Inpatient care for depression?

Question

My best friend has been suffering from very bad depression for the past 3 years. She is on meds, sees a therapist but nothing is helping her and she told me she thinks she might need to go to a hospital but is worried about the cost. I am trying to find info for her but I havn't been too successful. She is 23 and lives in CT. Any help is greatly appreciated.

Answer 1

I suffered from major depression most of my life. I started experimenting with various prescription medications and it took me 5 years to find the right meds. Now I haven't been depressed for over 4 years. I take Zoloft 200 mg, Wellbutrin 300 mg and Ativan 2 mg.

Unfortunately there are no low cost mental hospitals. My boyfriend recently checked himself in for a couple weeks and the bill was well over $30,000. He's on Social Security Disability for Bipolar Disorder, so they paid the bill through Medicare. While he was in there, he told me how people were being discharged immediately when their insurance benefits ran out, regardless of their mental state. That's really sad.

Perhaps she should consider filing for disability.

Another solution may be having her doctor switch medications. Don't give up. There's a medication out there for her. She has to keep trying.

Answer 2

1) If she has health insurance, help her to call the healthcare finder (a telephone number on the insurance card). Tell them you want to be assessed for inpatient psychiatric hospitalization, (tell them why if they ask); find out the nearest psych hospital units that accept your insurance. From that point, contact the hospital(s) and ask for the admissions department. Tell them your friend needs to be assessed and give them the insurance information. The hospital admissions office will check with your insurance company to find a psychiatrist who is on the provider list of the insurance company, and the hospital's business office will check with the insurance company to determine what your insurance company expects in terms of documentation in order to approve the admission.

The hospital might want to have your friend come into the hospital to talk to one of the hospital staff first for a preliminary screening. Eventually your friend would meet with a psychiatrist to determine if hospitalization is required. Most insurance companies are restrictive of admissions and your friend's depression would have to be pretty bad to have the insurance ok the admission (with most insurances, the insurance company representative is informed by the doctor and hospital of the symptoms and need for hospitalization, and then the insurance company decides whether they will approve it or not. That process is called "preauthorization" and many insurance companies won't pay one cent unless the admission was preauthorized, so there's often no getting around that.)

Working out all the above takes hours and hours and is often very frustrating for entering patients and their family/friends as they sit around and wait...and wait...and wait... for the insurance company to call back the hospital.

Only after all this is worked out can the hospital's business office tell you what the cost will be. Every insurance company decides whether or not it will obtain a contract with individual hospitals. If it has a contract, then the hospital's normal daily charge will be reduced to whatever the contracted rate is. Each insurance company has multiple insurance plans that it offers and each plan will have different copays and different deductables. That's why it's not easy for the hospital to know what your cost is going to be. The business office may know that the contracted rate with the insurance company is, say, $800 a day, but they won't know until the insurance company tells them whether the patient will have to pay a deductable, what the patient's copay will be, and how many days of coverage per year the patient has under the plan. Further, some insurances pay for mental health care but not drug treatment, while others pay for drug treatment but not mental health care. If your friend has both a mental health and a drug problem, that is going to complicate things further as the insurance coverage might depend on the primary admitting diagnosis.

Yes, totally frustrating, but no one's figured out another way yet. Me, I support single payer insurance, but that's another subject

2) If your friend doesn't have insurance: in many ways, the process is much easier. Contact the local county mental health crisis services hotline for your area, see link: http://www.ct.gov/dmhas/cwp/view.asp?a=2902&Q=378578&dmhasNav=|
They should give you some direction. When you have no insurance and use county provided or county contracted services, they will have the person fill out a questionaire regarding income and resources and will use this to determine charges for services. If the person has less that $2000 or so in savings/cash resources and monthly income of $1000 or less the person will pay little or nothing for county provided or contracted hospitalization, but the hospital stay will probably be very short compared to stays payed for by insurance. If the patient has over $2000 in cash resources and income considerably over $1000 a month the bill for the hospital stay will be proportional to income, and could come to full rate if the person was determined non-indigent. Full cost per day in a psychiatric hospital is likely to run more than $1000 a day, not including doctor's services and lab services.

(an additional note regarding Dee's answer: Yes, ANY hospital, profit or nonprofit, must, by law admit you if you are in an immediate crisis...usually meaning if you are suicidal or homocidal if it's a psychiatric hospital. However, you'd still get stuck with the bill. EMTALA - the law that mandates a hospital admission under a crisis situation if the hospital has a bed available - says nothing about who pays for it.)

Answer 3

I was an inpatient for 2 weeks but not in CT. Try looking for some county help available in your/her area.

Answer 4

I suffered chronic depression for over 20 years and the good news is that Depression is TREATABLE! There are many recourses on-line for you and your friend:

http://www.docguide.com/News/Content.Nsf/Patientresallcateg/Depression?Opendocument
http://www.allaboutdepression.com/

This is a link to an on-line screening test that may prove helpful:
http://www.med.nyu.edu/psych/screens/depres.html

She is fortunate to have a friend like you to help her - find out what your local Crisis Line phone number is so that she will have help if she can't reach you. I wish you both the very best and feel free to email me if there is anything else that I can help with.

Answer 5

Most community hospitals are not for profit and can not deny a patient admittance due to an inability to pay. If she is truly depressed, and is considering harming herself or others, call 911.

Good luck and take care of you!
Dee

Answer 6

How to Help a Depressed Person
• Do not tell a depressed person that you know what he/she is feeling. This may make the person become angry with you.
• Be supportive and patient.
• Let the person know that you are concerned and that you will be there for him/her.
• Encourage the person to seek professional help if symptoms are persistent and seem to interfere with activities for daily living.

Answer 7

certain conditions (i know suicidal, homicidal, or catatonic) are considered medical emergencies that warrent immediate hospitalization. your friend can go to any hospital, thru the emergency room, and they will find an appropriate placing for her. if she doesn't have insurance, they'll send her somewhere that recieves state funding & accepts people without this luxury. trust me, all she has to do is go into ANY e.r. & tell them she is suicidal, and it's their responsibility to take care of it. i have done it many times.

Answer 8

See depression treatments, at http://www.ezy-build.net.nz/~shaneris on page 2.