healthcare, mental health

High priced help for the hungry…

For some reason, my post about Adam and Darla Barrows’ love story has attracted a lot of attention. I am intrigued, because it’s somewhat uncommon for items in newspapers to generate interest for so long. Usually, you get a burst of interest in the hours or days after something hits, then people move on to the next thing. And I am especially surprised by the interest in my comments on Barrows’ piece, which was a Modern Love story, rather than a hard news item. I’m just an American blogger in Germany. Why do people care what I think? Why do they care so much that they want to respond or even set me straight? And do they know that sometimes their comments lead me on unexpected paths? That’s what today’s post is about– my unexpected trip into high priced help for the hungry in Switzerland. I never thought my post about a newspaper story would lead me there.

I recently got comments from two people who have never posted here before, both of whom have direct experience of loving someone with anorexia nervosa. One commenter seemed to agree with my take on Adam Barrows’ New York Times article about how he fell in love with a woman with anorexia. The other one clearly did not agree with me, and in fact, says my views are “outdated”. Both commenters have children who have suffered from anorexia. I appreciated that they took the time to read and comment. I won’t be surprised if others also comment, since that post is clearly very hot even a month after I wrote it. Adam Barrows’ story obviously really resonated with and rattled a lot of people.

I just want to mention a few things about that post. First off, all of my posts on this blog are mainly just my opinions. I share them with the world, but I don’t necessarily expect people to agree with me, nor do I assume I’m always right. I wouldn’t want everyone to agree, because it’s hard to learn anything new if everyone thinks the same way. Secondly, I really think that Barrows’ story was less about anorexia and its treatment, than the development of Adam’s unique love relationship with his wife. I think a lot of people read Adam’s story and got very triggered by it and felt the need to judge him. He probably knew people would have strong reactions to the story. Ultimately, I think a lot of people missed the point entirely, and focused on anorexia rather than the love story and his perspective as a man who loves someone with an eating disorder. Furthermore, Barrows’ story is not a long piece and was probably edited a lot, so it’s not a good representation of Adam Barrows’ character. It pained me to read so many nasty comments about Mr. Barrows, and that was why I wrote about his NYT piece in the first place. Finally, I’m really glad he wrote that story and shared it, despite the polarized reactions. It has really made me think and, as you can see, continues to inspire new posts for my blog. 😉

Which brings me to today’s fresh topic. One of the people who commented on my post expressed disappointment that The New York Times shared Barrows’ piece and “glamorized” anorexia. Looking on my Statcounter results, it appeared that “Danielle” might have been writing to me from England. If she is from England, it would make sense that she would give me hell about my comments. She may or may not be aware of how different the US and UK healthcare systems are. In the United Kingdom, citizens have access to the National Health Service, which means healthcare doesn’t cost people as much as it does in the United States. A basic level of affordable care is available to everyone.

In the United States, healthcare is very expensive for most people, even for those with decent health insurance, which is also expensive on its own. Mental health care coverage is often woefully inadequate. It’s been years since I last had a “civilian” health insurance policy, but I seem to remember that my coverage only allowed for thirty days of inpatient psychiatric treatment per year. And that’s if there were no pre-existing conditions! Outpatient care was somewhat more generous, but it was not covered the same way or to the same extent a physical problem would be.

In the United Kingdom, there is also a process called “sectioning”, in which people can be involuntarily hospitalized for mental health conditions. The Mental Health Act of 1983 allows for family members and physicians to act in another person’s best interests when it’s clear that they need psychiatric help and won’t cooperate on their own. Anyone who is being sectioned must be assessed by health care providers first, but it appears that a person can be sectioned for a much broader array of reasons than they can be in the United States. Someone who is starving to the point of death because they have anorexia nervosa could possibly be sectioned, for instance, even if they are over 18 years old.

In the United States, we do have the means for hospitalizing people against their will for psychiatric reasons, but it’s a lot more difficult to force an adult into psychiatric hospitalization than it is a child. A lot depends on the laws of specific states. Moreover, in the United States, involuntary commitment seems to be done most often in cases in which a person is clearly a danger to other people as well as themselves, and is not in touch with basic reality. Someone with anorexia nervosa is probably not going to pose a genuine threat to anyone other than themselves. They also tend to be basically rational in things besides their body image. Anyone who is curious about how eating disorders in the United States are treated may want to watch the excellent 2006 documentary, Thin, by Lauren Greenfield. As you’ll find out if you watch this film, a person’s insurance coverage is also quite important in their ability to access care. I can’t say that adult people with eating disorders never get forced into treatment in the United States, but I think it’s more difficult to do it there than it is in England and Wales.

In the 1960s, there was a big push in the United States to deinstitutionalize people with mental illnesses, which meant that a lot of facilities closed down, for better or worse. The emphasis is more on outpatient treatment. In fact, healthcare is more for outpatient treatment for regular medical conditions, too, mainly because of how bloody expensive it is.

An eye-opener about how eating disorders are treated in America.

As I was thinking about Danielle’s comment and chatting a bit with my friend, Alexis, who is herself employed in healthcare, I got to wondering how eating disorders are treated in Germany. I went Googling, and found a few items that didn’t tell me much. But then my eyes landed on an ad for a rehab in Switzerland– specifically, Paracelsus Recovery in Zurich.

I know Switzerland has really excellent medical care. I also know that it’s an eye-wateringly expensive place. I know healthcare is not cheap in Switzerland, either. I was interested to find out what this place in Zurich was like. I found out that it’s a family run business. Clients are treated one at a time, and have the option of staying in one of two huge penthouses.

The fees include five star treatment, to include a personal chef and a counselor who stays with the client 24/7 in beautifully appointed accommodations. There’s a medical staff, including nurse practitioners and physicians, a wellness staff, with personal trainers and yoga instructors, and therapists. If you access their Web site, you can take a tour of the posh penthouse, which includes a bedroom for the therapist. If you like, you can pay separately for accommodations at a hotel, although the accommodations are included in the price of the treatment and I’m not sure if you get a price break for staying off site.

A very comfortable place to recover in Zurich.

This center treats several different psychiatric conditions, including drug addictions, eating disorders, mood disorders, alcoholism, and behavioral addictions (porn addiction or gambling, for instance). It’s a very discreet place and, judging by the fees they charge, is intended for helping only the very wealthy. At this writing, it costs 80,000 Swiss Francs per person per week to be treated at this facility. To put this price into perspective, at this writing, 80,000 Swiss Francs is equal to about $86,000 or roughly 72,000 euros. The fees cover everything related to the treatment, although if you fall and break your arm or get sick with COVID-19 and need hospitalization, you will have to pay for that medical treatment separately. Also not included is accommodation for anyone who accompanies you or a two day pre-assessment, which is an additional 20,000 francs.

As I was reading about this place, it occurred to me that there must be a market for it. I’m sure their clients are mostly extremely wealthy people, such as royalty from the Middle East, Hollywood movie stars, rock stars, or business moguls from Wall Street. Paracelsus gets excellent reviews online, but I wonder how many people have had the opportunity to experience this kind of treatment. Still, it’s fascinating to read up on it. I wonder what it would be like to work at such a place. I’m sure they deal with some extremely high maintenance people. I also wonder what would prompt someone to start such a practice, which seems to cater only to extremely wealthy people. To be sure, that population is unique and may need special accommodations, but I’m sure the cases are uniquely challenging, too. People with a lot of money are often used to hearing the word “yes” a lot. Maybe such posh surroundings are less effective for people with addictions. But again, I could be wrong. At the very least, it looks like a very competently run place, and in a city well known for psychiatric care.

Wow… very beautiful and very expensive! And no need for a translator.

I found another rehab in Switzerland, Clinic Les Alpes, that has a relatively bargain basement cost of 45,000 Swiss Francs per week, although the typical stay is for 28 days, so you do the math!. It looks like there, you can be treated for exhaustion or burnout or addictions. They seem to focus on addictions the most and offer care that emphasizes comfort, as well as the classic 12 step program to sobriety. It’s in a beautiful area, just off the shores of Lake Geneva, in an area with many forests and no sound pollution (which sounds wonderful to me). But this program appears to be a lot less private. There are 27 rooms for clients to stay in rather than two exclusive penthouses.

I would imagine that healthcare in Switzerland there is delivered expertly, especially if one is paying many thousands of Francs. My experiences in Switzerland have mainly been in a few hotels, a couple of which were high end. The Swiss definitely do high end hotels right, although on the whole, I find it a rather boring, soulless place, even if it is also very beautiful and scenic.

Well… I’ll never darken the door at one of those very special rehabs in Switzerland. I do find them interesting to read about, though. They’re not for ordinary people with big problems. They are for extraordinary people with big wallets. Obviously, there’s a need and a market for them, since at least two of them exist… and to think I found out about them because of a comment on my post about a Modern Love story I read in The New York Times over a month ago! I am always amazed by what inspires me to think and to write… and that’s why I like to hear from people. I’m sure Danielle never knew her comment about how wrong my opinions are would lead me to research luxury rehabs in Switzerland. You learn something new every day!

Standard