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uppose you’re in need of a service that
falls under the vast umbrella of the
term mental health. Assuming that the
intellectually and emotionally acro­
batic terms and conditions that gov­ Patients and providers agree: H M O s are shortchanging folks with mental health needs by Patrick Collin?
ern today’s health maintenance organizations
aren’t enough to discourage you, add to the mix
plan’s limit requires justification, which means
“I owe almost $15,000,” she says, bluntly.
are working towards having more money spent
the fact that you’re queer.
more paperwork.
Bruce says since high school she has suffered on it.”
“What’s happening to mental health is
Also, the agency has also experienced a dras­ from what was only recently diagnosed as bipo­
But Bruce is hardly waiting around for that
what’s happened to health care in general,” says tic staff reduction, dropping from 18 therapists lar depression, a condition which has, over the
to happen.
Terry Lejeune, a licensed clinical social worker in January to its current six.
years, brought her extreme highs and even more
“I would like to branch out and form some
who has served as clinical director for the past
Lejeune approaches the agency’s dilemma extreme lows.
sort of support group for gays and lesbians,” she
eight months at Phoenix Rising Foundation, a with spirit, but says she often finds the restric­
At high tide, Bruce says, she’s bought cars, says. “Also, I’d like to go into high schools and
Portland-based group that caters to the sexual
tions and the lack of resources— time and peo­ started businesses and spent thousands of dollars speak on depression and bipolar issues. People
minorities community.
ple— frustrating.
on miscellaneous items. At her lowest points,
are real funny about their emotions, but it’s time
For Lejeune, the frustrations of managed
“For us, the challenge is getting people in,” she’s attempted suicide.
to say, hey, it’s OK.”
care are a part of daily life.
she says. “Lots of people are waiting, so we’re
For her suffering, Bruce’s insurance kicks in
She adds: “For so long I questioned God and
“Mental health is being bought out by big making room by moving clients further out, but up to $2,000 per year for mental health treat­ thought I would be so much better off dead, and
corporations because it’s really hard to make it as that’s kind of sad because lots of people could
ments. That doesn’t even touch her hospital
now I think the reason I’ve survived is to get the
a nonprofit. They’re collapsing all over the
benefit from weekly visits. People often need a bill, she says. At an average of $500 per month,
word out.”
country. You need a whole business unit to take
Fortunately there are those within the health
care of the details,” she says.
care bureaucracy who are trying to address men­
“The paperwork is overwhelming,” adds
tal health issues before they reach the crisis
Lejeune, who left private practice to come to
stage.
Phoenix Rising during its most turbulent peri­
Ron Bloodworth, youth suicide prevention
od.
coordinator with the Oregon Health Division, is
The financial troubles that plagued Phoenix
currently drafting a statewide plan to address
Rising, she says, are the result of good inten­
youth suicide, which will specifically include gay
tions.
and lesbian youth issues.
“We’re sort of damned if we do, damned if we
“The whole thing about gay and lesbian
don’t,” she says. “We tried to maintain a sliding
youth suicide is very controversial,” Bloodworth
scale approach in order to serve our clientele,
says. “Over the last 20 or 30 years, the profes­
and we still do, but there’s less sliding now.”
sionals have not looked very closely at youth
The results of a survey of doctors and nurses
suicide in relation to sexual orientation.”
released recently by the Kaiser Family Founda­
Bloodworth plans to do something about
tion point to a number of disturbing trends
that, although he’s proceeding with a certain
linked directly to managed care.
degree of caution.
According to the survey, 87 percent of the
“Research on sexual minority youth is more
respondents said that during the past two years
complicated for a number of reasons,” he says.
their patients had been denied some sort of care,
“Many of them are still struggling with sexual
including mental health services.
identity and not ready to identify as gay or les­
Depending on the type of care denied, one-
bian. They may engage in heterosexual behavior
third to two-thirds of the doctors surveyed
to prove to themselves or others that they’re not
believed it resulted in serious health conse­
gay”
quences.
TJ Bruce
He adds: “Young people, if asked face to face,
One can only guess how many of those
are most likely not going to tell the truth about
impacted patients are queer.
minimum of six solid months to come to terms her medicine alone will cost her nearly $6,000
it. If they’re given a survey it increases the
Phoenix Rising is now recognized by the
with a problem and reach some sort of resolu­ per year, or three times the insurance limit.
chances that they may disclose gay or lesbian
tion.”
Oregon Health Plan— a blessing and a curse,
identification.”
These days find Bruce in a more proactive
Lejeune says. A blessing because a previously
Regardless of all the complications, Lejeune
mode. She plays third base for the Red Wings, a
Accuracy concerns aside, Bloodworth says
unreached population now has access to ser­ says there are quality services available.
Rose City Softball Association team. She
that the research he’s reviewed indicates that
vices; a curse because many of those who previ­
“The biggest issue is that gays and lesbians recently put a rainbow sticker on her truck, and sexual minority youth (those aged 10 to 24) are
ously enjoyed the services now find themselves are concerned about accessing their own private she joined the National Alliance of Mental Ill­ anywhere from two to seven times more likely to
insurance for fear that something will happen,” ness of Clackamas County.
ineligible.
engage in suicidal behavior than their hetero­
There are other issues that can make access­ she says. “That’s why people were attracted to
On June 7, Bruce participated in a video sexual peers. Among gay males the risk is high­
Phoenix Rising. We tried to get around the reg­ conference with Vice President A1 Gore and his er than among lesbians.
ing services at Phoenix Rising tricky.
ulations by developing our own sliding scale, but wife, Tipper, to discuss issues around mental
The Oregon Health Plan, for example, will
And that, for now, is sufficient evidence for
that sank the place financially.”
health.
only cover visits every other week for six
Bloodworth to include sexual minority youth in
For TJ Bruce, a 38-year-old Clackamas
“People from three cities were chosen to par­ the state’s plan. How the political machine will
months.
Lejeune says that many clients could benefit County resident, financial distress is not an ticipate,” Bruce says. "It’s been confirmed that
receive his recommendations, however, remains
depression is a biological disorder, and the Gores
to be seen.
from weekly visits, but anything exceeding the abstract concept.
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