I’ve been through this situation with family members. I understand the frustration and agony.

I also understand the hesitancy to pay for two months at a “retreat-like inpatient psychiatric facility.”

In publicly funded system, it’s likely facilities like this would not exist or would be strictly private pay.

I’m not aware of any country that makes such a thing available on short notice like this.

I also understand the frustration, as often times facilities like this are all that exist in terms of medium-term care. And often times some of their services are at least formally in-network.

The understanding is you pay for it by selling your house.

We’ve been tempted to do this (sell our house), but been advised against it - but the reasoning in our case is patient specific.

I wish insurance was clearer about what covered and what isn’t. I wish we had more mainstream (not retreat-like) medium term care places.

Maybe I’m misreading the phrase retreat-like.

But id this isn’t something a public system would pay for, it seems inappropriate to blame a private system to not pay for it, unless it’s clearly in the wording.

Regardless, mental health care in America stinks, and you can always argue over the details.

> I also understand the hesitancy to pay for two months at a “retreat-like inpatient psychiatric facility.”

> In publicly funded system, it’s likely facilities like this would not exist or would be strictly private pay.

In France, 80% is paid by the public healthcare if a psychiatrist greenlit you, which still make you liable for ~30€ per day in a room you share with another patient (and if you want a private room it's ~90€/day out of pocket) (maybe the prices around Paris are a bit higher though, i'm a country boy)

[edit] more accurate numbers, i had to check and correct them. Also, 30€ per day also covers medication if needed and a spa session

What gets me is that they probably could afford it out of pocket but didn’t want to deplete savings.

For a clear case like this, an insurance denial shouldn’t even be shared with the suicidal patient, their spouse should shield them from that and just pay from their checking account. The life of your spouse is worth more than a few more dollars in retirement.

I will note that in a lot of places in the US, the role of medium term acute psychiatric care is taken by partial hospitalization programs, where patients go to a facility (usually a few conference rooms in an office building) during the workday for intensive therapy and medication management, but go home with family in the evenings. These programs are a lot cheaper than inpatient programs, and the standard workflow in my experience (with "good" insurance) at this point is 3-10 days inpatient, followed by 2-10 weeks in a PHP, and possibly some part time program after that. A lot of people skip the inpatient part if there's no acute danger.

I'm surprised the author makes no mention of those sorts of programs in the article. It makes it sound like the options were a luxury 8 week inpatient or nothing, when there's really a lot of stuff in between.

It sounds like this guy needed around-the-clock, in-patient care. That's inherently expensive. While those facilities exist in countries with publicly funded healthcare, there's a huge shortage of in-patient beds, so there is some mechanism to funnel patients to outpatient care.

Maybe i missed the part of the article that suggested a public system would have paid for a 2 month retreat?