Getting Government Help (Part II)

Now that funds are so tight, government resources for the mentally ill are getting scarce on the ground. Just because you qualify doesn't mean you'll get them. Here's the second installment of my 3-part series on struggling with bureaucracies:

Be concise and polite. Losing your temper will get you thrown out the door, hung up on, or given the worst possible service. If you do lose it, take a deep breath, then smile and say sincerely, “I’m sorry. This is a stressful process and sometimes I get angry.” Even though these people are dealing with the mentally ill all the time, they have few people skills and no psychological skills or patience  (my apologies to the few shining exceptions!). DO NOT TAKE IT PERSONALLY. Paranoia will end the conversation every time, and get you marked down as a troublemaker. Their attitude is NOT about you.

Do not tell a long, detailed sob story. Do not try to make them feel sorry for you or give them every last detail. They’ve heard it all. They don’t care.

Have plenty of proof of your claims. Back up your diagnosis, your work history, your hospitalizations, and anything else they’ll question. Get paperwork from doctors and employers, or their agreement to back you up if someone calls them. Have a lease to prove your residence, or a friend who will verify that you are staying with them.

In bureaucracies, paperwork is God. You cannot afford to be disorganized about this.

Getting Organized: What if you are disorganized by nature? Here’s a simple system.

  

1) Get a box. Not a huge box, just one about the size of a milk crate or a standard box of books.

2) Get some folders – one for each agency you’re trying to get help from. Write the name of each agency on a folder – Medicare, SSI, Disability, Housing, Medicare Part D, Therapist, Psychiatrist….whatever the issues are you’re working on.

3) Every time you get a piece of paper about that issue, put it in the right folder on top of whatever’s there.

4) Every time you send out something to that agency, put a copy of it on top of whatever’s there.

5) Every time you have a phone call or make notes or memos, or do ANYTHING about that issue or agency, you write it down and put it in the right folder on top.

6) DO NOT THROW AWAY ANY OF THE PAPERS.

This system keeps it simple. Whatever is most recent is right on top. Whatever is going on will be right there when you reach for it. Even if it’s old and somebody starts making a fuss about it, you know it’s just further down in the stack.

So all you have to do is develop a habit of putting each paper in the folder the second you put it down. Don’t put them anywhere else. Don’t leave them somewhere ‘temporarily’ or ‘till I can get to it.’ If you use this system your papers will always be in the same place every time, and nothing will be missing.

It doesn’t matter if the notes are crumpled or scribbled or have phone numbers scrawled on them in 3 colors of ink, or coffee spilled on them. It doesn’t have to be neat. It just has to be COMPLETE and FINDABLE. Just keep the box in the same old corner of the closet, or whatever.

The rest of your life can be as messy as you want.

The above is an excerpt from the book Is There Room For Me, Too? 12 Steps & 12 Strategies to Coping with Mental Illness, copyright 2010 by Deborah Fruchey. Available on Amazon.com, Kindle, as a Apple iBook, or by request at your bookstore. See the posted link for a short video about the book, or visit www.lafruche.net

Getting Government Help (Part I)

  Now that funds are so tight, government resources for the mentally ill are getting scarce on the ground. Just because you qualify doesn't mean you'll get them. So here's the beginning of my 3-part series on struggling with bureaucracies:

I have a reputation among my friends for getting the most out of the bureaucracy. Here are some tips gleaned from 20+ years in the mental health system.

First of all, don’t expect fast results. If you need housing next week, start counting up friends’ sofa-beds right now. Approaching the red-tape establishment in desperation puts you at a nasty disadvantage. Public employees often don’t listen well to the urgent or the stressed. They get very huffy about the pace at which they will move.

Expect that big benefits, like Disability, will take up to two years to achieve. Small ones, like assistance paying for your pet’s vaccinations, about six weeks. Government-sponsored benefits are always harder to get. There are more hoops to jump through. Volunteer groups have been formed strictly to help you. Government employees have been trained to safeguard the taxpayers’ money and keep out frauds – so, sadly, you are considered a fraud till proven otherwise.

So that’s the first rule: give it time.

The second is: never miss deadlines or appointments. Even if you are sick, or need an attendant, manage it or reschedule it. If you miss, you can mess up the whole works and they can deny your application on the grounds that you ‘didn’t do your part.’

The other tips follow in no particular order.

Get everything in writing – and keep the paperwork. If it’s an interview or a phone call, be sure to write down any instructions or promises made, along with the date and who told you.

Keep names and phone numbers you find helpful. If you find an employee with a surprisingly good attitude or good information, ask for that person by name next time you call that office. You may even want to call them again about more general info, or a referral. “Hi, Michael. It’s Deborah again. I just wanted to ask you: what department do I call for X situation? Do you have any numbers there?” Contacts are priceless, and might even become friends over the years. But don’t wear out your welcome.

Keep copies of everything YOU send. It is a savvy trick to send things by certified and/or registered mail, so you can prove an office got something on such-and-such a date. If the office completely loses the information you spent six weeks gathering, and you have no copies, you are S.O.L. It does happen. Horrifying but true. So be persnickety about this.

Get friendly with your phone book. When you need something and don’t know where to start, look in the city, county, and federal pages at the front. Think of other names for it if you can’t find it at once. It may be under ‘Human Resources’ instead of ‘Social Services.’ The Internet is great, but not all of us have it, or are good with it. The phone book is free.

Go in person if you can. If you want a service and you can get to the office, get presentable and go there. A friend of mine needed housing. We went together to the county office and received a 25-page handout of places to look and agencies to contact! Nobody’s going to give you that over the phone. You have to be there. And the human touch works wonders.

The above is an excerpt from the book Is There Room For Me, Too? 12 Steps & 12 Strategies to Coping with Mental Illness, copyright 2010 by Deborah Fruchey. Available on Amazon.com, Kindle, as a Apple iBook, or by request at your bookstore. See the posted link for a short video about the book, or visit www.lafruche.net

Pills

 

About the best thing you can do for yourself, if you have a major mental disorder, is take your medicine. And the best thing to do with your medicine is to take it regularly, and never run out. Here are a few tips on how.

Let your pill counting be an every-night or every-morning ritual. Never go to bed without taking the last pills of the evening, and setting out what you will need the next day. You may be fuzzy in the morning, especially before coffee; it would be easy to skip one (or double up on the wrong one) and suffer for it later. I take quite a few, so I do need to specifically count how many of each item I need for morning, lunchtime and bedtime doses. While I’m counting, I glance in each bottle to make sure I have enough to last at least 3 more days. If one of the bottles looks low, I turn it upside down on my dresser so the next morning I will notice it. When I see an upside down bottle, that’s my short-hand for “Call the pharmacy, today!”

Your morning pills belong just an arms-length away from your pillow, maybe on a little saucer by a glass of water. When you get up, you can grab them and swallow them down without even looking or thinking about it. That’s what you want: an instant, automatic action. The pills for the rest of the day should have a tiny container of their own that lives in your purse or wallet or back pocket. ALWAYS. Never be caught anywhere without your pills.  If you are on public transportation and start to hear voices, you need your antipsychotics with you, to take right now, not in some drawer at home.

In fact, I recommend you have an emergency supply of one extra days’ worth that you keep on your person at all times. This doesn’t have to take a lot of space. Mine goes in the cellphone pocket of my wallet. In even the best-ordered life, the unexpected can happen and you can be stuck somewhere overnight or caught in a disaster with no access to the pills that will keep you sane and functioning until you get to safety. How are you going to handle it without your meds? If this sounds like too much to bother with, let me put it another way: would you rather carry a few extra pills, or explain things to the police?

‘Nuff said.

About pharmacies: pick a national chain if you can, one that will hold your computer records even if you are traveling to another state. It’s a good idea to check, before a vacation, that you have enough of each medication to see you through, including a couple of days’ worth for after  you get home. Try to give your pharmacy two days’ notice at least for refills. Things go wrong with distressing regularity. What if you have no more refills, and they need special authorization? What if they have to call your doctor or your insurance and don’t get an answer right away? Lots of things can go wrong with your order. For instance, maybe you’ve needed a little more medicine than usual – so now you’ve used up your prescription early, and the insurance company says it won’t pay for replacements till some time next week. Twice I was held up because the pharmacy was faxing the old office number of a doctor I hadn't seen for years! Naturally, he didn’t bother answering them. Or what if they’ve simply run out of supplies? Give your pharmacy a little lead time to sort things out. They will appreciate that you don’t breathe down their necks and rush them – and when there really is a special hurry, the people behind the counter will be more likely to be helpful and understanding if you’re usually not a pain.

But what if, despite everything, you do run out?

If you always go to the same pharmacy, and they know you, they will probably help you out. Explain that you need X days of emergency supply. Tell them why (in as few words as possible – they don’t need a long sob story). Be sure to show them the bottle you just emptied so they can verify that you really do have this prescription in this exact dosage. They will probably give you the small supply you need – possibly without charge. It really pays to be a regular customer. But even if you are new in town, if you show the bottle, you may be able to get help; especially if you can say “I’m seeing Dr. So-and-so in 5 days.” Give them the doctor’s number so they can verify that, too. Psychotropic drugs are very powerful and can be dangerous to the wrong person, so they’re right to be cautious in giving these things out to strangers.

Don’t put new pills into old bottles, though. I did this by mistake once. The old bottle read “one refill remaining”, so I thought I was alright. But it was actually time for a new prescription, and I didn’t have any refills left! I had to make a rush appointment and get an emergency supply. So when you get your medicines refilled, any leftovers should go into the NEW pill bottle. Throw the old one away.

One last tip: If you give them a list of your usual meds, Walgreen’s is capable of making out a comparison chart of the various Medicare Part D plans in your area, including a cost comparison. It pays to do this each December, during the time when patients are eligible to switch coverage.

Be serious, disciplined and reliable in the way you handle your prescriptions, so they can give you serious and reliable results.

Deborah Fruchey is the author of a general self-help book for psychiatric patients. Entitled  Is There Room For Me, Too?, it is available on Amazon.com and other online bookstores. It is also available as an ebook on Kindle and in Apple's iBookstore. Or you can request a copy from your local book vendor. See the attached link for an explanatory video, or visit Deborah at www.lafruche.net.