Tag Archives: United States

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 The other one clearly did not agree with me, and in fact, says my views are “outdated”.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, 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!

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complaints, disasters, mental health

What’s the point?

This morning, as Bill and I were waking up to another day of COVID-19 life, I read a couple of articles in The New York Times about the plight of today’s youth. The first article was about how the United States might hope to reopen schools soon and why it’s so necessary for the mental and emotional well-being of young people. The second was about the youth of Europe and how many of them are becoming despondent because of the toll the pandemic is taking on their budding lives. In both articles, mental health issues were cited as major reasons why young people are suffering so much right now.

Both articles hit home for me, even though COVID-19 was not on the radar when I was young. I remember my teens and twenties as an especially difficult time for me. I suffered significantly from anxiety and depression during those years, mainly because I wasn’t sure what my place in the world was. I didn’t have tons of friends or boyfriends, so those years weren’t especially fun for me in terms of a social life. I did have some fun, mind you, and compared to a lot of people, I was fairly privileged. But I wasn’t doing what most young people do when they’re young. I worried excessively about the future and dwelled a lot on the past. It all kind of came to a head when I was in my mid twenties. I had a crisis and felt compelled to seek psychiatric help. I remember wondering back then what the point of living was.

Remembering what I was like in those days and how anxious and hopeless I felt, even if I did appear to be resilient, I think about what it must be like for the young people of 2021. These young folks have been raised in very anxious times. For most of their youths, they’ve had to worry about violence in the form of school shootings and foreign and domestic terrorism. Today’s twenty year olds were born around the time of 9/11, which is when the world really seemed to change a lot. They grew up hearing about people being kidnapped and beheaded in faraway lands. Maybe some of them saw their parents go off to war, never to come home again. All the while, the cost of living kept rising.

From the very beginning of this COVID-19 crisis, I’ve had a soft spot for the young. This should be the time when they’re allowed to be free… to explore relationships, try new things, travel, make life altering decisions. They should be enjoying school, dating, learning to drive, starting their first jobs, taking field trips… But thanks to the pandemic, along with the chaos that comes from having incompetent and criminal world leaders like Donald Trump, those normal milestones are being curtailed or delayed for most of them.

In my day, if young people couldn’t find a job in a field they enjoyed, there was always restaurant work. Waiting tables is a great skill– one that’s usually portable and plentiful. But thanks to COVID-19, a lot of restaurant and retail work has been sharply curtailed. And while some young people might be glad for the extra free time, bills still have to be paid. Some of these young folks are halfway to earning college degrees that they may or may not ever get to use or be able to pay for. In the case of the article about the European young people, a lot of them were saying they didn’t see the point of continuing their educations, given the lack of jobs. Many of them report feeling suicidal, and those who have mental health issues are having worse problems. Some of those who were mentally healthy are developing depression, anxiety, and eating disorders, and mental health experts are hard pressed to be able to help them. Inpatient beds in psychiatric wards in European hospitals are full.

I think about athletes who have been preparing years for the 2020 Olympics. The Summer Games were postponed until this year, and now it looks like they could even be canceled. I think about someone like Simone Biles, who is a great gymnast who’s fighting the same enemy of all great gymnasts… time. She’s in her early 20s. This is when a lot of female gymnasts retire because their bodies don’t cooperate as well as they used to. She was hoping for another Olympic bid, but may not get her chance if the pandemic doesn’t come under control soon.

I think about young ballerinas who have trained their whole lives to be great dancers. But the pandemic forced live entertainment to shut down. What do they do now? The same goes for budding musicians and actors who have spent their whole young lives preparing for a reality that, at least for now, has radically changed. The virus has made it a lot harder for young people to do things like date. This morning, I read a truly nauseating comment on an article about how caution has become “sexy”. Someone said they think masks are “turn ons” because it means a person who is wearing one isn’t a sociopath and cares about others. But face masks cover up the face, which takes away a significant conduit for non-verbal communication. The masks are further isolating and a visible reminder of how fucked up things are today.

For the record, I don’t agree with the idea that a person who doesn’t want to wear a mask might be a sociopath. Mask wearing isn’t normal. It’s not comfortable or convenient. It makes perfect sense to me that many people don’t want to wear them. Not wanting to wear masks doesn’t necessarily make people sociopathic, and while the articles about this phenomenon go into more detail as to why some vehement anti-maskers may have sociopathic tendencies, a lot of people never read beyond the headlines. While I can see the idea that a person who flat out refuses to wear a mask could be considered a sociopath if he or she has other sociopathic traits, I don’t think that’s always true. I think it’s a mistake to promote the idea that anyone who wears a mask is “caring”. That’s also not necessarily true. It could be that they simply don’t want to be fined or harassed. Likewise, I don’t think that all anti-maskers are necessarily people who are uncaring and sociopathic. Some of them are, but not all.

Then there are the mean spirited comments by people who feel the need to shame and lecture young people who are complaining about these unusual and unpleasant conditions we’re living in right now. Frankly, I think anyone who can’t see how difficult this situation is for the young should have an empathy check. It’s true that generations before us have had to deal with terrible adversities. And they dealt with the adversities without the benefit of the technology that we have today. But times were different in those days. The people of the past had some things that we don’t have. I don’t think, for instance, that there was as much pressure to perform or achieve. A person could get by with less. People had closer connections with each other, and there was more of an emphasis on family.

When you’ve grown up in a hyperactive society like ours, where both parents work just to keep the lights on and you’ve been taught since birth that you have to achieve to get into college or find a job– and then all of that is taken away because of a virus– it can be very difficult to cope. It can make anyone wonder what the point is. Especially when, in those other times of adversity, people could literally lean on each other for support. Now, they have to do it on a Zoom call because being in close contact with others is a no no. Humans were meant to touch each other. It’s a need that most of us have. But right now, it’s forbidden, and that’s causing people some real angst.

I understand it, although I wasn’t living in pandemic conditions when I was in my 20s. I felt like I was trying to do so much to make it in the world. I made some good choices that led me to where I am, but I was also very lucky. I have been feeling kind of depressed and hopeless lately, but I also realize that I’m lucky to be dealing with this now, instead of back then… I would have absolutely HATED being locked down with my parents. And even given the fact that I was pretty reclusive when I was single and I relied on my jobs for human interaction, I think I would have HATED dealing with lockdown in my 20s. I was always worried about making ends meet in those days. I think it would be even harder now.

Count me among those who feel great compassion for the young. I think they should get more priority in the vaccination drive. And I am one of those who isn’t going to tell them to “suck it up and drive on”. I don’t think that’s a particularly good or helpful comment in most situations. It often comes from a place of privilege and a lack of empathy for others. Dare I say it? The hyper anal, mask-wearing, middle-aged person who shames a young person for feeling sad and hopeless is probably more of a sociopath than they realize. Personally, I think we should make more of an effort to help the young get back into life. My husband’s daughter is a young mother of two. She and her husband need to be healthy because they have small children to support. The 21 year old college student should be given a chance to launch– to finish their education and get to work. Those of us who have already had a chance should be more mindful of how hard this is for the young.

Once again… I feel kind of grateful to be childless.

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