A 12-year-old boy named Strazh hangs from the monkey bars, staring at the ground. The other kids in the park aren’t interested in him. And he’s not interested in them.
“I just like to play by myself,” he says.
Strazh has autism. Today is a good day. But on most others, Strazh has meltdowns. Something frustrates him and he can’t control his emotions.
“I sometimes end up screaming,” he says. “And I end up yelling and screaming.”
And hitting and banging things, throwing things, adds Strazh’s mom, Natalie Dunnege. As a single parent, she says she bears the brunt of it.
“He told me that I disgusted him,” she says softly. “He tells me he hates me.”
Dunnege puts all her spare money into therapy for Strazh. She says it helps a lot. But Dunnege herself is struggling, feeling depressed and overwhelmed. She decided to look for her own therapist.
“One of the things that I’ve really had to wrap my head around is that I can’t change him. I can only change how I handle the situation,” she explains. “And not that I would want to change who he is. He’s a really good kid, but it’s a lot to handle, especially as a single parent.”
But when she logged onto her insurance website to find a therapist, she realized her copay for a mental health visit was going to be upwards of $75 — more than double her copay for other doctors’ appointments. Under a 2008 federal mental health law, those copays are supposed to be the same.
“There’s no way,” Dunnege says. “It’s out of my budget right now.”
Dunnege lives in a one-bedroom apartment with her son and her father in San Francisco’s Haight district. Grandfather and grandson sleep in twin beds side by side. It’s an awkward walk past those beds to the only bathroom. Dunnege says $75 a week for therapy is impossible.
“My income, I just made lower-middle income. Just by the skin of my teeth,” she says. “So I just have to hold off until I’m actually middle class.”
More than 43 million Americans suffer from depression, anxiety and other mental health conditions, according to the most recent federal data. But more than half the people who felt like they needed help last year never got it. Even people who had insurance complained of barriers to care. Some said they still couldn’t afford it; some were embarrassed to ask for help. Others just couldn’t get through the red tape.
Recent health laws, the 2008 Mental Health Parity Act and the Affordable Care Act, were supposed to fix this. They require health plans to provide benefits for mental health conditions on par with physical health conditions. Under the law, insurance companies can’t charge higher copays or set up separate deductibles for mental health care compared with other medical or surgical care. They can’t limit hospital stays or require preauthorization for mental health treatment if the same limits are not applied to treatment for physical health conditions.
But advocates say insurance companies are still finding ways to keep people who need care from getting it. Some are still not complying with the law. And some have found subtle, technically legal ways to limit treatment.
Problems with mental health provider directories:
Dunnege encountered some of these barriers when she tried again to find a therapist. In the past year, she got a promotion at work and moved into a larger apartment. Her employer switched to a better health plan, too. Now she has Blue Shield coverage, and her copay for mental health appointments is only $20.
“Which I was really excited about,” Dunnege says.
But when she looked for a therapist who took her insurance, she struck out.
“I contacted six or seven,” she says.
Only three called her back.
“One of them, they were completely booked,” she says. “And then the other two just didn’t accept the insurance anymore.”
Zero hits out of seven. Had to be a bad draw, right?
To find out, we decided to conduct our own survey and called all the psychologists — 100 in total — that were listed on the Blue Shield website for Dunnege’s plan in San Francisco.
This article was originally published on Single mom’s search for therapist foiled by insurance companies