Papers

Today I go through a mountain of papers. Why do I never throw anything away? One filing cabinet is filled with medical records, insurance forms; and correspondence between myself, and doctors, and the aforementioned insurance companies. The files start with Colby's upper respiratory infections and strep, and move to asthma (age 3) and to his sulfa allergy. That happened when he was five. Colby was prescribed a sulfa drug for strep and became partially paralyzed from the waist down. That was a little scary. Fortunately the effects only lasted about five days.

Then we move to depression (age 8), anxiety and behavior difficulties in school (age 10), the diagnosis of dysgraphia, a learning difference that affects writing, math calculation, organization and knot tying (age 11). At 12 there were panic attacks and at 15, anorexia (yes, boys get that, too). There was also mood disorder at 15 and that's when the long-term hospital stays began. A week here, ten days there, a month, four months. From 17 to 18 he rallied some, was on regular meds, had good medical care. Then the diagnosis of schizophrenia and the cancellation of not just his insurance policy, but the closing of the entire division of that insurance company.

Now I see the applications for new insurance and all the rejection letters. There are a ton of them, one from every major insurance carrier in the state, and they all say variations of the same thing. "Due to pre-existing conditions . . ." "Because of extensive hospital stays . . ." "Considering the mental instability . . ." "Because of the . . ."

After that I find receipts where I paid out of pocket for what I could. The amount of money spent is staggering. But it wasn't enough. I could not afford the more expensive testing they wanted to do, the hospital stays, and because of this Colby's mental state deteriorated. I couldn't get him to go to the dentist, to walk into the doctor's office. If I had known then what the future held I would have sold my house, lived in the truck, done anything. Anything . . .

I keep some of the papers, throw most of them away. The papers fill a large trash can and clean out the majority of the filing cabinet.  I refill the space with Colby's autopsy report, findings from the attorney who looked into his death, and information from his celebration of life. The drawer is, once again, full.

Statistics

As many of you know, my son Colby had several mental illnesses and passed from a drug overdose. So many people focus on the drug issue and yes, it was a big factor. But what most people do not realize is that a good percentage of drug users also have either a diagnosed or an undiagnosed mental illness such as depression, bi-polarism, panic disorder, etc. Here are a few interesting statistics from a presentation by Don McVinney, MSSW, M.Phil., ACSW, C-CATODSW, CASAC at a recent Harm Reduction Psychotherapy and the Treatment of Dual Disorders Northern California -Kaiser Permanente Conference:

37% of alcohol abusers and 53% of drug users also have at least one serious mental illness

Of all people diagnosed with a mental illness, 29% abuse either alcohol or drugs

As many as 50% of the mentally ill population are reported to have a substantial substance abuse problem

Axis I Disorders: (mood, anxiety, psychotic disorders) are 4 times more prevalent among alcoholics than non-alcoholics

Mood Disorders alone are two times more prevalent among alcoholics

Axis II Personality Disorders: (paranoia, schizophrenia, antisocial, etc,) are diagnosed in 65% of opiate addicts

Colby had diagnoses of depression, anxiety, panic disorder, paranoia, and schizophrenia. Yes, he died of a heroin overdose. But, so many people do not consider mental illness as a reason for drug use. Not all drug users are mentally ill, but you can see by the statistics that a good number of them are. Mental illness has such a stigma. Would people think differently of someone if, rather than a drug overdose, they had passed from a heart illness, or a liver illness? Sadly, I think they would. The difference is that a heart ailment or a liver ailment usually does not cause people to behave differently. A mental ailment does.

I mention this in the hopes that those of you who have loved ones who have a mental illness will keep a closer eye on them. I mention this in the hopes that those of you who are medical professionals will consider that the patient who presents as a drug user is using because he or she is mentally ill. And, I hope those of you who work in health insurance will consider that many, not all, but many, of the people who are either mentally ill or addicted can be helped if you will only offer them health care coverage. Give them a year, rather than 28 days, to recover in the knowledge that many of these people can be (and want to be) productive menbers of society. 

People who are recovering from cancer or from heart surgery typically have more than 28 days to recover. So please offer that same courtesy to those who are addicted and mentally ill.

Reform

Health care reform is in the news. It's an ongoing topic, has been for months, and is polarizing. I've written about this before so I won't rehash the details, but I do have to say two things:

1. Many people are under the perception that if you are uninsured and go to a hospital that the hospital has to treat you. That is not true in practice. Twice I took my suicidal son to an emergency room and they weighed him, took his blood pressure, and his temperature. Then we waited in a waiting room for two hours so they could hand us a piece of paper that referred us to agencies we had exhausted months prior. That is how our hospitals "treated" my son. Six weeks later he was dead.

2. Others think that all Americans already have access to health care. This is also not true. As a teen, Colby was on a state insurance plan that I paid for because I was self-employed. Then that program was shut down due to lack of state funding. Because Colby had existing and extensive mental illness diagnoses, no other insurance program would cover him. By the time he was homeless and qualified for Medicaid, he was so paranoid I could not get him to a doctor.

I do not understand why all Americans cannot have access to health care. I believe that if Colby had medical care that there is a chance he would be here today. There is a chance that he could have led a productive life and fulfilled his dream of making the world a better place. There is a chance that I would someday have grandchildren. There is a chance that I would not have to grow old without any family.

All I ask our lawmakers in Washington is that whatever deal they strike, whatever language they finalize, whatever clauses they add, the end result is that no other American parent will suffer the anguish of not being able to get his or her son or daughter the medical attention they need.

Maybe

I have a growing sense that Colby's passing is fate, destiny. I don't feel this way all the time, but I do frequently, and this morning is one of those times. Maybe Colby was never supposed to be here long. Maybe his entire purpose on Earth was to meet and encourage those he did meet, and to pass on at a young age as an example so others could live.

Colby's story is getting some attention in the health care reform debate. I will not take sides here other than to say I think every American deserves the opportunity to have affordable health care, and that mental illness should not be treated solely by taking vital signs and pulling blood for a drug screen. Beyond that I will leave it to those who are more knowledgeable to work out the details.

Colby's memorial web site gets a lot of hits from people who never met him. I get a lot of emails from that site from people I do not know. All say his story, his life, is both an inspiration and a wake up call as to the state of our health care system. Maybe in his passing, Colby will save others. One person, 20, 100, 5000. From the time he was small, Colby always said he would not grow old. Maybe we do have some input as to our path here on Earth before we are ever born. If so, maybe Colby had some sense of that. Maybe this was supposed to be.

I might be I am rationalizing here. It might be that as his mother I am trying to find some sense of peace, of acceptance. It might be this kind of thinking is part of my grieving process. Nothing will bring my son back or return my life to "normal," but right now, this morning, I find a small comfort in these ideas. Time will tell, but from where I sit at this moment, I hope with all I have that I am right.