•  Insurance
    • Premium: a monthly cost for one’s insurance
    • Maximum out-of-pocket: a limit to what one pays, per year
    • Copay: for a given service or medication, the amount of money that one’s insurance won’t pay
      • The insured must pay this amount
    • Deductible: the amount of money the insured must pay before their insurance begins covering their expenses
      • This amount is yearly
    • Coinsurance: for a given service or medication, the percentage that the insured must pay
  • Image result for insurance copay deductible terms
  • Here is a good example:
  • Related image
    • If someone has more than one insurance
      • Primary insurance: The insurance that first picks up the bill
      • Secondary insurance: The insurance that pays for (part of) a service after the primary insurance has already paid their part
      • For example: Medicaid (public) and Medicare (public)
      • Other example: Medicaid (public) and BCBS (private)
    • Coverage: what services an insurance plan covers
      • In-network: services covered by one’s insurance
    • Case worker: a social worker of sorts who helps their clients apply for governmental assistance (mostly insurance)
      • Since public insurance in the US, particularly Medicaid, is so difficult to gain reimbursement from, many people have jobs that solely revolve around it
      • Helps fill out applications
      • Gives rides to meetings
      • Assists in documentation
    • Public insurance plans (United States)
      • Medicare: a more valuable insurance
        • Takes two years to determine eligibility
        • Usually means that one is eligible for SSI/SSD/SSDI (receiving a stipend each month from the government)
        • Senior citizens are eligible for Medicare
        • People with severe, lifelong disabilities are eligible for Medicare
    •  
      • Medicaid: a less valuable insurance
        • Assuming all documents have been sent, takes 45 to 90 days to determine eligibility
        • Ensures food stamps (EBT)
        • (In my experience) pays for living in a group home
        • Pays for care by psychiatrist and therapist in public mental health institutions
      • Both Medicare and Medicaid pay for inpatient treatment, for varying lengths
      • One must have a relatively low amount of both saved money and income
        • However, establishing a trust may be a loophole to preserve one’s wealth
        • This infographic summarizes things fairly well:

Image result for group home benefits medicaid federal

Otherwise, the below infographic offers a fair amount of information, as well:

  • Image result for infographic medicaid medicare
    • Private insurance plans
      • Blue Cross Blue Shield
        • Many different sub-plans
        • Strangely, government offers this private insurance to many of its employees
        • Image result for blue cross blue shield
      • Various college insurances
        • Can take a long time to be sent reimbursement
      • Much easier to secure coverage from, if applicable
      • Oftentimes government workers can have their children put on their insurance as well
        • This usually expires when they are 26 years of age
  • Care environments
    • Inpatient: receiving treatment in a hospital
      • Can be public, private, or partially each
      • Acute care hospitals can keep a patient for 15 days
      • Hospitals designed for somewhat longer than acute care, the next level, keep people for an average of about two months
        • Ten years ago, this average was 10 months
      • To keep a patient longer, there must be consent among two or more doctors that the patient is still a risk to himself or herself, and requires longer-term care
        • After being admitted to the first level (acute care), one’s doctor has the power to keep a patient there for 15 days
        • The next authorization grants the doctor two months
        • The next authorization means that the patient can be kept for up to six months
        • For longer-stay hospitals, after compliance has been ensured, passes to leave the hospital for a few hours or days, may be an option
    • Partial hospitalization: treatment received in a hospital and the community
      • For instance, perhaps the day is spent in the community, and at night time, patients sleep in the hospital
    • Outpatient: receiving treatment while living in the community
      • Living at a friend or family member’s house
      • Paying rent to live in one’s own housing
      • For the particularly unfortunate, there should be an accessible homeless shelter
      • Halfway House: addicts living together with oversight
      • Group home: a house in which about eight to 15 people with significant mental illness live together
        • Supervised 24/7 by staff members who are skilled in basic mental health support
          • One staff member heads the house
          • Each person is assigned a staff member
          • Goals are written down, and tracked with monthly meetings
            • Service plans (future goals, and how to achieve them) are created for each resident
          • A chat is usually not far away
          • Each member makes dinner with their staff member once during the week
        • Dinner is made every night
        • There is food to make sandwiches
        • There is milk and cereal
        • Coffee is provided
        • People are granted many amenities
          • Nearby bathroom
          • A means of maintaining hygiene
            • Towel
            • Toothpaste
            • Toothbrush
            • Dental floss
            • Shampoo
            • Conditioner
          •  Bed
            • Mattress/box-spring
            • Pillow
            • Pillowcase
            • Sheets
            • Blanket
          • Dresser
            • Ample space
          • Lamp
            • All ready to go
          • Bedside desk
            • Has drawer in it
        • Each person has their own room
        • Kitchen and other living areas are shared
        • Food is always available for residents
        • Group homes are oftentimes a first step to eventually living entirely independently!
      • Single room occupancy (SRO): an apartment complex for people who need a bit more hep than groups homes offer
        • More permanent
        • Each person has their own room, including a bathroom and kitchenette
        • Each resident has a service plan
        • In this type of housing, they may not include transition to less-supportive housing
    • Here we see an interesting guide to the rigor of therapy involved in various levels of care
  • The Diagnostic Statistical Manual V: The book used by mental health officials to diagnose mental illness
    • Image result for DSM-V
    • Approximately every ten years, mental health professionals hold a large meeting to discuss updates
    • Diagnosis:What mental illness one is labeled as having
    • Prognosis: a prediction of how functional one will be in the future
    • Treatment-resistant: a specific number of medications, based on illness, that have not significantly been effective at treating it
    • Augmentation: a fancy work for adding another medication to an existing one, for greater efficacy in treatment
  • FDA: The Food and Drug Administration of the United States of America
    • The FDA approves all medicinal chemicals for a specific illness
      • Called an “indication”
    • If the medication hasn’t been approved for mental health use by the FDA, it cannot be prescribed, or only very rarely, for mental illness
    • Off-label: a drug used to treat an illness that it’s not officially licensed to treat
      • Some medications get prescribed much more often for off-label use
        • An extreme example: gabapentin
    • The medication approval process is quite extensive, both in terms of time, and money

  • Classification of drug legality
    • This is gone over more comprehensively in The Five Legal Divisions of Recreational Drugs
    • Schedule I: “no currently accepted medical use and a high potential for abuse”
      • Very difficult, or impossible, to conduct studies on
      • Questionably contains some potentially medicinal hallucinogens (LSD, psilocybin)
    • Schedule II: ” high potential for abuse, with use potentially leading to severe psychological or physical dependence”
    • Schedule III: “a moderate to low potential for physical and psychological dependence”
    • Schedule IV: “a low potential for abuse and low risk of dependence”
    • Schedule V: “lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics”

  • Non-controlled substances
    • Prescription-only: similar to scheduled substances in that they are only intended for one person, must be prescribed by a doctor, and have to be purchased at a pharmacy
      • However, they are significantly less dangerous than scheduled substances
    • Over the counter (OTC): can be bought off of shelves without doctor’s prescription
    • Age-restricted: one doesn’t need a prescription, but they must be over a certain age in order to purchase and/or use the substance, as it can be dangerous
      • Some cough and cold medicines
      • Alcohol and tobacco
    • Unregulated
      • Various “nootropics”
      • It can be difficult or impossible to know about purity
    • Generally recognized as safe (GRAS)
      • Green tea

Sources: Dr. Kevin Davis, Dr. Theodore Papperman, Stahl’s Essential Psychopharmacology, Ben Komor, http://www.healthline.com, https://www.dea.gov, http://www.fda.gov, http://americanaddictioncenters.org, Dr. Paul Povinelli, http://sphweb.bumc.bu.edu/otlt/MPH-Modules/HPM/AmericanHealthCare_Paying/AmericanHealthCare_Paying4.html, https://www.zencare.co/mental-health-insurance-guide/, https://www.slideshare.net/BarbaraONeill/aafcs-2015-2-workshophealth-insurance-terminology-and-technology-tools0615, https://www.woosterhospital.org/services/behavioral-health-services, https://www.psychiatry.org/psychiatrists/practice/dsm