Robbin Miller

Bravo to the physicians for speaking against the upcoming cuts in Medicare reimbursements and the threat of refusal of accepting more patients in their medical practices. How come mental health professionals can’t follow this same pursuit? Our profession has a big white elephant in our presence for refusing to speak out against cuts in payments for providing mental health services to our clients. I will give you an example on what I am talking about.

I wrote a previous blogpost on counselors being mindful before signing the papers for their clients to apply for social security benefits for either themselves or their child’s mental health diagnosis. While many will be denied for the first and second attempts, most of the appeals end up going to court.  If a client wins, their lawyer gets 30% of the SSI retroactive payments.  Unfortunately, the SSI game is a money racket for lawyers to get rich for the majority of the cases they win. Please note I am not saying that all people should be denied SSI for either their physical or psychological conditions. I am talking about individuals who are seen on the outpatient level and not from institutional settings or have severe chronic illnesses.

This week, my client’s sister passed away peacefully in a nursing home under hospice care. My client questioned when her sister would ask for her support over the last twelve months. When she did talk to her sister either in person or via telephone, my client said that her sister always asked how she was doing and did not talk about her illness at all. My client visited her twice a day for the last two weeks, seven days a week. As her sister laid in bed in a conscious state, she continued to ask my client the same questions about how she was doing. A few days ago, her sister became congested in her lungs where she needed increased dosages of morphine to decrease her pain. While morphine decreases pain, high dosages will suppress your breathing. Three days ago, her sister lapsed into a coma. Under hospice comfort measures, intravenous fluid treatments for hydration and medicinal purposes are withheld.

Last week, I saw a client who is vent-dependent and has a chronic muscular disease. This individual uses round the clock personal care attendants and lives in her own apartment. The client informed me that her sister is dying from numerous brain tumors and from lung cancer. Her sister is receiving hospice care in a nursing home. The client also talked about her family grieving about the inevitable since her sister was born able-bodied and healthy.

I heard about a very sad event that an adoptive single parent endured this past week. She had to relinquish her 17 month old preadoptive son from the state foster care system to his biological father. Apparently, the birth mother told the state who the father was after a year in which she refused to identify him at birth. The birth mother held back the information due to her belief she would get custody back of her baby after she cleaned up her act in a drug rehabilitation facility. When the birth mother found out her parental rights were terminated this year, she decided to identify the birth father so she can still see her son in his custody. What a tragedy for my colleague and for this baby.