Who’s Watching the Mental Health Providers?

Who’s Watching the Mental Health Providers?
By Warren Berke, Chair, NYC Department of Health and Mental Hygiene Community Advisory Board

Proper Customer Service Can Prevent a Mental Health Crisis
A functioning client with bipolar and anxiety disorders, of a well known mental health service provider in NYC, has to have his regulated drug prescription renewed every thirty days. Being responsible and knowing his need for the medication, he visits his provider and requests the renewal prescription one week prior to finishing up the current doses. The doctor informs him that he will send it electronically to his pharmacy.

Two days go by and the client does not get notification that the prescription is ready. The client calls his pharmacy to check and they inform him that they have not received the prescription. The client calls the provider. They inform him that the prescription will go out “right away.” The client checks with the pharmacy the next day; still no prescription. The client now has two doses of medication left, calls the provider, and is assured the prescription will be sent out. Client checks with the pharmacy the next day; no prescription has been received. With one dose left, the client begins to feel the symptoms of anxiety.

Another day goes by and the client is out of medication due to the non-performance of the provider. Client is getting very anxious, and, for the second time, goes to his provider on Saturday morning. He sees his doctor and is told by the doctor that the prescription will go out that day before the doctor leaves. Client checks with pharmacy early Saturday afternoon, and is told that the prescription has not been received. Client calls provider and is informed the doctor has left and will not be back until Tuesday. Client asks if another doctor can submit the electronic prescription. He is told it is not the provider's policy and to go to the emergency room to get the medication. Client is having an anxiety attack and physical discomfort, goes to the emergency room, waits two hours to request four doses to hold him over until his doctor returns on Tuesday. The doctor at the emergency room checks records and agrees, giving client one dose (Saturday night) and a paper prescription for three more doses.

It is Tuesday, eight days after the client requested the refill of the prescription. The client is informed that the doctor is not in until 5 pm. On the ninth day, the pharmacy receives the prescription.
The provider has failed to deliver the proper services to its client. By shirking their responsibility to provide good customer service, both the doctor and provider created both a human and financial toll.

The Human Toll: a client goes from wellness to crisis, not due to his mental illness, but due to poor customer service delivered by the provider and its doctor. The client had to invest 10 direct hours and three days of discomfort from anxiety, trying to receive the simple, basic service of a prescription refill.

The Financial Toll: the provider will be paid for two visits and the hospital will be paid for an emergency room visit and other services provided. One could speculate that the above services will be invoiced for a couple thousand dollars versus the much lower cost of one office visit, all due to the provider's poor customer service.
Is this an isolated patient experience or does this happen more often than we know? Mistakes happen, but for a provider to not correct the mistake and cause a series of events that result in a mental health crisis that wastes scarce mental health treatment dollars is grossly negligent. The State and City have sophisticated methods to evaluate the level and effectiveness of care being delivered to persons with mental illness. Providing good customer service should be a major part of that equation.  

Editor's Note: This article does not necessarily represent the views of City Voices, our readers, or the New York City Department of Health and Mental Hygiene. If you live in NYC and something similar has happened to you with your provider, you can call the Office of Consumer Affairs at (347) 396-7194.