A mental health provider was kind enough to leave the below comment on my blog. I found it so unsettling that I want to put it front and center as a post. I personally feel that this mental health provider is an absolute hero for standing up for her patient the way she did. If only every woman with depression or PPD had a patient advocate like her!!! Please read and let me know what you think. (I just wish I knew what insurance company this was.....)
This topic struck me today specifically because I "had it out" with an insurance company and their "clinical review counselor" today....
I have a client who is a 35-year-old woman who is moderately depressed, and trying to get pregnant. She is responding nicely to psychotherapy and wishes not to start medications because of her desire to become pregnant, and I support this as do her physicians. The "clinical review counselor" from her insurance company disagreed with me because meds would make her treatment progress faster and therefore cost the insurance company less -- he cited this new literature that you cite here in your blog -- I hadn't read it yet but told him that it was ridiculous to medicate someone who is responding to psychotherapy and who wants to become pregnant just to speed things up. It's not worth the risk, no matter how small. His only response was that it was afterall the patient's decision.
What annoys me is that if I were not one to advocate for my clients or one who was up on the research, I may have been swayed by this and felt pressured to lead the patient in that direction. In this case, I totally feel like I won though, especially when he asked me for the expected length of treatment; I said "6 months and if she gets pregnant she'll need to be monitored throughout the pregnancy and the postpartum period because her risk of postpartum depression is increased." He said "ok" -- NEVER do they say "ok." Their job is to limit benefits to save money - he clearly had no clue about perinatal mood disorders.
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