I am number 27 on the list for Mental Health Skill Building. I applied for it in Feburary 2015. Yes that is right almost a year and a half ago. What is mental health skill building? It is an in home service for the chronic mental health patients that have been hospitalization. We help them go to their medical appointments, their medications, socialization, and other needed services for 10 hours a week. There professionals have a bachelors or better. They are paid well. They keep people out of the hospital.
These agencies like mine can hire about 10 people. Right now an agency is number 285 on the list. That is 2,850 jobs waiting for almost 10,000 clients. We have shootings of and by mentally ill people. The hospitals are full and can’t keep them.
I called to find out why. They have two people for the whole state of Virginia to process the paperwork. Virginia has 8.401 million people. If 10 % are mentally ill, that is 840,000 people. These workers have to verify information, do office inspections, background checks and see if forms and procedures match current laws. 2 people.
If they move 3 steps a time, it will take an additional 9 months for my application to start the process. That will be next year. How long can our mentally ill people wait? How many jobs go unfilled?
I have contacted the papers, and wrote a Senator. I am pushing on. Next I go to television. I want to serve the disadvantaged, employ people. Do my civic duty.
Number 27 is not so great after all.
I probably should not watch the news. I get too upset over injustice. A prisoner in our jail who was mentally ill died. He was in jail for shoplifting candy. Most times he would spend a few days in and be out. He was detained for months on a mental health order. No bed was available. He did not get proper treatment. He was malnourished and suicidal. He died. The news papers and TV are all over it. But there are no beds it isn’t our fault. Why was he in jail so long for a shoplifting offense. He wasn’t even convicted. Jail guards are not prepared to deal with chronic mental illness. He was in solitary, which deteriorated his condition. His family tried to get him out. Many visits were denied due to his behaviors. If there was no bed, he should have been sent home with a mental health skill building agency to work with him. Oh wait, there aren’t enough of those. Why is that? I applied in 02/15 to be a mental health skill builder provider. I was number 178 on the list. Now in May I am number 38 on the list. They have two workers in Richmond processing all the applications for developmental group homes, outpatient, MHSB, TDT, IHH, IOP, substance abuse, and transitional living. The whole state of Virginia has two workers to process at the present time 258 applications. This isn’t the department that audits and monitors. I bet the fraud unit to recoup medicaid money has more than two workers.
The young man needed help. His family wanted to help him. We let him down by trying to save money.
Do the math. Each agency would probably hire about 10 workers at over minimum wage. 258 x 10=2,580 jobs in our state. New graduates just out of school in all parts of the state. One of those workers could have helped him, but the paperwork has bogged down their agency.
We should be ashamed. Call your state delegate and senator. The next person might be someone you love.
I finally have started my novel on my career as a therapist. I will post exercpts from time to time and hope you will critique it. I will try to be as honest as possible without giving away any client privledged information. I also will shed light on various diagnosis, failed treatments, modalities. I hope to have me grow as a person and learn as I write. Many people go into this field wanting to save the world. They have no clue. The textbooks do not tell you about assessments in the hood, walking the park to engage the homeless, going into homes to look after children, watching people detox, doing therapy in a soup kitchen and jail. It is a journey for me and for my clients. I also apologize to my first clients that I learned with and hope they got better anyway.
And don’t get me started on insurance billing. They don’t touch that.
For many years I happily used my DSM V book and many of the codes I had memorized. I could write ADHD 314.14. anxiety 300.02. Fast and easy. October 1, 2015 the ICD codes made their entrance. Nothing is memorized. Now I have to look through the book and try to find it. Slowing me down. They have letters in it like algebra. I hated algebra. The mental health word is always changing, new diagnosis, new medications, new codes. Now Asperger’s has been changed to autism spectrum. So if you have called yourself Asperger’s for twenty years, do you now call yourself a spectrum.
The best decision that I ever made was to hire someone to bill for me. Therapists do not bill. We learn theory, interventions, methodology, disorders, and other fun stuff. We don’t learn office management, billing, how to argue with insurance companies, authorizations. We learn as we go, because we are too poor to hire people when we start.
Sometimes I wonder if they make changes just to print a new edition to a book, make themselves feel important, slow down the billing to slow down paying. I will reluctantly memorize the new codes. Hopefully they won’t change before I retire.