New to this community. Diagnosed twice before 16, but stopped treatment after high school. I didn't know ADHD is so much more than difficulty paying attention!
I didn't realize how much ADHD is behind a lot of my issues until relatively recently. My marriage is in shambles and I need HELP. I began taking adderall again about a month ago, but I need some kind of individual therapy/coaching to help me learn proper ways of managing my ADHD.
I'm specifically looking for someone that is covered by Kaiser, but I don't know where to search . Calling Kaiser's Mental Health number has been very unhelpful; "We don't have anyone that specializes in ADHD, but all our providers are trained Psychiatrists, so they'll have experience with it."
Can someone please point me in the right direction?
Thank you.
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Lupercal
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I saw a link on the CHA AD website For ADHD coaches and there is another link to an organisation that's specialises in therapist that for ADHD.
And actually find it very interesting that adhd is being blamed for our inability to successfully be in relationships when nobody's actually shown us how to successfully be in relationships no one ever modelled it for us and we didn't get a class in high school. But somehow worse post about how to manage our trauma, our reactions, our emotions and perfect little robots.
Be careful. I've seen a story about Kaiser suggesting they may not be the most ADHD-friendly company to deal with. From: washingtonpost.com/health/h... :
"Over three visits with her managed-care plan doctor at Kaiser-Permanente in San Francisco, Crawford, 57, a busy mother of two and professional editor, complied with urine and blood tests some doctors require to rule out drug abuse, and was checked for any preexisting heart condition that might make stimulants too risky.Then came the last step: a telephone interview.
“What kind of student were you in elementary school?” she remembers the psychiatrist asking.
“I was an A student,” Crawford answered.
“I’m sorry,” he said, as Crawford recalled. “You don’t meet the qualification for ADHD and we can’t give you medication.”
“I couldn’t believe it,” Crawford said later. Two private therapists had already told her she had ADHD, she said. But her plan’s psychiatrist said it was company policy to deny diagnosis and medication if a patient had done well in school as a child.
This left Crawford with the option of paying several hundred dollars for a private psychiatrist’s evaluation, plus recurring costs for new prescriptions over time. For now, she’s not pursuing that. After her three appointments, “I just felt exhausted,” she said."
[...]
Stephen Faraone, a leading ADHD researcher at SUNY Upstate Medical University, said many physicians mistakenly deny ADHD treatment to patients with a good academic track record, but that he didn’t know to what extent this might be formal policy among health insurers.
Representatives for two other managed health-care plans, Aetna and UnitedHealth Group, said they had no such policy. In response to questions about Crawford’s case, a Kaiser spokeswoman emailed a statement that didn’t address the specifics but concluded: “Our priority is to tailor the clinical evidence we have to an individual patient’s needs in order to support his or her well-being.”
Thanks, yeah I've already had less than stellar support from Kaiser.
I actually tried to get started on ADHD treatment through them over a year ago, before the pandemic started, and both of the Mental Health providers I talked to were very dismissive; "why do you need ADHD medication if you're not in school?", "You just have anxiety." I ended up not following up with them because of how discouraged I felt. And I can't help but feel that things would be much better, now, had they been more supportive.
In any event, that's why I'm trying to find someone that's outside of Kaiser, but still covered by them (at least in part), if that's even possible? And I'm just not having luck finding a list of local providers that Kaiser works with our getting useful info from Kaiser, themselves.
I just really can't afford to be paying out of pocket ~$200 per session for someone that isn't covered.
After doing a quick search, it really looks like this has been a persistent pattern of behavior for Kaiser :(Source: dmhc.ca.gov/AbouttheDMHC/Ne... )
"The California Department of Managed Health Care (DMHC) announced today that it has reached an agreement with Kaiser Foundation Health Plan, Inc. (Kaiser Permanente) to correct identified issues with the plan’s oversight of and access to behavioral health services."
Also, there’s this collection of people's experiences with Kaiser that supports this impression (source: nuhw.org/kaiser-dont-deny/p... ); here's one that mentions ADHD:
"MY SON HAS AUTISM, ADHD, DEPRESSIVE DISORDER, AND ANXIETY
Published Saturday, October 12, 2019 #
My son has autism, ADHD, depressive disorder, and anxiety. He has been hospitalized three times. Before all of his hospitalizations, there were warnings signs and severe behaviors that needed to be addressed. If we had been able to schedule an appointment rather than exchanging phone calls, his hospitalizations could gave been prevented. He is more stable now, but we only get to see his psychiatrist every six months. Urgent appointments are not available if a crisis happens. I also feel they are lacking therapists specializing in kids. All of my son’s hospitalizations were outside of Kaiser, and we’ve had to see therapists outside of Kaiser because Kaiser lacks the resources and facilities to handle mental health care.
April
Santa Clarita"
There's a part at the end of the first article you may find particularly interesting as someone in the state of California: 😉
"If a consumer is experiencing difficulty accessing care they should file a grievance with their health plan. If they are not satisfied with their health plan’s resolution of the grievance or have been in their plan’s grievance system for 30 days, they should contact the DMHC Help Center for assistance by calling 1-888-466-2219 or at HealthHelp.ca.gov."
DefinitionReclaimed, thank you for that info. I filed my greivance about being blocked to be assessed for ADHD on September 3rd of 2021. Next Monday it will be 31 days and nothing has happened and I will use the resource you posted. THANK YOU!!!!
in reply to
Well, I did contact the California Dept. of Manged Health Care, and they transferred me to a legal group that provides pro bono legal help in writing grievances for the CDMHC to pursue. The legal group told me the following: Because I do not have medical proof of a disorder, I cannot file a successful grievance to be assessed or get care for the same disorder. In other words: I have to have a diagnosis to get a diagnosis. Further Catch-22 BS that is ridiculous, not unlike Kaiser's own view that I cannot have ADHD because I was not assessed by age 12, when it was believed by doctors I could not have it because I was female. I am so over everyone dismissing me and dangling carrots only to snatch them away and say I can't have them because: Arbitrary conditions I can never meet. I have contacted CHADD, NAMI, ADDitude Mag, and now a Hallowell ADHD center, as well as Stephen P. Hinshaw, the former Chair of UC Berkeley's Behavior Science Dept. and an expert (with 20 years of research) on Women and ADHD, asking everyone for advice, more resources and/or help. The only thing that "MAY" help is me paying hundreds out of pocket to get a diagnosis outside of Kaiser and submitting it. Then Kaiser will determine if it's "legitimate." I am going to get it from Hallowell's clinic, which holds a nationally recognized level of care for individuals with ADHD. Let's hope Kaiser does not think their shitty care is above Hallowell's and make me get another diagnosis. I wouldn't put it past them, however. Kaiser does what is in Kaiser's best interest. The "thrive" appears to only apply to the organization itself and it's profits and providing as little mental healthcare as possible.
I typed a long response below, but thought I would tell you....have you filed a complaint/grievance with Kaiser about them not treating you? It's a messed up process, but I honestly believe the patient advocate who is handling my grievance about not being able to be assessed for ADHD, is really caring and concerned about me getting care. But she was not hopeful Kaiser will agree. I gave her a scientific resource to cite, considering all Kaiser's decisions are supposedly "evidence based," according to her. This was a review paper published in February of this year, by Dr. Stephen P Hinshaw (an expert in AD(H)D in females), et. al, where he cites dozens of peer review studies about ADHD in women and girls, and also in adults, that blow Kaiser's criteria for who can be assessed straight out of the water. The one thing that really sucks is if you file a grievance, the advocate that takes your case works outside of the KP.org website, and they have no email. They are overloaded with cases, and even leaving a voicemail can be impossible because their VM can fill up in a couple of hours. So all correspondence is done via snailmail. I am suspicious this is done by KP to make it feel hopeless so people will drop their grievances or not follow through. Their "Thrive" mantra is complete BS. Sure, if you only need to go to your PCP to get an infection dealt with and a couple of other small medical issues, Kaiser is great. But if you need mental health, dealing with their system can give you mental conditions you did not have before dealing with them. Now, my chest is constantly tight, I have a hard time eating, I am more distracted than ever and pace a lot. I just want care, and I cannot seem to get it. F*** Kaiser.
in reply to
And one more thing Lupercal,
YES!!! YOU can see a therapist who is contracted and outside of Kaiser, however, you still have to go through Kaiser. It will help if you call your local mental health care intake system, and don't be afraid to seem upset about it, play up your symptoms or highlight extreme things that make you look like you are having a hard time, especially if you have comorbidities. You can now (it's a new feature) find their phone number on kp.org. I did this and they elevated me to urgent and within a day or two I was called back by someone to schedule me for another issue (Trauma), and I am excited to be seen by this outside therapist, because her specialty is Trauma Care, and she does EMDR which I need and it a highly specialized skill. If I had not had a meltdown on the phone with the person I reached when I called my local Kaiser mental health center, I would never have gotten this quality of care. Play the system and do what you gotta do to get what you need. Once you are under the care of a specialist, what goes on there is between you and them and the Kaiser machine is not involved anymore in the day to day meetings. Good luck.
I would check with your local CHADD group, they should have resources that can help you find the help you are seeking. Just curious as to where about you are located...
I also have had several marriage issues, then I opened up and discussed with my wife my brain and how it works sometimes.... knowing ADHD is not going away, it made it a little easier for us to communicate and try to turn things around...
Thank you. I'm in the coastal Los Angeles area. I see there is a local CHADD chapter. I'll definitely try contacting them.
Unfortunately, between the pandemic and my wife's line of work, things have gotten to a breaking point for her. ADHD seems like just an excuse to her. We've started couples therapy, but it's clear that I need someone to work just with me on managing ADHD.
Hope things with you and your wife are going well.
We are getting better, thank you. There are a lot of dynamics to a relationship, ADHD is not an excuse but a reason... with coaching you can turn some things around,
It’s like needing glasses... you can’t see where you are going... but once you have the right glasses you can see very well...
Once I was diagnosed I understood a lot of the things I did, but more importantly for me I learned why... non ADDers... neurotypicals see it as an excuse, but we know it is the reason, and knowing that we can work on stuff 👍
I am sorry you have had trouble with your insurance. It is hard enough as an adult to get the medication for ADHD.- I have insurance but I have to use GoodRX to get a discount on my medication because my health insurance doesn't approve ADHD meds for adults. I see a counselor, but she has to say she is seeing me for anxiety, rather than ADHD- and it's true, I do have a lot of anxiety, but it makes me mad that my health insurance won't approve therapy for ADHD.
As far as you needing to see a counselor v. marriage counseling, maybe it would be good to do both? I would suggest two different counselors, though, so your wife doesn't feel the counselor is skewed in your favor. I would also suggest educating yourself about ADHD as much as possible, by reading books about it, and then you can explain to your wife that there actually is a problem with three neurotransmitters in the brain that can cause the symptoms, and it causes problems in the executive functioning in the brain. You can even say, I understand you are angry about my behavior, but I am trying to address the problem. Maybe the marriage counselor can help with her viewpoint.
I just read the book Women with Attention Deficit Disorder, and I know that isn't real helpful to you, except that it mentioned that the non-ADHD partner has to go through the grief cycle to come to terms with the ADHD in their spouse. And the first stage of grief is denial. So the good thing is, she is on her way to acceptance....eventually. Take care.
Thank you. There is definite a LOT of anxiety that comes with my ADHD. The result of a lifetime of failures, real and perceived.
We have already started sessions with a marriage therapist and I do think that is helping. So, now I am looking for my own separate counsel to focus on me and my issues, so that I am better able to function and contribute to us.
I've read quite a bit already. And I've tried to get my wife to read up a bit too. I got her to read some of "The ADHD Effect on Marriage" and she agreed that it describes, almost verbatim, our issues. But, I think right now, she still feels like ADHD invalidates her experiences with our various problems. It doesn't though. I still did(or mostly didn't do) those things. ADHD is not an excuse, just explanation. So, hopefully she just needs a little more time.
I haven't read the ADHD Effect on Marriage. My first marriage was to a man I am sure has ADHD as well, but in addition to that he was verbally abusive. Now, I'm married to a man who has some of the traits of ADHD but because of it, has accepted me and all my foibles with love and compassion. He had an advantage in that he knew about ADHD and knew about MY ADHD before we ever got involved. I pray for the same acceptance for you, from your wife. I did read that a non ADHD spouse can feel like they are expected to just suddenly stop being angry for the things the ADHD spouse did before getting help, and it's not that easy. I can see how she might feel like it invalidated her experience, and would be resistant to the acceptance of ADHD, but I'm sure you must feel some hope in that she is attending marriage counseling, and was willing to read part of the book you mentioned!
Kaiser has a less than stellar reputation for mental health. You may wind up needing to hire an attorney or contact the Health Consumer Alliance or Health Consumer Action Center at the Legal Aid Society if access to appropriate specialists is not given to you.
Hi there! I am a Kaiser patient, so I'll share my experience.
I've had to fight to get assigned to a counselor at Kaiser twice in the past two years, even when going through somewhat of a crisis. By "fight" I mean, be on the phone, email, for hours just bugging the crap out of them until I got help.
That said, the two counselors I've ended up with are just wonderful, so in my experience, the problem is definitely the system, not the therapists at Kaiser.
Then I realized I probably have ADHD. So Kaiser assigned me to a psychiatrist, and that did not go so well. He did not want to consider evaluating me for ADHD until I went through months of therapy for depression. I kept saying my depression is likely made worse by ADHD, but I could not get him to even agree to evaluate me. Oh and yeah, I had to do a pee test to rule out substance abuse, which was a little humiliating. It didn't start us out on the right foot.
Exasperated, I went out on my own and paid $200 for evaluation and treatment through a telemedicine group associated with UCSF. I now get my prescription sent to Costco, which out of pocket is actually cheaper than Kaiser's rate for covered prescriptions.
So now I continue go to Kaiser for my regular therapy, but to date have not been able to get ADHD-specific counseling.
I'm fortunate to have a decent job right now, so I'm probably going to pay out of pocket for short-term ADHD counseling soon. I just decided the exasperation with Kaiser wasn't worth the added stress. But like I said, I'm glad I can afford to pay a little for counseling.
If you haven't already, I would call the main office of the providers and ask to speak with someone who could help you find the provider who had the most experience with ADHD.
Kaiser won't do that. They tell you your only resource is to read the Dr. Bio on their website, which may or may not (which is most of them...) be very detailed. It's just a general blurb about what motivates them or their philosophy with treating people, and a list of some of the disorders they treat. Nothing more. I have even called the specific office coordinator for a couple of psychiatrists, and asked about the Dr.'s work (do they treat a lot of "x"?) and I get told the office coordinator has no way of knowing. And Kaiser won't let you speak to the doctor, you have to select them and schedule an appointment, so you can't even see if someone would be a good fit for their personality. The triage nurses don't know any more either than the worker bees at the bottom of the mental health ladder who answer the phone. To say Kaiser's mental health system is disjointed and ineffective is a huge understatement. I call them almost every single day. I have one grievance on their ADHD assessment criteria for determining who they will assess, asserting it's ageist and sexist. I have another human resource specific grievance on the ageism and sexism, and I have another trauma nurse (I have spoken to 4 in the last 2 months), put in for me to get a second opinion about the ADHD, which is supposed to produce a result in 2 weeks. I will believe it when I see it. I don't know who else I can squeak to, but I am not sure that a squeaky wheel will get any attention in this cruel facade of a mental health system.
And none of this even touches on the fact that I have also been approved for trauma mental health care (from a rape, several physical sexual assaults, domestic violence and growing up with a highly misogynistic father) and awarded 52 visits, and have called 25 therapists in my area, who are supposedly accepting new patients and not found one, and a couple just called me back and said I was not a "good fit." I was awarded special elevated status because I had been trying to find a therapist for trauma on their horrible system for a month and was called and told there is a new "pilot" program to hire more contract therapists. This guy who called me set-up an appointment with a therapist a month out. I was not happy about that because I had already wasted a month using their inaccurate system to try to find someone who was accepting an adult patient with trauma experience. But fine...late care is better than nothing I said to myself. HA! Well that therapist called me 2 days ago, frantic that Kaiser had dumped a bunch of patients on her; more than her small practice could handle and she informed me that I was the last one and that it's likely she won't be able to take me, because she will give the others who were schedule first priority, IF she can even see any of them. So---I really don't STILL have a therapist for trauma. Kaiser is just a sad, sad epic fail on all mental health.
By the way, here are some resources that might help you find a therapist in your area (with filters for insurance, specialty, etc.) if you didn't already know about them:
I am in the same boat. I am in Sacramento County, and have Kaiser and I cannot be assessed for ADHD, because I was not diagnosed by age 12, which is the only criteria Kaiser is using from the DSM-5 to decide who can even be assessed, at least in the Sacramento area. Here, Kaiser has a specific ADHD Assessment Center, and the gatekeeper is some jerk who did not take my gender and age into account, and ignored (or was ignorant to the fact) that at age 52, I was 12 in 1982, when it was a settled belief that girls could not have the ADD disorder. There had only been one study published in 1979 that suggested females COULD have the disorder, and that idea was considered a "fringe" idea, at that time. The second study about girls and ADD was publish in 1983, the year I was 13. It was nearly impossible for me to be diagnosed because of this. It's ageist and sexist, and Kaiser does not clearly have any awareness that ADHD is often missed and not diagnosed. I have begged them to get a specialist that is experienced in diagnosing Adult Women. Why a specialist for women? Because our symptoms are very different from men, and currently all the markers for behavior to diagnose ADD are made up from predominately studying males, so females are not in the data. I have always been very active for a girl, I was a tomboy, I played rough and tumble with the boys in my neighborhood, did jobs that were traditionally male and very physically demanding, I have a hard time keeping female friends. I have always had to work extra hard to stay on task, be on time, and not lose things like keys, glasses, my purse and the like. I would be considered high energy for a woman, even at age 52, but not off the charts hyper like my brother who had ADD in the most obvious way from a young age. By comparison, I looked calm. By comparison to other girls, I was high energy. I have been fighting Kaiser for 2 months now, screaming at anyone who will listen. I am going to start researching hiring a Class Action Lawyer. You are not the only one who has Kaiser who is not getting the care they need. BTW, for women, the 2 most common misdiagnosis for those who actually have ADHD are anxiety and depression. Your depression likely stems from not being helped with your ADHD. Hang in there, I know how hopeless it feels. Hugs.
I’m a Kaiser member in N. CA. I’m receiving treatment via Adderall. They offer classes as well as counseling here. I wonder why there isn’t consistency in care. I had great Kaiser coverage for ADHD before moving to N. CA as well. However, sometimes it seems there is a culture or attitude adopted towards the patient if they are a pain patient as my friend is.
I am also a Kaiser member in N. CA. I was just diagnosed with inattentive type ADHD, and so far it looks like Kaiser does very little for adult ADD-ers. We've made it this far, so we must be fine, right? After doing some digging, I found that you can search for a specialist that accepts Kaiser insurance through beaconhealthoptions.com. That's where I'm at right now. I'm hoping that this is a good stepping stone. It's so hard to live a balanced life without proper help.
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