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Community Centers: Is this just how it is?


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Hi, I'm new. *wave* I just have a little question. I don't have any insurance so I've been going to a local center in my town that has a sliding scale/works with your income. I've been seeing a therapist with them and an ARNP (I think), who's been prescribing my meds.

The problem I have (besides still feeling as bad as I did when I walked in the door) is that I feel like the ARNP just hands me pills without really trying to figure out what's going on with me or how I'm reacting to them. And maybe its just my distrust of doctors or my general paranoia, but I honestly only get like ten minutes with her before she's standing up, hurriedly wrapping up the conversation, promising me we'll "figure it out" and ushering me out the door. And ten minutes is probably the max I've ever been in her office. Every time I see her I feel so rushed, so pressured to get everything out just right, make sure I cover everything that's been going on with me so that when she decides to change my meds again or add a new one, maybe she at least knows what she's trying to fix. And thus, that gives me extra stress because I feel like if I don't communicate myself properly in those 5-10 minutes then it will be my fault if I'm not treated properly.

Anyway. My question is for those uninsured like me who have gone to community center or places with sliding scale rates that are always busy, understaffed, etc, is this just one of those things I have to accept? Is this normal to only see the pdoc for ~10 minutes? (especially since she's changed my meds 3 times in the last 3 months.) I'm really, really bad at speaking up to people, but if that's what I need to do to get her to pay attention to me and you all think it would actually work, I'll try it. I'm just not sure it would do much good with how many clients she has to see in a day, etc.

Issues: depression, possible Bipolar II, anxiety

Currently taking: 60mg Prozac, 75 mg Wellbutrin, 500 mg Depakote, Vistaril

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I go to a sliding scale clinic. I see a p-doc there. He's alright. I kinda feel rushed, but he listens to me go on if I have to.

I don't think that what you described is necessarily characteristic of community centers. They have their downfalls, that's for sure.

Definitely speak up if you feel like you aren't being listened to! That's what she's there for. She should be doing her job.

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I can't speak to the community center issue, but I am terrible at remembering what's wrong with me when I'm actually face to face with a doctor (or at extemporaneous speaking, for that matter), and have learned to write everything down ahead of time, in as much detail as I need, so that I can just read it out like a letter if I need to.

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I would suggest that you write down everything that you'd like to discuss. Give her the paper and let her read it herself. That'll give you plenty of time to figure out exactly what it is you want/need to say and it's quicker for her to read than for you to explain it all. Also, she'll have something she can stick in your chart that you can refer to at a later date should you need to.

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well I'm fully insured and that's how it goes with my pdoc...I think they plan on 15min...the very first visit she did take an extensive history...but that's it...she expects the patient to be proactive

does she say anything like "how are you?"

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I am insured, and my monthly appt is scheduled for 15 minutes. And I don't feel rushed, because I write down a list of everything I need to cover (moods, meds, suggestions) before I enter the room. But I csn run over my time if I'm having some really big issues.

I went to a community mental health center for about a year. It was hard, as I always saw someone new. I had several med changes, because the meds they hand me on weren't working. I didn't really feel rushed as much as I felt I wasn't hsving my opinions taken into consideration. I had some say, but not as much as I do now.

But for the most part, the mental health clinic helped me make it through a period of time that I couldn't have if I went unmedicated. So they were a lifesaver for me.

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I went to a community mental health clinic for about two years, like Gizmo I always saw a different doctor. Before that I had been with the same pdoc for 10 years, so after two years at the clinic I went back to my original pdoc. I don't have insurance but at the clinic I was paying $85 each time I saw a pdoc. This place supposedly operated on a sliding scale and I submitted paperwork to them about mine and my husband's income and the $85 was the figure they came up with. I thought it was too high. I'm now paying the same amount to see my pdoc but I'm okay with that because he's a good pdoc and I've been seeing him since I was 18, minus the two years I went to the community clinic. I think most of them are good places and they definitely provide a good service for the uninsured and people who might be low income. I think you've gotten some good suggestions like writing down the things you want to discuss, I do that with my pdoc.

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My experience with community mental health centers wasn't very good. Keep a mood chart and make good notes to aid the pdoc in med changes. They just have SO MANY people to see and they are over-booked and under-staffed.

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  • 3 weeks later...

I'm in Arizona and qualify for services at an SMI community clinic. It's not a sliding scale clinic. It's for people who meet certain criteria. The state paid for my treatment when I didn't have insurance and now I have Medicare and Freedom to Work (a program that lets me buy-into medicaid/AHCCCS even though my husband and I are above the income threshold). The services I get are great. I've been seeing the same doctor for 2 and half years. The appointments are 30 minutes. When I've been psychotic and going through med changes, it's been every 2 to 3 weeks. When there's been an emergency, he's seen me the same day. I also have a case manager/social worker to help me get community services like Freedom to Work and SSDI, and a tdoc.

I don't see my pdoc as much since I've stabilized. My last appointment was only 15 minutes and my next one is in 2 months, but, I'm really happy with the services, anyway. I feel so lucky. I know the governor of my state has a son who's MI so she's a huge reason resources like this are available.

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