THE COST of PTSD - Mental injury
Part of me hesitates to write this, as at times I have felt like a 'burden' as a person with permanent disability. Accident Compensation Corporation, ACC, provided me with a breakdown of the costs so far for my mental injury (I requested this information). The figures are in New Zealand dollars, inclusive of GST, and are for the last four and a half years. Nearly NZ$20,000 so far, mostly spent on therapy from a clinical psychologist (still ongoing).
The costs below also include reports from three separate psychiatrists for the purposes of lump sum compensation.
The legal fees for ACC to oppose me in court appeal for lump sum compensation were over $600. This was for the two solicitors. It would have been more but I requested an accommodation of doing the hearing via video, so there were no travel costs. My personal printing and scanning costs were hundreds of dollars (unable to be recovered). My time on it can not be recovered.
I am eligible by law for another assessment and even though it is stressful, I have decided to apply to be reassessed again (even though I have no confidence in the process). The threshold for compensation when I started the process was a bit over $3,000. More has been spent in doctors and lawyers than to pay out the minimum compensation.
The ACC costs is only scratching the surface of the true costs of PTSD.
From the top of my head, I have been seen by five other psychiatrists via mental health services. Plus one private psychiatrist last year, for an autism assessment and to review my diagnoses. He concluded that I am on the autism spectrum and that I also meet criteria for bipolar disorder (type 1) and post-traumatic stress disorder. He charged me less than $1,000 although originally quoted more than that. I saved up on a low income, as I was frustrated that ACC's psychiatrist tried to use autism as a reason to deny compensation.
There is no charge to see a psychiatrist with mental health services but because of the very high demand, only moderate to severe cases can be seen. From doing research online, I would estimate the cost for a psychiatrist with mental health services is around $250 per half hour. The actual face-to-face visits were probably less than 20 minutes.
I have made at least 5 presentations to mental health services (MHS), over the past few decades, before finally being referred for PTSD treatment. The first three psychiatrists treated me for depression. I only saw each of them a few times. The last psychiatrist with MHS, I saw over a dozen times, when my diagnosis was changed to bipolar disorder.
Estimate around 20 times seen by a psychiatrist through the public heath system. At least $5000 in fees, covered by the taxpayer.
I was referred within mental health services for an autism assessent (my first assessment). There was a long wait but a psychologist evaluated me in around 6 hours, then wrote a report. No charge to me. Clinical psychologists charge around $200 per hour. So that likely cost over $1,200 for the interviews alone. The psychologist went against and autism spectrum disorder (ASD) diagnosis and diagnosed PTSD. The latter was more important, as finally I could be referred for treatment.
I had a psychiatric ward admission in Australia in 2015. I looked up some figures and apparently my nearly 2 entire months' stay would have cost over Australian $50,000. I didn't pay for it. I had no means to pay for it, anyway. It was there, I was formally diagnosed bipolar 1 disorder, although PTSD was noted in my medical records by the lead psychiatrist (but no one bothered to tell me this). I was diagnosed PTSD back in New Zealand.
Before I moved to Australia, I had a 'treatment resistant depression' diagnosis. I was on antidepressants and had already had a few rounds of Cognitive Behavioural Therapy (CBT), 6 sessions at a time. That will do nothing much for trauma. A mental health nurse did the CBT. It didn't help my distress much. So there were the costs of at least 4 mental health nurses. One did weekly counselling with me for anxiety while I was waiting for trauma therapy. No idea how much that would have cost.
I trained to be a teacher back in 2000. Didn't last long, as I couldn't handle the stress. I am now on a minimum wage part-time job to supplement a benefit for those with permanent disabilities. ('Permanent' meaning will be reassessed every two years). I feel very vulnerable to think about my future, as I don't have financial security.
So there are costs of lost potential, of what I could have earned but can't, as I am unable to work fulltime. I only did with difficulty, in my twenties. There are the costs of the benefit, of course, which some judgemental types see as being a 'dole-bludger'.
There are the personal costs. I lost my home, my marriage, my son. I lost friends. I lost my health. My cognition. My dreams.
It is not possible to put a dollar figure on it. I lost years. I can't get those years back.
Two psychologists who assessed me said I've had PTSD for 45 years. It was missed and labelled other things because I have the avoidance and shutdown presentation. Could things have not deteriorated to the extent they did, had I been treated years ago?
Back to ACC. Compensation for permanent impairment is not very generous in most cases. I was told by ACC going into it that they don't give a high rating for PTSD.
Bipolar disorder was the convenient excuse to reduce my impairment to below threshold, as ACC doesn't cover bipolar disorder.
ACC pay millions on their chosen psychiatrists and lawyers to deny paying out the equivalent in compensation. Another psychiatrist during the process went well in my favour. It's pretty subjective but the money goes to the doctors and the lawyers rather than to the claimants. There's something wrong with that.
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I am no longer blogging or vlogging as a mental health and disability advocate. The politics of it is too toxic for me.