The reality is that it just IS.
There is a national shortage of psychiatrists; more than 1,000 jobs are posted for psychiatrists in Massachusetts alone; the majority of the available psychiatrists are over 50 years of age in the United States with and heading into retirement in the next 10 or so years. In addition to that grim news is that the insurance companies don’t reimburse at a rate that actually pays for psychiatrists. Those hospitals and agencies that understand the value of psychiatrists do so understanding that it is about patient care and generally lose money on the services that they provide. It is also why many psychiatrists have moved away from accepting public insurances, which just adds to the challenge of finding a psychiatrist that accepts your insurance.
Fortunately, there are other options. Psychiatric Nurse Practitioners (NP’s) are also able to help care for patients that are diagnosed with mental disorders and behavioral problems. These practitioners are often easier to access than a psychiatrist and are a great option for those that do not need an MD. Nurse Practitioners work at different levels depending on his/her training, education, certification, as well as state laws which dictate medications that can be prescribed as well as physician oversight.
While I encourage you to tell all young people that you know to look into the field, here are some tips to help you navigate the mental health system to get the care and medication you or your loved ones need:
Stay compliant with the demands of your mental health providers.
This is critical.
Practices have different processes in place that require you to do varying things for you to access medication. Here at Harrington, we approach mental health disorders and addiction therapy through multidisciplinary programs with a focus on the whole person – a complete continuum of care. This means that in addition to medication management we ask our clients to be involved in either individual or group therapy. Other practices require other processes. I hear all the time from patients that they get frustrated with one process or another and leave a practice only to realize that there are no other providers accepting patients.
Understand the amount of time that it takes to get your medication refilled.
It is imperative to read the fine print on how long an office needs to process a refill for medication. Many offices have a minimum number of days that they require to process the medication refills. This is not done to make it harder for patients to get their medication, it goes back to the shortage of psychiatrists and nurse practitioners and the demands placed on them. It is also important to remember that most practices do not work on weekends or holidays so you cannot count those days as ones that you gave the office notice to refill your medication.
Many times I hear, “The pharmacy faxed in my refill, why did the doctor not fill it?” Pharmacies are a business and often fax over refill requests well before the prescription is up for renewal. With the intensity of medications that are typically prescribed by psychiatrists and nurse practitioners, they are not inclined to give out medications early for the safety of the patients. I suggest following up with your prescriber’s office well in advance of needing your refill and not just relying on the pharmacy.
Check Your Voicemail
I cannot tell you the number of times that I have heard from patients that they were not notified of a task required by the Psychiatrist or Nurse Practitioner and this caused them a delay in medication refill, a missed appointment or even worse no refill of a medication. Many practices utilize an automated system of notification all which comes from numbers that you may not associate with your prescriber. Before you hit delete, I encourage you to listen to that message just in case! Also, make sure that the front desk has your correct phone number.
With startling data month after month about the rise in mental health and the need for addiction therapy services, psychiatry is not surprisingly a sought-after specialty; it speaks to the huge need for qualified people who are committed to the field of behavioral health. But the success of one’s treatment lies in both the provider’s dedication to care, and the patient’s dedication to the program.
Kelly Madden is the Director of Operations for Harrington Behavioral Health. She has been happily working in the mental health field for over a decade.