Mental health is a luxury for the uninsured

When I get anxious, I call Jeff. He sits at a government desk in an old, dilapidated building at a large state mental-health complex that has everything from an inpatient hospital to a facility for northern Nevada’s criminally insane. Like most mental health nurses, he’s a busy guy, fielding phone calls from hundreds of patients, many homeless, some disoriented, all desperate.

I met Jeff at the outpatient clinic when I was one of the alleged 47 million Americans without health insurance. I was pretty down. It wasn’t always this way. I had jobs with insurance in the past. But like thousands of others, one day they disappeared. I moved to Reno and in with my mom.

I admit, the facility is not much to look at. The computers sometimes don’t work; the state is woefully broke and the facility overcrowded. Statistically, Nevada has one of the highest suicide rates in the country, a reflection of the transient nature of the state’s population and the gambling industry that attracts down-and-out people desperate for a miracle at the poker tables.

Sometimes in the waiting room I see patients with laptops, some dressed in a suit and tie. Perhaps they are off to a job interview. Perhaps, like me, they just want to feel good in some nice clothes bought long ago and pretend they are not broke. It’s tough. Some days there are 30 walk-in patients, many waiting eight hours to get free Ambien so they can rest at night. There isn’t always time for all to get help. They are told to return the next day. While the government argues about healthcare reform, millions are worrying themselves through the night until the sun comes up, losing sleep over everything from their lost houses to their lost lives. It’s tough.

For many, we rely on the nurses more than the overwhelmed state psychiatrists who run between the clinic and the hospital, getting up at all hours of the night, dealing with the emotional fallout of the nation’s economic crisis. Eventually they get tired of balancing caseloads of 500 patients, and one day we find out that Dr. So-and-So has left.

Then there’s Jeff. After years working in the state mental health system, he’s seen every problem in the book, listened to a million stories about things existing in this life and those on other planets. He has no plans to go anywhere. Instead, he offers up advice that often makes sense. His favorite line is, “In these times, who is not stressed out?”

I confess, I once turned to the private sector, barely scraping up the $300 for a visit to a fancy doctor. I figured that maybe if I paid more money, went to an office with an oversized aquarium filled with exotic fish and quiet music playing in the background, my anxiety would miraculously disappear into the plush carpet. I discovered something important: The nurses there weren’t the same. Their conversations were short and to the point. All they wanted to know was, “What is your specific question?”

Sometimes, I don’t have specific questions. Sometimes I just want to talk to someone who gets it. I don’t care if they have fish. I want someone like Jeff, who asks the question, “Just what is normal, anyway?”

Palchikoff is a freelance writer living in Reno.