Mental health care in America is one of those things you don’t realize is broken until you really need it. Unfortunately for me, and millions of Americans every year, I was forced to navigate our system when someone I love needed help. Rather than explain what’s broken in theory, I want to start with sharing my story in hopes of humanizing this issue and highlighting the need for companies to support their employees more effectively.
From PPO to EAP to OON: When “good health benefits” still leave you out in the cold
My story begins in the Spring of 2019, when my wife gave birth to our daughter, Isabel. While this was unarguably the greatest day of my life, the events that transpired after we arrived home from the hospital thrust us into a world we were not prepared to navigate. My wife was later diagnosed with postpartum depression and anxiety, but in the early days of our return home from the hospital, all we knew was that we needed help. Within a few days back home, I was on the phone with my health plan trying to find a mental health provider.
After speaking with a representative, I received an email with a list of providers within a 10-mile radius. It had over one hundred names and phone numbers. There was no other information given to determine whether these people would be a fit for us–just their names and contact details. So, I began dialing. One after another, I reached the provider’s voicemail, and left a message. I made over thirty calls that first day, with not a single live answer. I figured it was normal, and that I would get plenty of responses in the coming days.
Over the next week, I received two calls back. One provider told me they were not comfortable supporting postpartum issues, and the second told me that sure, they were available to meet with my wife–in five weeks. Clearly, we had reached a dead end trying to access care through my health plan and we were now over a week into a very difficult situation.
My next step was to reach out to my company to see what other benefits, if any, could help. I was pointed to our EAP (employee assistance program), and given a 1-800 number to call. Interestingly, I had been at the company six years at this point, yet I had no idea there was an EAP, or what purpose it served. I was happy to have something though, so I called the number. I was routed to a representative who asked me an extensive list of questions about what my wife and I were dealing with. While this customer service associate was polite, they were also cold and impersonal. After ending our call, I received an email with suggestions for care in the EAP’s provider network.
Of the providers sent to me, two were willing to see my wife, and only one was available within a week. Although we finally were able to see someone, this provider was a poor fit for my wife, and he had no experience with postpartum issues. After one session, she stopped seeing him and we were back to square one in this arduous process of accessing quality mental health care.
At this point, we really needed help, so we decided to go “out of network” (OON). My company at the time provided a generous OON offering in our health plan (70 percent reimbursement) and I figured this was my last, best option. I opened my laptop and started Googling. This process was just as laborious as the previous steps. I had no idea what conditions providers specialized in, what kinds of therapies they practiced, or if they were any good. The only resource I could find at the time was Yelp, which did not help me identify which providers were actually taking new patients. I began calling therapists and received just as many voicemails as when I called providers through my health plan. Unfortunately, I had no luck finding a provider who could help out-of-network, either, and reached another dead end in our search for timely care.
Out of desperation, I called a postpartum non-profit organization and begged them to help us find a mental health care provider. A kind soul there began personally calling providers until she found someone who specialized in postpartum issues and was taking new patients. While this provider was incredibly expensive (and submitting OON claims weekly was a monumental pain in the butt), my wife finally received appropriate care five weeks after we came home from the hospital with our daughter. Five weeks.
How getting care can look when companies get it right
While my wife finally received appropriate care, going through OON providers and processing claims was not a sustainable option for our family, especially if issues persisted or worsened again for either of us. Luckily for our family, things took a turn for the better a year ago when my then-workplace launched the Lyra Health benefit. The human resources team had shared with employees about what Lyra offered, and both my wife and I were excited to try it out when the benefit became available. On January 2nd, 2020, we both logged into the online portal and began the intake process. It took about three minutes to answer the clinical assessment questions, and my wife was immediately matched with a provider specializing in postpartum depression and anxiety that was 3 miles from our home. Not only that: This provider had availability within 48 hours.
By then, I also recognized the need to prioritize my own mental health–I needed help, too. I was very easily able to find a therapist that same day with immediate availability. Earlier in the process, I hadn’t even considered finding care for myself–but with a tool as easy to navigate as Lyra, I was able to find the care I needed and was in a better space to support my family.
This was our family’s happy ending–the light at the end of the tunnel in our mental health care journey. My wife got the exact care she needed, I got the exact care I needed, and our family was able to collectively get well. I am forever indebted to the benefits leaders at my former employer for offering Lyra Health–it was truly life-changing. In fact, I was so deeply impacted by the mental health care we received through Lyra that I ended up coming to work for the company.
Now that I’m a member of the Lyra Health team, my mission is to prevent as many people as possible from having to undergo the same experience my family and I did. My story is not uncommon, though–it’s the norm. There is a better way that is less despondent and broken. My hope is that through our work at Lyra Health, we can fix this long standing problem and break down the barriers that keep people from receiving the timely and effective mental health care they need.
If you’re interested in learning more about Lyra Health and how we’re bringing incredible mental healthcare to companies and their employees (or if you just want to chat about the mental health care experiences you’ve had), feel free to message me on LinkedIn or email me at [email protected]. I would love to connect and help in any way I can. My hope is that with every passing day, more barriers are removed and we can fix our broken system together.
CONTACT US
If you want help connecting with a therapist, Lyra can assist you. You can get started today if Lyra is offered by your employer. Sign up now.
For employers who want to learn more about how Lyra’s enhanced EAP addresses network adequacy and quality issues, download our whitepaper on quality or get in touch.
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DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
ABOUT THE AUTHOR
Jason Abrams is a Partnership Territory Director at Lyra Health. He lives in the San Francisco Bay Area with his wife, daughter, and two cats. Jason is also on the Board of Directors at the Berkeley Humane Society, a non-profit animal welfare organization serving the Northern California region.
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