My family member was hospitalized almost a decade ago and she has not had problems that severe since then. Now she needs to see a psychiatrist, but no one will see her once she says she was hospitalized. Why not? I feel like something a decade ago should not prevent her from getting help now. Please advise.

In any reasonable world, having severe enough symptoms to need inpatient care—ten years ago or last week—would move you to the front of the line to see a psychiatrist. Instead, your family member was shown the back door. Unfortunately, the world of getting mental health care is often not a reasonable one. The experience you describe may be outrageous, but it is not rare. Two pieces of advice might be useful.

First, don’t be shy about this issue. If your relative is insured by a managed care system, let the insurance company know about providers who are reluctant to see patients with a history of hospitalization. Insurance companies want people at risk for hospitalization to be the first in line for outpatient care, not last. And if your relative does find a doctor or therapist willing to provide appropriate care, it might help other people to leave a good review or recommendation in DBSA’s Find A Pro Search Engine.

Second, creating a personal crisis plan can help to prevent another hospitalization. A crisis plan includes a personal listing of:

  • Stressful events or situations that can trigger a crisis
  • Warning signs to look out for
  • Self-care strategies that help when symptoms are especially bad
  • People and other resources to call on

DBSA’s Wellness Toolbox includes more information and tools to create a personal crisis plan. Sharing that plan with psychiatrists and therapists can be very helpful—and might make psychiatrists or therapists less worried about working with someone who has been hospitalized. Of course, it really shouldn’t be the patient’s responsibility to make the doctor feel safe! It really should be the other way around.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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