Insurance/Medical/Mental Health Advice

[Airou]

Well some of you might remember what happened with my mom last year with her bi-polar outburst and hospitalization, she's much better now by the way. What this is about is now my brother, who's 18 and a Senior in High school, is going through something similar, but much worse.

My brother is a bright kid, rediculous gpa and had a ton of college and scholarships, and all of a sudden he began to breakdown, call it stress if you will, but he didn't work or have any other obligations and my parents were never hard on him to do well in school. He began to think there were problems were there were none, which led to speaking incoherently and losing touch with reality. He was admitted into the same psych center as my mom, he had some days where he looked and acted completely normal, only to regress shortly after. After 3 weeks he was closer to the normal side but was extremely anxious to leave and almost angry which was alarming to us and we didn't think he was ready, however the Doctor released him.

The first day he was ok but in the course of a week he began to get worse than ever, even on heavy meds he wouldn't sleep, speak incoherently, talk random things about religion which we don't really practice, began to worry thinking we were all suffering and eventually we took him back and began from square one.

Note: During that week we repeatedly made our concerns known to the doctor and all he would say is that he has the best available meds and that with a little luck and patience, hopefully he will get better, as if were supposed to just accept some crap like that. We began to think he threw in the towel, which is fine but help us find someone who can help him.

So back at the hospital, he's been the same if not worse, some days he doesn't recognize us and the doctor told us today he might release him any day now because "insurance company is pressuring him". What kind of shit is this? In his current state, my brother is currently unfit to function in society, one day in the week he was home his anxiety got to him and he picked up a knife and wanted to end his life, he didn't obviously but the doctor is seriously considering releasing someone in this state of mind? He hasn't been given an exact diagnosis and its been over 1.5 months, but they are treating for bipolarity, schizo, and psychosis.

My question is, how can a doctor release him, what if he hurst himself or someone, is there any legal action to help us here? I don't believe my bro will be like this for life but I find it impossible that everyone in mental institutes has family, and I find it impossible that those that do can all afford care.

If anyone has any helpful suggestions or things to add, it would be much appreciated

 

[Linhjah]

Tell the doctor flat out that he will have a malpractice suit on his hands should he release your brother because of insurance problems should your brother hurt himself or someone else; insurance should not be a factor when someone's life is in danger. Speak with the administration at the hospital and see if they can provide some sort of financial assistance or at least back you up that your brother does need to be hospitalized. Make sure that you guys are documenting everything just in case.

Good luck, Airou. Sucks, man.

 

[masterorion]

i dont know how hospitals work, however, i do work for an insurance company so i know that side. i highly doubt that the insurance company is "pressuring" him. if they are pressuing him, its because of his diagnosis. insurance is either going to cover it or not going to cover it. insurance companies dont care how long your in a hospital or the kind of treatment you get. its going to come down to what the dr bills and if the policy covers it and to what extent it covers it to.
i would say hes looking for an excuse to release him because there isnt anything else he can do in particular.

 

[bigbroon]

To reiterate what has already been said, I know nothing about either hospitals or insurance, but document EVERYTHING - phone calls, conversations, letters, emails, everything. If you have to pursue legal action, which I hope you don't, you'll need as strong a case as possible, and documenting these things will help massively.

In my current situation, though different, I'm currently in discussions with a Lawyer about a previous tenancy and the withholding of my deposit. I have some records of the correspondence, but some vital pieces are missing. With these pieces, I'd be guaranteed a win/settlement, but without them, it's going to be more difficult.

 

[Weiing]

I know this is a month later... I just don't check QCDN as often, especially the general discussion page. I'm wondering, how is he doing now? Got any updates on him?

Insurance companies suck in that usually they want to end treatment/services ASAP if they can, since they don't want to keep paying for long-term care for certain diagnoses. So in a way, I can see how your doctor said something about insurance companies pressuring him to discharge your brother. I don't know how your doctor is, or what kind of doctor he is for that matter, but I have come across many private practice psychologists/social workers who are really infuriated with having their hands tied by insurance companies.

From your description of your brother, it does sound something like schizophrenia or schizoaffective disorder. Obviously, this is only a guess since I don't really know your brother or how he's behaving in order to assess. His age of onset seems to be consistent with it, too.

I would agree to document everything that has happened...and make copies of all the paperwork that you guys have done, just so save your own butts in case you need them.

But like I said, I'm curious... how is your brother now? How is your family fairing? How are YOU doing?

 

[masterorion]

Insurance companies suck in that usually they want to end treatment/services ASAP if they can, since they don't want to keep paying for long-term care for certain diagnoses.

here is the problem with your opinion on this....when you pay your premiums for insurance, it goes to your employer to have active insurance. when claims come through, your employer is essentially the person that pays your claims. insurance companies only administer the insurance plan you/they are on. no money comes out of the insurance companies pocket.
i cant even begin to tell you how many times i have to tell this to people that want to complain about the injustices by insurance companies. HELL, most plans are custom made to suit the employer. they choose the benefits they want to offer their employees.
so, before downtalking insurance companies, you may want to start blaming employers first

 

[Airou]

Well so far, nothing bad has happened. My brother hasnt gotten any worse, but I cant say hes gotten much better. At the moment, he just seems overcome with anxiety, but not the kind of anxiety you get from being stressed over something going on at work, home ,etc. He invents odd things, or brings back random memories. Sometimes, he realizes he shouldnt be anxious and instead of saying something odd like he normally would, he just shuts up, but that anxiety is still there inside him.

For example, he repeats anything you ask him. If you say, How are you, he will reply "How am i? Im ok", for everything. You can even ask, "Why do you repeat every question", and he cant help himself and respons "Why do I repeat questions? I dont know".

You can see it in his face that he is always worried, and he paces around the house alot, he also has problems holding his bladder but I think thats a side effect of the meds. He continues to just out of the blue, tell us "I dont want you all to suffer for me", things like that just out of nowhere.

As for us, I think we're all starting to just deal with the possibility that he might stay like this for a long time. It just really gets to me, that no one can explain how this just happens seemingly from one day to the next, he never had a history of issues and was never on any medication, ever. He had his whole future ahead of him, scholarships that he worked his ass for, all thrown out the window. Those are the least of our worries, and I can understand someone breaking down from pressure/stress, but not like this. He's homeschooled now during his senior year, he will miss all of those activities, I just cant accept the fact that this is possible. Sometimes I wonder if its the medicine that keeps him like this, I dont really know.

 

[Weiing]

First: Masterorion--you bring up a good point that sometimes it is the employer who is to blame. I never really thought about that, so thanks for the other perspective/insight. I hope I didn't overly offend you or anything.

Airou-- I'm really sorry to hear that. Behaviors do seem peculiar. It also seems like he is somewhat aware of his condition. I'm not sure the extent of what was done when he was in the hospital and how much your family can afford. I'm talking like a thorough body exam and MRI/PET scan. Sometimes these things can happen out of the blue, as seems to be your case. It seems to me like there is some element of loss and grief of who your brother was/is, at this point anyway. Stay strong though! I hope that there is some light for you and your family. If not too intrusive for you and you want to talk more, can email me at [email protected] or AIM: catbisld or MSN: [email protected] Obviously, if you rather not, I can understand... I'd be like "who the hell is this random girl asking me about something so personal?" It's just that stuff like this strikes a chord with me and makes me want to help if/whenever possible. Regardless of your choice, I am sure your family can pull through this together! Best wishes.

 

[Acutie]

First: Weiing, damn nice choice of avatar.
Second: Damn nice choice of avatar.
Third: Dayum....

 

[masterorion]

First: Masterorion--you bring up a good point that sometimes it is the employer who is to blame. I never really thought about that, so thanks for the other perspective/insight. I hope I didn't overly offend you or anything.

Airou-- I'm really sorry to hear that. Behaviors do seem peculiar. It also seems like he is somewhat aware of his condition. I'm not sure the extent of what was done when he was in the hospital and how much your family can afford. I'm talking like a thorough body exam and MRI/PET scan. Sometimes these things can happen out of the blue, as seems to be your case. It seems to me like there is some element of loss and grief of who your brother was/is, at this point anyway. Stay strong though! I hope that there is some light for you and your family. If not too intrusive for you and you want to talk more, can email me at [email protected] or AIM: catbisld or MSN: [email protected] Obviously, if you rather not, I can understand... I'd be like "who the hell is this random girl asking me about something so personal?" It's just that stuff like this strikes a chord with me and makes me want to help if/whenever possible. Regardless of your choice, I am sure your family can pull through this together! Best wishes.

no insult taken at all. however, i wouldnt even blame it on the employer. its all about the provider. they would be the ones i would start questioning in my mind, first

 

[Illyria]

First: Masterorion--you bring up a good point that sometimes it is the employer who is to blame. I never really thought about that, so thanks for the other perspective/insight. I hope I didn't overly offend you or anything.

Airou-- I'm really sorry to hear that. Behaviors do seem peculiar. It also seems like he is somewhat aware of his condition. I'm not sure the extent of what was done when he was in the hospital and how much your family can afford. I'm talking like a thorough body exam and MRI/PET scan. Sometimes these things can happen out of the blue, as seems to be your case. It seems to me like there is some element of loss and grief of who your brother was/is, at this point anyway. Stay strong though! I hope that there is some light for you and your family. If not too intrusive for you and you want to talk more, can email me at [email protected] or AIM: catbisld or MSN: [email protected] Obviously, if you rather not, I can understand... I'd be like "who the hell is this random girl asking me about something so personal?" It's just that stuff like this strikes a chord with me and makes me want to help if/whenever possible. Regardless of your choice, I am sure your family can pull through this together! Best wishes.

The bolded part is what I wanted to comment on. I am that girl too. I went through some emotional issues a couple years ago and people would worry a lot about me right after it happened but not a lot of people but me and probably my mom remember what I went through. It's always good to check up on things/people/situations it shows the kind of person you truly are kind/caring/compassionate.

Take Myrrh's thread as an example for a few weeks it was a huge thread but it has died off now. We can assume he is getting back to himself cause he is still around posting stuff but who knows.

Sorry I know I am random.