Forensic Psychiatrist for Court-Ordered Evaluation: Custody, Criminal, and Civil Commitment Cases

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David Park sat across from his attorney in a borrowed conference room in downtown Phoenix and listened to the words “competency to stand trial” for the first time in his life. His twin brother Jonathan had been arrested on a weapons charge during what David recognized immediately as a manic episode, the third in five … Read more

Anthem Blue Cross Blue Shield Mental Health Coverage: Plan Variations and Provider Network Reality

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Damon, a 41-year-old high school teacher in Rochester, New York, switched to his wife’s Anthem Blue Cross Blue Shield PPO during open enrollment after his district moved away from a UFT plan. He had been seeing the same therapist for OCD-related contamination concerns for three years. The therapist was in-network with Anthem, the directory said … Read more

Substance Use Levels of Care: ASAM Continuum, Detox, Residential Treatment, and Medication-Assisted Recovery

Why Substance Use Has Its Own Levels of Care The continuum of mental health care has a parallel continuum specifically for substance use disorders, with its own terminology, its own clinical structures, and its own evidence base. The American Society of Addiction Medicine, often called ASAM, has codified this continuum into a set of levels that providers, … Read more

Self-Employed Mental Health Insurance: ACA Marketplace, Health Sharing Ministries, and Direct Primary Care

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Elena, a 38-year-old freelance UX designer in Austin, left a salaried role at a software company in March to go independent. She had been managing generalized anxiety with weekly therapy at $25 copays and a low-dose SSRI. Six weeks into self-employment, her COBRA continuation premium for the same plan ran $749 a month for individual … Read more

Light Therapy for Seasonal Affective Disorder: 10,000 Lux Boxes, Timing, and Combining with Antidepressants

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Karen from Buffalo had been dreading October since college. Every fall the same pattern would arrive on the same schedule. She slept twelve hours and woke up exhausted. She craved bread and pasta and chocolate at quantities that did not match her summer self. She gained eight to fifteen pounds between Halloween and St. Patrick’s … Read more

Mental Health Parity Violations: How to Recognise When Your Insurance Plan Is Breaking the Law and File a Complaint

Mental Health Parity Is the Law That Most Patients Do Not Know They Have Federal law has required most health plans to cover mental health care at the same level as medical care since the Mental Health Parity and Addiction Equity Act passed in 2008. The law was strengthened by the Affordable Care Act, which extended parity … Read more

Religious Deconstruction and Mental Health: Leaving High-Control Religion and the Therapy That Helps

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Hannah grew up in Provo. Her family was eighth-generation Mormon. She served a mission in São Paulo at twenty-one, married in the Salt Lake temple at twenty-three, and by thirty-one was a stay-at-home mother of three who could no longer make herself believe. She did not announce it. She kept showing up to sacrament meeting … Read more

Synthetic Cannabinoid Emergencies: K2 and Spice Reactions and Why ER Treatment Is Different

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Marcus, twenty-three, walked into a corner store in the Bronx on a humid July afternoon and bought a small foil packet labeled “AK-47 herbal incense.” Twenty minutes later, his cousin found him on the sidewalk outside, frozen in a half-crouch, eyes locked open, drool tracking down his chin. He could not answer his name. By … Read more