN RUSHING: It's really amazing, because it doesn't take too long into the session and you forget that they're on television. You're talking to them. So instead of paying doctors to get in their car and drive two hours away to a whole clinic, we were able to use their entire day seeing patients. And that's a lot more efficient, and it's great for the patients, because they get to see highly qualified doctors in their own hometown.

SRIDEVI VEMULAPALLI: I'm glad you're doing better. Keep on using your coping skills, because I think that's helping you just as much as the medicine, OK?

ALICIA GREGORY: Yes, ma'am.

SRIDEVI VEMULAPALLI: All right, well keep up the good work.

ALICIA GREGORY: Yes, ma'am.

SUSAN RUSHING: We have surveyed the people that we serve and 97% of them are very happy.

MEDICAL WORKER: Dr. V would like to have you back in two months.

KIMBERLY GREGORY: OK, thank you.

MEDICAL WORKER: See you then.

KIMBERLY GREGORY: Alicia is opening up. She's trusting more. She's even telling people that she can use her skills. And for her to come home, not fuss and fight, but actually do chores—oh my, we should have been here a long time ago.

NARRATOR: Like millions of Americans, this Austin family struggles with debt for mental health care, and goes without treatment when they can't find a provider who accepts their insurance.

IRENE GOOD: Hey, I was wondering if you're accepting new patients. Today I'm going to try to find a therapist that takes my insurance. No? OK, well, thank you for your time. I've seen a lot of not accepting new patients. But more often than not, it seems in the last couple of years it's been, the insurance just hasn't been accepted.

It seems like it used to be an easier thing to make a doctor appointment, have the insurance cover it, not worry about co-pays too much. But it seems that it's gotten more and more complex, and it's just a pain at this point.

MARK GOOD: Kind of give credit to Irene more on that, because she makes more of the phone calls, she's the more skilled at navigating that system.

IRENE GOOD: So I need to know if you accept Blue Cross Blue Shield. When we found out that the insurance wasn't covering the medication, it was like, it was really heartbreaking, because it's like, wow, things were finally starting to work, and now it's being taken away. You don't accept insurance? What is the out-of-pocket co-pay? Seriously?

MARK GOOD: So we haven't even started really on this one, right? Or is that the same?

IRENE GOOD: No. This is how much I've paid, and this is the balance.

MARK GOOD: Oh, OK.

IRENE GOOD: I've even had words with the insurance company before, and telling them, listen, if you do not cover this, I will end up in the hospital, and that is going to be more expensive for you. But the amount of upset that I had to get to get to that point was ridiculous. And to threaten that you're going to be institutionalized—it should never happen. Come here and get it.

MARK GOOD: With my job, my insurance is paid. So we use a program through the exchange to get coverage for Irene and the boys. And that's more than what we pay for our mortgage. So when you've got that expense just off the bat, it's kind of gotten to the point where we hope we don't get sick-sick.

I've had to cut the dog's hair myself because we don't like to spend the extra money. So she even suffers. I think that that is one of the big things when it comes to any mental issue, regardless of if it's, you know, something more severe or something just with a minor OCD, is that some people, with therapy, and with the right meds, can learn to get by. Others require a little more. Everyone deserves that chance, you know?

[MUSIC PLAYING]

26.2 Check Your Understanding

Question 26.1

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
Correct!
Incorrect.

Question 26.2

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
Correct!
Incorrect.

Question 26.3

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
Correct!
Incorrect.

Question 26.4

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
Correct!
Incorrect.

26.3 Activity Completed!

Activity results are being submitted...