MH 101: Access to Care and Why or Why not?

Blog readers:

I’m writing this because I have a question and I don’t have an answer. As our country enters the process of health care reform, I continue to run into problems with the present system and questions about how we got here and how to fix it.

So here’s the problem: I have a client — a little boy who has been homicidal in the past (or maybe he just wanted attention) — who takes a certain med to help control his behavior. The med costs $180.00 for a one month supply and he’s on MassHealth of one sort or another. Mom apparently didn’t know there was a form to fill out, so her insurance (and thus, his) insurance ran out. Until his mother gets whatever it is straightened out, the boy can’t get his med. The pharmacy said that they can’t give him a partial to “carry him over” without cutting him off for the rest of the month because it’s a “controlled substance”. Mom doesn’t have $180.00 to buy a full month’s prescription.

I don’t know the specific med he’s on, but in the past, clients have abruptly stopped “simple” anti-depressants and went psychotic (an expected consequence of stopping it that way). This client is not on that med, as far as I know.

So here’s my question: If a person (adult, child, teen, whatever) and — through a paperwork problem — the client stops their med against their own wishes, and goes crazy/psychotic/something else, who is responsible for this? How did we get into this mess? More to the point, how can we prevent this from happening?

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One thought on “MH 101: Access to Care and Why or Why not?

  1. This is a sad state, agreed. I’ve seen this issue before, and I agree, you’re at a loss. A few questions/thoughts. Is there a generic of the med he’s on? If not, is there a comparable med that’s not as pricey? Check into the website of the maker of the drug. Sometimes they can help with script prices. Worste case scenario, if he becomes homicidal again, you pink slip him and help Mom work the process out while he’s in-patient. I wish there was something better, and I know that’s what you’re looking for.

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