Working Inside a Collapsing Mental Health System
After the passage of the Affordable Care Act, tens of thousands of people suddenly had access to health insurance. Here’s how it affected my job.
In December 2013, I changed positions in the nonprofit community mental health agency I had worked at for about three years. I left the stress and constant pressure of the front desk and got a desk in a different, quiet office where I became the asshole who asks nosy questions about your symptoms and drug use when you’re interested in scheduling a first-time appointment. For about two weeks, the job was a dream. I could stream music, the office had a couch, and I could walk away from my desk without everything getting out of control. Then, two weeks later, tens of thousands of more people suddenly had health insurance, maybe for the first time in their life, and they all wanted appointments.
The effects of the Affordable Care Act shouldn’t have come as a surprise to anyone who was part of an organization that dealt with Medicaid, and this is the sole funder for the outpatient mental health program. Somehow, though, no material changes to the programs were made. The community mental health system is known to be brutal to the people who work inside it, and unforgiving to people who use its services, and the introduction of thousands of people seeking services was an unprecedented new strain.