How to Find Treatment
May 25, 2020
Written by: Sarah Jenkins, MSW, RCSWI
As a social worker working in the mental health and addictions field, one of the biggest challenges for people and families is how to find treatment. Working on an inpatient behavioral health unit, it was often difficult to find appropriate drug or alcohol treatment, residential treatment, or long-term mental health treatment for clients. It was also very difficult to find placement or treatment for clients who are elderly with dementia, hostile, or aggressive. There are resources you can use that can provide the care you are looking for. This article is to help guide you on questions you need to ask, what insurance companies are looking for, and to help you find the best possible treatment for yourself or your loved one.
Crisis Treatment and Baker Act
First, are you or the person needing treatment in imminent harm or immediate danger? Are they in a crisis, such as actively suicidal or homicidal, having overwhelming suicidal thoughts, actively psychotic with little ability to reason or a loss of touch with reality? Are they inconsolably fearful or paranoid? If so, they need immediate crisis stabilization. Under Florida Law, there is a Baker Act which protects people with mental health conditions requiring emergency care who are in danger of harming themselves or others. The Baker Act places people on a 72-hour hold and guarantees a psychiatric evaluation mandated by law. Police officers, licensed therapists such as licensed clinical social workers or licensed mental health counselors, psychologists, and psychiatrists may initiate a Baker Act. As a non-professional, you can call 911 and request a mental health crisis intervention team and let them know your loved one needs a Baker Act. If it is safe and they are agreeable, you may also transport them to your local emergency department and request for them to be hospitalized under a “voluntary” admission. This means they are signing in voluntarily and can sign out of treatment voluntarily, unless the psychiatrist believes they are a threat to themselves or others, at which case the doctor may initiate a Baker Act and they will be hospitalized involuntarily.
Often, Baker Act receiving facilities will help detox clients who need medical detox, start medication management to adjust medications and reduce high feelings of anxiety, depression, or agitation often associated with crisis. Once the person is stabilized, discharge planners in the hospital will assist in finding placement: residential treatment, addiction treatment, day treatment services, assisted living facilities or nursing homes for people requiring a higher level of care and longer management, or outpatient treatment, such as individual therapy or a psychiatrist. For more detailed information on the Baker Act law, see Baker Act.
Alzheimer’s and Dementia
If your loved one is elderly, has dementia or Alzheimer’s, or is wheelchair bound and you need help getting them to the emergency department and if they are in immediate danger (harm to themselves or others) you can call 911 to explain the situation, and again request the mental health crisis team. The mental health crisis team is trained to deal with high levels of aggression, agitation, or paranoia which helps to reduce the amount of stress for the person in crisis. If they are not in immediate danger, you can call their insurance company or Medicaid to request wheelchair transport. This is a safe and secure way to have your loved one safely transported. Wheelchair transport will have safety restraints to ensure your loved one is transported safely and securely. St. Anthony’s Hospital in St. Petersburg, FL has a specialized medical/geriatric unit where they can treat elderly clients and clients with dementia related disorders safely on a locked unit. They have one of the only combination medical/psychiatric units in Tampa Bay. The discharge planners will also arrange transport when they are ready for discharge to get them back home, to their living facility, or find placement if placement is needed.
How Inpatient Psychiatric Treatment Can Be Extremely Helpful
The terms “Baker Act” and “inpatient psych” have a lot of stigma surrounding them. Having worked inpatient for much my career, I often see how scared almost everyone is when they first get admitted to an inpatient psychiatric unit. It is scary to be on a locked unit with complete strangers and no escape. I really enjoyed running groups in this setting because most people would have the realization, “they’re just like me,” and feel surprised, elated, and accepted when they realized most people on the Baker Act unit were struggling with very similar things: depression, anxiety, stress, paranoia, fear, low self-worth, low sense of self, feeling out of control, uncontrollable anger, difficulty feeling emotions or expressing emotions, suicidal thoughts, alcoholism and/or addiction. No matter what brought them into treatment or what their symptoms were, they often realized how much they could all relate, support one another with their experience, and find a sense of community in a place where they least expected it.
Unfortunately, outpatient psychiatrists and community mental health centers are very limited, so if a person needs their medications adjusted, often psychiatrists are booked three months out and people have a difficult time meeting with their psychiatrist to get medications adjusted quickly. One benefit of going to an inpatient unit is to get medications adjusted immediately, in a controlled environment to help manage symptoms, and to be kept safe, especially if symptoms of depression, anxiety, or suicidal thoughts have gotten worse and become unmanageable. Also, people will get a follow up psychiatric appointment quickly after discharge from their inpatient stay to safely manage wellness outside of treatment.
When asked what they got out of treatment from their inpatient stay, many people have said how they gained a healthy comparison to what other people are going through such as debilitating addiction, homelessness, no family, friends or support, financial ruins, psychosis that will not go away, dementia, etc. Many people at discharge frequently had the enlightening realization that their life stressors were not as bad as they thought before they came to the hospital and how much they were just like everyone else, regardless of diagnosis or symptoms. There are a lot of benefits to be gained if you or your loved one must go to an inpatient psychiatric unit for emergency mental health treatment. When you put your fears aside, you see how much there is to be learned.
Addiction Treatment
One of the first things to consider when looking for addiction treatment is how you will be paying. Can your family afford to pay for private or residential addiction treatment? Or will you be using insurance to help cover the costs of treatment? This is an important question to ask. If you will be paying privately, you do not have to consider all of the questions insurance will ask and can go straight to my resource page to see some of the top rated addiction treatment centers in Tampa Bay, at Recover Life resources. I worked previously for BayCare Behavioral Health and Clean Recovery Centers, so I have seen firsthand how many clients have drastically improved throughout the course of treatment with both organizations. They have great teams, compassionate staff, and person-centered care. Clients are treated with dignity and respect, which is vital in recovery treatment. I also have professional acquaintances at all the treatment centers on my resource page. The rule I go by is if I would send my own family there, I will recommend the resource to you.
If you will be using insurance to cover the cost of treatment: insurance companies are going to ask if the person has tried treatment before. If a person has never tried treatment (e.g., inpatient psychiatry, residential treatment, intensive outpatient (IOP), partial hospitalization program (PHP), or outpatient therapy) insurance companies seldom pay for residential treatment. One way to get around this is to go through Clean Recovery Centers or Coalition Recovery, see addiction treatment centers, as they have found a way to provide residential level of care utilizing PHP and/or IOP benefits. They also offer transitional housing.
You may have to call your insurance company to see what benefits are offered for mental health or addiction treatment, then start your search from that avenue. If you have residential coverage, then you will be able to go to almost any treatment center with beds available. If you need any help navigating next steps, please fill out my contact form and I will assist where needed.
Next Steps
Recovery and whole health wellness do not happen overnight, nor after one treatment center, because recovery is a lifelong journey. Once you begin the journey of getting to know yourself, if never ends. After treatment, it is recommended to continue to stay connected with a supportive community. This community can be found through local 12 step groups (download AA meeting guide app), Celebrate Recovery which is a Christian based 12 step group (CR Meeting Locator), Depression Bipolar Support Alliance, or Recover Life Online Community Support where we have an online recovery community to reach out, give and receive support, find resources, share stories, and connect. You might attend your local church or spiritual groups. There are many mindfulness centers, such as Florida Community of Mindfulness which has multiple groups and classes, as well as Recovery Dharma which is a Buddhist centered 12 step approach with multiple local groups.
Another recommendation is outpatient therapy to help people to continue to get to know themselves, gain awareness, learn to listen to their bodies, and continue improving their mental health. Too often, people rely on medications to take away their symptoms of depression, anxiety, mania, schizophrenia, or stress, yet neglect learning the necessary tools to help understand where the sadness or fear are coming from in the first place. This acceptance helps people gain the power to reduce and manage the discomfort themselves. Too often as a society we try to get rid of the pain and “fix” the pain before learning what the pain is teaching us. To illustrate this concept, there is a great article on Psychology Today I often give to my clients for homework called The Irony of Emotional Acceptance.
For the most effective treatment, evidence based practice supports combining modalities of treatment, such as medication management, individual therapy, group therapy and community/ social support, to reduce symptoms, improve wellness, and improve long-term recovery and sobriety. By combining various methods of treatment, people do not become reliant on one thing or one person, rather gain the self-efficacy and confidence in themselves, which is necessary for recovery and whole health wellness. The only one really with the power and control in your life is you.
Outpatient therapy can also help family members who have loved ones in an out of addiction treatment, family members with chronic relapse, loved ones in and out of psychiatric units, or family members with dementia. So often, family members have been focused on caring for their loved one and trying to help them that they often neglect their own needs, forget to take care of themselves, and forget how to put themselves first because their loved one has needed the help more than they did. It is vitally important for family members, and all people in the helper role, whether you are a caregiver or work in the field professionally, to put your needs first. Therapy can help teach you how to do that and remind yourself that you are also important and deserve love, support, and compassion just like your loved one does.
Lastly, people are constantly growing and changing as the world is ever evolving, sometimes drastically and unexpectedly (thank you #Covid-19 for this enlightening realization). The reality is life will change, stress will come, relationships will end, loss will happen, and none of these things are avoidable. The one thing you can change, that you have control over, is you. Understanding how you feel, how you choose to react, how you choose to spend your time, who you choose to spend your time with, these are all things in your control.
I hope this has been a helpful resource for you. If you have other questions, feedback, or wisdom to share, please share this with others or comment below. Let’s keep the conversation going about #feelings, #addiction, #mental health, and #recovery for all!
