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With all the national focus on bullying, and the monies and time spent on anti-bullying campaigns, one would think that bullying is so prevalent as to warrant its own brand of “victim services.”
Think again.
Recently, an adolescent well known to me began presenting some distressing psychological symptoms. The child’s parents went in search of a base diagnosis from a colleague of a friend, while waiting for practitioners within their insurance network to return phone calls.
The diagnosis they received startled them, but it was the follow-up to that diagnosis that was/is truly distressing. In the post-consultation de-briefing, they were told their child was suffering from PTSD as a result of bullying suffered in middle school.
As they grappled with the diagnosis itself (PTSD—Really? Could distressing days in middle school be put on a par with the traumas suffered by veterans? Their child had had friends with whom s/he spent free time, had been invited to parties, and seemed to have negotiated the nastiness and intense social jockeying in a reasonable way), they began looking for a trauma specialist in NYC. Although PTSD still seemed a stretch, an emerging awareness of how desperately unhappy their child had been in middle school shed new light on current struggles in HS. Braving merciless cruelties had seemingly resulted in the loosening of any mooring to a future (let alone a ‘bright’ future), making it important that issues be quickly sorted and addressed.
Turning to their major insurance carrier, the family was pleased to immediately be sent a list of qualified practitioners within a 10 mile radius. Little did they know that this was the point at which parental trauma would begin.
Although their provider—list was well into double-digits, and although a quick internet search categorized almost all practitioners as accepting new patients, only two returned their calls—only to notify them that no private insurance was accepted. (They came to learn that practitioner names appeared on the list because the doctor had privileges at a hospital that accepted the private insurance). Broadening their search parameters (their child needed help and surely even a therapist who was not a trauma expert would begin to provide some relief) the child’s parents began to look at adolescent psychiatric services.
Programs and adolescent clinics affiliated with NYU, Columbia, and teaching hospitals returned phone calls, but they did not accept private insurance either—though many did accept medicaid. One even mentioned a six-month waiting period, which might sorely strain their child’s ability to successfully finish out the school year, as no support would be available before that time.
In short, despite having “cadillac coverage” from a top provider, and guaranteed 100% in-network mental health coverage, this family struggled to find someone to work with their child. The hurdles they encountered must serve as a wake-up call to all of us. As we increasingly single out and even penalize social aggressions, (even as we speculate what damage a presidential candidate who models bullying might be causing) we must attend to the growing need for “victim services” for our young people.
A first step in this direction is to raise awareness of the new games that insurance companies are playing.
Lest they be accused of discrimination, or sued for denying mental health coverage (for treatments they deem not medically necessary), insurance companies now advertise their commitment to mental health coverage, providing separate phone numbers which will connect the insured to unhurried, caring operators who are there to help find help, 24/7.
The reassurance offered by these obliging operators, who promptly offer a host of resources, is all too quickly countered by the harsh reality that the large lists of providers are “fluff.” While a handful of providers will see your child, the ones I found (on the list these parents provided me) were not practitioners one would opt to have treat an adolescent: one was over 70, two had 1 or 2 stars, and a third had a host of ESL grievances posted to zocdoc / healthgrade.
Insurance companies now comply with new mental health coverage mandates, but make it so difficult for providers to be reimbursed—let alone reimbursed in a timely manner— that they cannot afford to accept private insurance. Nonetheless, their names pad the lists provided to patients, who are often in no shape to negotiate the bait and switch in this latest shell game (a “short con” with the soothing insurance-company operator in the role of shill).
The difficulty in finding an in-network professional to work with a victim of bullying is not only a reflection of the limitations surrounding mental health coverage, but of the uncertainty—even incredulity—surrounding claims of severe psychic ‘damage’ resulting from social aggression.
Unfortunately, mental health issues that result from bullying are real. But until disruptions to cognitive functioning are understood to be linked to social aggression, until parental advocacy reaches such a pitch that institutions (DOE’s, insurance companies) find it in their best interests to respond (think of the new ‘legitimacies’ and resources attached to ‘the spectrum’—from autism to ADHD) victims of bullying will continue to have difficulty negotiating the psychological wounds they suffer (unless parents have the ability to pay for help, out-of-pocket). Until such a time, school guidance counselors and the occasional visiting social worker will be left to pick up the pieces.
Sadly, parents might need to decide whether they should drain college savings accounts in order to get their child through high school.
