What does mental health treatment look like after the military?

happysailor

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During my time in the military I found MTF psychiatrists to be obsessed with my mental health diagnosis at the expense of me feeling better. They “diagnosed” me with 4 personality disorders despite me not meeting the criteria for any personality disorder.

Now, a few months after being medically retired, I find myself in the midst of a manic episode no medication combo can tame. My psychiatrist has tried so many medication combinations and nothing is working. I may have to resort to hospitalization unfortunately.

I am reluctant to go back to a MTF. I definitely do not want to go to any VA. I have Tricare but if I go to a civilian hospital it would be about $800 just for an ER visit (I am Group B Tricare Select so I have a lot of copays).

Any advice?
 

WL202

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During my time in the military I found MTF psychiatrists to be obsessed with my mental health diagnosis at the expense of me feeling better. They “diagnosed” me with 4 personality disorders despite me not meeting the criteria for any personality disorder.

Now, a few months after being medically retired, I find myself in the midst of a manic episode no medication combo can tame. My psychiatrist has tried so many medication combinations and nothing is working. I may have to resort to hospitalization unfortunately.

I am reluctant to go back to a MTF. I definitely do not want to go to any VA. I have Tricare but if I go to a civilian hospital it would be about $800 just for an ER visit (I am Group B Tricare Select so I have a lot of copays).

Any advice?
Can you try to see a civilian psychiatrist? We did last year and she accepted Tricare until my husband was discharged and lost coverage. She then only charged him a cash price. It was worth it for his sanity, although we just changed to a new one.
 

tony292

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My advice after the military is to stay away from VA mental healthcare, they won’t give you any newer or expensive drugs because they are restricted in that they can only prescribe what’s on the formulary list…. Only older and generics drugs. Also if your situation is severe, they have to see you within 30 days, so this means you’ll get shuffled around a lot. At one point I was seeing 3 different mental health providers there, a psychiatrist, psychologist, and therapist, just so they could check the block and say they had always seen me every 30 days. I also went inpatient twice, and left just as bad as when I went in, they just shuffle you in and right back out it’s a revolving door, they have such few beds, they have to make room for the next person.

by all means, use your tricare, or VA choice program and see a civilian mental health doctor, it is so much better. You can get newer meds and better treatment without all the hassle. To use the VA choose program, you would have to go to the VA and get referred out to a civilian psych doctor, no guarantee that would happen, but if your VA mental health is swamped like most are, it should be easy to get a VA choice referral.
 
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tony292

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Also, if you’re manic, you most likely need an antipsychotic and a good mood stabilizer. SSRIs and SNRIs will usually make the mania worse… there are only a few meds that work for mania and a lot of meds that either don’t work, or will make the mania worse.
 

chaplaincharlie

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Certain military providers, MH and otherwise, are very disappointing. The MC was formed to have providers promoted independently of the Line. Unfortunately some providers have forgotten there first love should be healthcare.

Civilian providers don't get the military obligations co-mingled with their professional responsibility, but there are other distractions. Like payroll, rent, insurance filing, insurance reviews, malpractice premiums...

So try a civilian provider for a minimum of six months and see what you think. You have to also remember that medications are not a majic wands. You must work a plan!
 

happysailor

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Certain military providers, MH and otherwise, are very disappointing. The MC was formed to have providers promoted independently of the Line. Unfortunately some providers have forgotten there first love should be healthcare.

Civilian providers don't get the military obligations co-mingled with their professional responsibility, but there are other distractions. Like payroll, rent, insurance filing, insurance reviews, malpractice premiums...

So try a civilian provider for a minimum of six months and see what you think. You have to also remember that medications are not a majic wands. You must work a plan!
I have a civilian provider. He is excellent. But unfortunately it is out of his control that all the medications I have tried, have not worked. This is a one-off episode for me that was possibly triggered by a combination of being in too many time zones for the past few weeks from traveling and being prescribed the stimulant Adderall, although nothing is certain why I have a manic episode to begin with and what could have caused it. At any rate, I have made some extremely impulsive decisions while manic, my brain feels like it is a spinning hamster wheel, and I am going on 72 hours with no sleep again. That is why I think I may need a hospitalization, but I don’t want to go to either a VA, a MTF, or a civilian hospital for reasons listed above.

Thank you for your reply
 

chaplaincharlie

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Military, VA, or Civilian pretty much sums up the choices. At 72 hours without sleep it is hard to make a decision. It will not be easier to decide at 96 hours.
 

happysailor

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Military, VA, or Civilian pretty much sums up the choices. At 72 hours without sleep it is hard to make a decision. It will not be easier to decide at 96 hours.
Hi Chaplain charlie

I took your advice and went to an ER at my local MTF, but they told me mania isn’t an emergency, they didn’t even let me talk to a psych resident, they only let me talk to a general resident who said mania isn’t an emergency because it isn’t harming myself or others and they wouldn’t prescribe my anything, they said to try Benadryl even though I have already tried it. I don’t know what else to do…
 

happysailor

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Go to a hospital that does MH.
Can you clarify what you mean? At the MTF I went to yesterday they have a psych ER, but they wouldn’t let me talk to a psych resident or intern. I’m just afraid if I go to a civilian ER, they will do the same thing, blow me off and tell me that hypomania isn’t an emergency, and I’ll be stuck with an even bigger bill
 
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