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I am advising a young black man who has come from the most horrible possible background and seems to me to be coping with great mental challenges. Although very very intelligent, he obviously is suffering from OCD, along with this depression, and an inability to deal with the least amount of structure. Although not violent by nature or in his past history, he and his wife have developed an explosive relationship which has brought separation. I cannot help but believe that he needs proper medication and in depth therapy to unpack his difficulties and teach him strategies for dealing with the pressures that continue to bear on him. The problem is that this all costs a lot of money. I wondered if it is possible for him to be ruled “handicapped” and come under social security provisions that could afford him this help. He is handicapped. It is impossible for him to hold down a job or to stay in school for a complete semester. I can see that if he doesn’t get help, this extremely bright man could end up a homeless person wandering the streets. The problem is, how to get him the help he needs within our present system of delivering medical and psychiatric services.

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The insurance system in the USA is in crisis. Many persons fall through the cracks in the present systems based on their not being employed and being able to take advantage of private health care, but also not being qualified for the public systems that are in place. Heck – things are so messy right now that even many employed persons can’t get the insurance they need. Public health insurance is available in most locations which will pay for some psychiatric care. The only thing is that there are strict rules and criteria for qualifying for such coverage. It would be wisest to contact a case-management professional and/or social worker in the place where you are for the best way to get someone in need into the public health insurance system. A case-worker will know the best way to massage the system so as to help your advisee.

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