Lost coverage of mental health drug sent me into tailspin and hospitalization

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By Julie Whitehead
Mississippi Center for Investigative Reporting

Julie Whitehead

I sat down on my unmade bed and ticked off the questions.

Did I want to end it all? Yes.

Did I have a plan? Hmmm. Did stuffing my head inside a plastic garbage bag count?

Did I think I could survive one more day thinking this way without breaking in front of my daughters?

No.

It was March 2016, and I had been on a long slow slide to nowhere over the last six months, into a depression I couldn’t reverse.

I felt it comings since October of the previous year when my husband’s company had changed insurance plans. The new company told our pharmacy it would no longer cover Abilify, a mood stabilizer I had taken for a little over 10 years. No generic version was available, leaving me with a jaw-dropping $1,000 cost for a month’s worth of pills.

My doctor had tried to convince the new insurance company that Abilify was essential for my treatment, but the paperwork was denied. So, we started trying other drugs, but none of them worked as well. After maintaining so well for so long, I had no choice. I was headed back to the hospital. I didn’t know what else to do.

Here we go again

The more questions I answered, the less convinced I was at the prospect of suicide. My life seemed fine, with “seemed” being the operative word.

More practical questions came to mind. What kind of disruptions would I cause in our family life if I left the house to go to the hospital?

Not sure.

And if I did, how long would I be there?

Not sure.

I had already cancelled my youngest’s 11th birthday family party, because her sister was sick with an upper respiratory infection, still coughing after going to the doctor days earlier.

Waiting on going in until after spring break was impossible — I needed to be well for the family trip to Natchez we had planned for vacation.

Here we go again, I thought.

I decided to call my husband and tell him what was going on. I didn’t feel afraid, just resigned.

My youngest was watching cartoons on TV, and my middle child was upstairs taking a quick shower — unaware of the drama going on inside my head. I was about to upset their worlds all over again for the first time in five years. My youngest had been in kindergarten the last time I went on the ward.

My husband, Bob, could tell something was up as soon as we started talking. I was near tears. After a couple of general questions about how I was doing, he asked me, “Are you having self-destructive thoughts?”

“Yes,” I replied. “And I can’t make them stop.”

“Then I need to come home.”

“Yes.”

After we hung up, I tried calling my psychiatrist, hoping he would admit me.

I looked up and noticed it was almost 5. And a Friday to boot.

My odds for catching him seemed as good as my hitting the jackpot in Vegas.

His office said he was out of town until Tuesday. His receptionist recommended the emergency room. I called my counselor’s emergency number and left a message for her, only for her answering service to call me back and also recommend the ER.

I was beginning to feel desperate. There was no doctor to admit me, and my nerves were frayed even more by the thought of going to the emergency room.

When my husband arrived home, he called his mother to come sit with the kids until he could get back home. Our middle one remained on heavy cold medication. She couldn’t be left alone with her sister like we might have done otherwise. The eldest was away at college.

I tried to remember what to pack and what not to pack from the last time I had been at St. Dominic’s Hospital in 2011.

Could I bring jewelry? I took off my rings and watch, just to be safe.

Could I bring deodorant?

Not sure.

In my confused state, I couldn’t remember anything. I finally settled on my makeup bag, contact lenses and clothes.

By the time I finished, Bob had already explained to my youngest that Mommy was going to the doctor, but when my middle one came down the stairs and spotted my mother-in-law in the kitchen and me standing in the den, she stared at me wide-eyed.

“I’m going to the hospital again,” I said.

Her eyes widened because she knew what this meant — suicidal thoughts had invaded my mind again.

She hugged me, and I said, “Bye.”

She never answered.

Frontlines in battle against mental illness

At the emergency room at St. Dominic’s, the reality of what was happening began to soak in. I saw the triage nurse enter in the computer that I was there for suicidal thinking.

So this is what it looks like on the frontlines of the battle against mental illness ...

Another nurse emerged from behind a door and motioned to me. “Julie Whitehead?”

“Yes, ma’am,” I replied.

“Come on back here to holding.”

I told my husband to stay where he was, that they were calling me back.

I followed the nurse down the hall, wondering what “holding” meant. I soon found out when she escorted me into a windowless, gray-walled room with a box bed anchored in the middle of the area covered by a thin grey mattress. No TV and no telephone.

She asked me to change into a blue uniform made of some indestructible plastic material and put all my clothes and my purse into a “personal belongings” bag. Then she left me alone in the room to wait for the doctor.

And wait.

And wait.

And wait.

Finally, the doctor on call arrived. He asked me a few questions and left me alone again to wait, this time for an intake counselor from the mental ward.

After I talked to the intake counselor, I overheard her talking to a psychiatrist on the phone. “White female. Carries a diagnosis of bipolar disorder. Says she’s having suicidal thoughts with no real plan. Multiple admissions but none in the past five years.”

Word finally came that I would be admitted, but, of course, I had to wait until they had a person available to come pick me up and take me across the street to where the mental ward was.

Hours later, admission finally came that night.

It was 9, and I was sleepy — a drowsiness that no amount of sleep seemed to fix.

Whenever I did doze off, light would pour into my room or an employee would tap on my door, checking on me.

“I’m OK,” I kept replying.

Stability shouldn’t come at such a high cost

During my stay, I watched the patients interact with each other, the nurses, the psychiatric techs and social workers. In one session of expressive therapy, the jovial crafts lady asked us to draw our problems as mountains and draw our schemes for overcoming them. I drew angry black, brown and red mountains topped with jagged snowcaps. I labeled them “depression,” “anger” and “anxiety.” I colored in green grass at the bottom of the mountains and myself on the right side of the paper, having climbed my way there, in my favorite red dress and red high heels. Other people drew butterflies and flowers at the tops of their mountains. We then showed our pictures to the class and explained what the images symbolized.

Every day I saw the hospital’s psychiatrist for a few minutes. He wasn’t my regular doctor, but he seemed nice and competent enough. I told him my story about losing my mood stabilizer, Abilify, when we changed insurance companies and my long downward spiral that followed.  I told him we had tried Geodon, Xanax, Lexapro and an increased dose of my antidepressant, Pristiq, as replacements. But here I was.

Before I entered the emergency room, my husband had told me if there was no other alternative, we would find a way to start paying the $1,000-a-month bill for the correct medicine. That was reassuring and terrifying at the same time.

How long could we afford to do that? Was I that desperately sick without it? It seemed that I was.

The doctor restarted my Abilify, which had me thinking logically again. On the fifth day, he released me from the hospital.

As I was leaving, I reflected back on my time there, glad I had the courage to come in when I needed. The second psychiatrist convinced my insurance company to cover my Abilify through the year 2039 — reducing my costs to a manageable level.

I came away with the thought that it should not have taken a full-blown episode and hospitalization to convince my insurance company to do the right thing. When people can be maintained on their medications, the system should work with them to enable independence and wellness — not further crisis.

This story was produced by the Mississippi Center for Investigative Reporting, a nonprofit news organization that seeks to inform, educate and empower Mississippians in their communities through the use of investigative journalism. Sign up for our newsletter. Email Julie Whitehead at julie.whitehead.mcir@gmail.com.