Letter to my boss

The purpose of this communication is to dispel any concerns you may have of late about my performance. Believe me, I have been discouraged many times to be so open and vulnerable in a professional setting. My hope is that you hold up your end of the bargain in telling me your company sees employees as people and not machines that are replaceable at the first sign of defect.

You see, I am fighting for my very existence as we speak. Every moment of every day, I am holding onto what I can in a tsunami of depression, and at the same time trying to recall what the standards of proper financial statement presentation is. My mind is flooded with thoughts like “I just want to disappear” and “I hope my job can survive this time.”

I promise I had all the best intentions and gave my honest assessment of how strong of an employee I was when I interviewed four months ago. It is just, two months ago, I was ushered into a doctor’s office and given grave news that I am still processing. The life-saving medication I had taken every day religiously for seven years was no longer an option and I was given two weeks to sort out what my future plan of survival would be.

Ironically, health insurance companies do not operate that quickly. They want to know all else failed for six months prior to approving the best and most effective treatment. I don’t fit that category. I was doing well on an unconventional drug that is not in their list of “try this first.”

But I digress into my own woeful experience. Back to what matters, and that is how is this going to impact you. I’m stuck in trying to explain how my brain is in complete dysfunction. First, my memory is shot. I know I passed all four exams for the CPA on the first attempt, something only 5% of accountants can accomplish. But I feel like none of that or the decade of experience is accessible right now. I forget to write an email moments after discussing it. I can’t remember how to format a document after a two hour training. Second, my concentration is infantile. I struggle to even remember what I needed to say in this letter. Finally, my energy or drive or motivation, however you want to call it, is at an all time low. You know how an overweight person gasps for air after climbing one flight of stairs. This is how my brain feels after one 30 minute meeting.

So, instead of doing what society says I should do, and “faking it til you make it” or just staying positive, I am sending this letter to ask that you please let me be a human and just suck at my job for a little bit. Let me be forgetful, and unfocused, and tired. Let it not matter until the insurance approves the treatment I need.

Because I am a life and a human and i don’t know that I can do even that right now. I know I haven’t proven my worth to you yet, but just wait and I’ll show you someday it was worth it.

Sincerely,

Someone who wishes I could actually send this letter to you

Letter to my boss

When Dreams Are Too Big

I started back down the path of learning how to get my dream of building and operating a state of the art, comprehensive, revolutionary mental health facility going once again. Looking at average salaries, I added up the cost of a core staff (2 doctors, 4 counselors, 33 nurses, 42 mental health techs, 10 kitchen workers, and 10 admin) and wow.

$5,472,000 in labor costs not including benefits. That is every year!

We are not talking about occupational therapists, or janitorial staff, maintenance workers, or accounting/billing department.

Excuse me while I look up contact information for every celebrity I have ever known. I honestly don’t know how this can be done. But I know big things can happen when you start small. At least I am telling myself this.

Throw in operating costs of the facility itself, the construction, the specialized network for a lock down unit, training costs, marketing. I guess I just need to pray some endowment for $20 million falls in my lap.

I know this can happen, but I am not quite sure how. One thing I know is it can’t happen by just one person, being that of myself. I will need people of influence on my side from day one and I will have to delegate even though I would love to be in every part of it.

So if you are reading this and have those special connections to people impacted by mental illness who have the funds to support a radical way to change the healthcare system, please send them my way. I will welcome them all with open arms, and we will create the dream that was too big together!

When Dreams Are Too Big

The Cost of Happiness

Several months ago I started a new “add-on” antidepressant medication to be taken in addition to my current medication regimen. The doctor handed me a small white paper bag containing a few months worth of pills in sample packs for me to “try before I buy.”

Much to my surprise, they worked! I had a long and disappointing track record of medications not being effective for me. The new technology in pharmaceuticals really is something! My brain fog lifted, I felt more grounded, engaged, and energetic.

The next visit followed suit like the first. I reported the great results and we adjusted the dosage slightly and I walked out with my white bag of happiness. A couple months later just before Christmas break, I phoned the doctor’s office requesting a script to be called into my pharmacy as I was running low.

My pharmacy run went smoothly, $57 for my first medication, and $32 for my new one. Despite a stressful holiday season, I made it through with a little more motivation and peace.

Last week, I needed a refill of my fancy new drug. I called up the doctor, and shortly after received a call from the pharmacy. I thought it was a bit odd because usually I just get a text notification when my scripts are ready. The pharmacy tech politely said, “We have your script here, and we already applied the manufacturer’s coupon for $400 off. But the balance for one month supply is $900, and we wanted to see if you still wanted this filled?”

*Gasp* NINE HUNDRED DOLLARS for 30 pills?? How in God’s green Earth could a tiny pill cost so much? Without the coupon, that is roughly $43 per 1mg pill. That is more than I spend to feed my whole family of three in one day, at a nice restaurant nonetheless. That is like me going out to eat a filet minion every day of the year. Apparently the last time it was filled, I had met my deductible and out of pocket max.

I smiled and thanked the pharmacy tech for the call and let her know I would pass on filling the script. Flashbacks to when I found the only effective medication was not labeled for depression and the typical administration of it was intravenous infusion, costing $500 each time. Thankfully, I was able to manage to convince the doctor to order me the oral compound version for $1,943 less each month.

What I can’t understand is how we expect society to avoid constant mental illness crisis among the poverty-stricken. To obtain my medication, I am required to visit my psychiatrist every two months, by law. If I had no insurance, this is $250 for 15 minutes, or $1,500 a year. Medication is not enough though. For my therapy every week, it costs me $70, or $150 for uninsured. That is another $7,500 a year. So sure, let’s go ahead and tack on another $15,000 for medication.

This is what I need to live. I know I quip this is the cost of “happiness” but it isn’t even that. It is the cost of functioning at a job, parenting my children, keeping myself alive. I have a terminal illness called major depression, where if untreated has a fatal prognosis.

So what can I do? What can anyone do? How does it change? I do the only thing I know… I go to my doctor and ask for another white paper bag, praying the day never comes that they stop receiving samples to give.

The Cost of Happiness

How do we prevent it?

I have had an idea brewing for a while and it seems so very clear to me these days. Mental health advocacy is at the top of my list of life purposes. I have a very soft spot for children’s mental health, believing we as a country and world need to do a better job at raising emotionally intelligent and aware human beings.

This is not an easy feat. We as adults already have a wealth of trauma and learned behaviors that hinder our ability to maintain emotional intelligence or mental awareness. But as I see it, we must start somewhere. When education systems are failing, we start at the beginning and look at the younger grades to see how we can prevent it becoming an issue later in school years.

I think we must do the same with mental health. When I was pregnant with my first child and nearing the end of term, I was barraged with questions from my OBGYN, family, and online mother support groups. These all focused on the physical health of my child. Who would be the pediatrician on record? Would he/she be able to make a visit in the hospital prior to discharge? I was informed of the 2-day, 2-week, and 6-week well child checks and how they are all preventative healthcare visits, covered 100% by insurance.

We are vigilant to care for all the externally noticed issues relating to proper eating, sleeping, and physical immune system. But we have missed a critical organ, the brain.

So this is where my idea comes in. I feel at the same frequency, a child should have a “mental health general physician” designated at birth, just like their pediatrician.

Prior to the child’s ability to talk, the MHGP would establish a mental health medical history with the parents. Screening would be performed for post partum disorders of both parents, and referrals made if needed. As often as a well check pediatrician appointment is made, a mental well check appointment would be made.

As the child reaches speaking age, the mental well check would be more inclusive of the child in the form of play therapy along with input from parents. Records would be kept. Issues would be addressed. Once a year, the child would meet their MHGP for an hour of therapy as preventative medicine.

When the child approaches adolescence and adulthood, a recommendation to a MHGP who specializes in an older age range would be made. Records would transfer and care would be continued with one visit each year considered preventative care. Additional sessions could be scheduled through this established physician/therapist if the need arises.

It is long past due for mental healthcare to be equal to physical healthcare in the insurance world. When we are always looking back at tragic events wondering how to prevent it, why do we not consider the possibility of “preventative” mental healthcare. And treat it the same as physical care and cover preventative care 100%.

Therapy is not just to fix the past. It is to educate the patient on proper coping mechanisms and emotional awareness. Just like a medical doctor should see you when you are well and when you are sick.

So, maybe this is the change we fight for. Maybe we can all agree to start at the beginning and provide the next generation the tools and support they need and 20 years from now, we won’t miss the signs of imminent tragedy.

How do we prevent it?