Stability of Mentally Ill Shaken by Medicare Drug Plan Problems

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Stability of Mentally Ill Shaken by Medicare Drug Plan Problems

Mon, 06 Feb 2006 16:23:34 -0800

 

 

 

To abrupty stop these medications for these people is nothing short of

criminal. When they abruptly stop them, all of their nuerotransmitters

will try to readjust to no meds being taken into the body and they

will go into severe withdrawal and severe mental problems. This will " scramble "

all of the neurotransmitters. It can damage the patient severly. No one should

ever come off them abrupty and all of the u.s. government and pharmacueticaland

know it. They obviously didn't care.

 

 

 

http://www.truthout.org/docs_2006/020606T.shtml

 

Stability of Mentally Ill Shaken by Medicare Drug Plan Problems

By Susan Levine

The Washington Post

 

Monday 06 February 2006

 

Some prescription denials have heightened distress.

 

Even among the incident reports crossing Craig Knoll's desk weekly

now, this one stood out: A 43-year-old client of Knoll's mental health

agency, a man who suffers from bipolar disorder, had come from his

pharmacy frustrated to the point of meltdown. There were snags in his

new Medicare drug plan. Of his four medicines, it would fill only two.

 

" I'm not going to take any of them anymore, " he yelled, according

to the report by caseworkers. Before they could do anything, he

grabbed the prescription bottles he'd just gotten, ran for the

restroom and dumped both in the toilet.

 

" He flushed everything he had on hand, " recounted Knoll, executive

director of Threshold Services in Silver Spring, whose staff spent day

after day last month grappling with the many ramifications of the

government's troubled program. Threshold came to the rescue of clients

who couldn't get any medications or who, despite their pills, were in

increasing distress because of all the confusion. It reimbursed

several who'd mistakenly paid hundreds of dollars for pills that

should have cost them a few dollars - and replenished the supply of

the client who had thrown his away.

 

" I'm not saying it's the federal government's fault he flushed his

meds, " Knoll said. " I'm saying it's the federal government's fault he

couldn't get his meds. It's not surprising that people with mental

illness respond in ways that people with mental illness respond. "

 

Since the prescription program made its debut Jan. 1, some of the

estimated 2 million mentally ill Americans covered because they

receive both Medicare and Medicaid have gone without the drugs that

keep their delusions, paranoia, anxieties or stress in check. Mental

health service providers and advocacy organizations nationwide say

they worry that scores are at high risk of relapse. Numerous people

have been hospitalized.

 

" The continuation of medications is absolutely critical to keep

them in community living, " said Steven S. Sharfstein, chief executive

of the Shepherd-Pratt Health System in Baltimore and president of the

American Psychiatric Association. Last week, the association joined

other mental health groups in a lengthy talk with Medicare officials

about the myriad problems.

 

" I really don't know what the future will bring.... I have a very

deep concern that psychiatric patients will suffer

disproportionately, " Sharfstein said. " If by the end of February or

March, if [federal officials] haven't figured this out, we could have

an epidemic on our hands. "

 

The mentally ill are nearly a third of the " dual eligibles " who

qualify for both Medicare and Medicaid because of income and

disability or age. Mark B. McClellan, head of the Centers for Medicare

and Medicaid Services, told a Senate committee hearing Thursday that a

prime focus is resolving the " remaining transition issues " for this

extremely vulnerable population.

 

That will not happen quickly. Like other Medicare-Medicaid

recipients, the mentally ill were to have been signed up automatically

for Part D at the start of the year, with responsibility for their

prescriptions shifted seamlessly to private drug plans. Clinicians

expected a bumpy beginning even in the best of circumstances. The new

coverage often forces beneficiaries to switch from their usual

pharmacies to different locations and strange faces, changes that Pam

Cudahy of St. Luke's House in Bethesda said can have a huge effect on

someone with few coping resources.

 

" Is the environment familiar? Is the person [behind the counter]

familiar? When I show my prescription card, will the same thing happen

as happened before? " Such questions represent daunting challenges,

explained Cudahy, whose agency provides crisis care and psychiatric

rehabilitation to about 1,000 teenagers and adults. " You don't want

something to happen they're not expecting. "

 

But repeatedly, she and others say, people have fallen through the

program's cracks and discovered they have no insurance - and have

either run out of pills or rationed their medicine because they feared

they would be left without.

 

Or they have been assigned to plans that will pay for some but not

all of their psychiatric prescriptions - an untenable and potentially

dangerous situation given the complicated multiplicity of drugs people

often take, with some pills to treat symptoms and others to counteract

side effects. Unlike many medicines, psychiatric drugs are not easily

substituted.

 

In Alexandria last month, a mother of two with a history of

homelessness and attempted suicide left a drugstore empty-handed after

being told her antidepressant was not covered. " For her, it was

overwhelming, " said Lix Wixson, director of acute care at the local

Community Services Board. " She shut down. "

 

The agency bought her a week's supply of Lexapro while it changed

her plan and stabilized her condition. In fact, it made repeated

purchases for clients in January at a cost exceeding $2,400. That's

money unlikely to be reimbursed. " We can't do that indefinitely, "

Wixson said.

 

St. Luke's House turned to Montgomery County's mental health

prescription contract for assistance. At one point, the organization

was counseling 15 people with disabling illnesses, Part D errors and

dwindling prescriptions. Michelle Ponder of Rockville was among them,

and she admits she was scared as she counted down her pills. Her daily

dosage includes Lamictal, a finely tuned mood stabilizer; Seroquel,

which is used for schizophrenia or bipolar disorder; and Lithobid, a

controlled form of lithium. Together, the three keep her out of the

hospital, she believes.

 

Her housemate, Geraldine Champa, came close, too. More than a week

into 2006, she was down to only two of the orange tablets that

minimize the extreme mood swings and panic attacks that otherwise

derail her life. With medication, she can manage much like the next

person, with a part-time job and her own independence. Without it, she

starts to lose control. The upset returns, and the anger. She has more

and more difficulty dealing with others.

 

" You can't skip a day, " she explained recently, as Ponder and

several others at St. Luke's nodded their understanding.

 

Yet even months of well-informed guidance and planning are no

guarantee. " It still crumbles in front of you, " said a tired Cherie

Sammis, clinical director of the Perry Family Health Center in

Northwest, although the calls that have been waking her at 5:30 a.m.,

interrupting her at work and continuing late into the night have come

not from center patients but from family halfway across the country.

 

Sammis's younger sister struggles with manic depression and

schizophrenia. As her fears about her Medicare prescription coverage

spiraled - fears borne out by repeated computer glitches and plan

inconsistencies - she deteriorated precipitously. Recently, she told

Sammis long-distance: " 'I've hurt myself before.... I'll hurt myself

again. I've got to save my life.' "

 

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