The denial letter arrived in a thick envelope from Hartford, addressed to a 47-year-old project manager in Minneapolis who had been out of work on long-term disability for nine months with major depressive disorder and generalised anxiety. The envelope contained 31 pages: a benefit denial, a four-page summary of “subjective complaints lacking objective medical evidence,” … Read more

The 988 line is a real improvement over what came before it. The counsellors are trained, the wait times keep shrinking, and the safety planning approach actually saves lives. But anyone who has spent thirty minutes on the phone in the parking lot of a Walgreens at 1am, trying to talk down a sister whose … Read more

A Calmer Door Into the Crisis System For decades, the only doors into the mental health care crisis system in the United States were the psychiatric emergency room and the inpatient hospital. Both work, in the sense that they can keep people alive and stabilise the most acute episodes. Both also have well-documented downsides: long ER waits, … Read more

Bipolar I and II treatment guide: choosing a mood disorders psychiatrist, lithium and other mood stabilizers, evidence-based therapy, lifestyle, and higher levels of care.

Diane had been a senior project manager at a Fortune 200 logistics company for nine years before her panic disorder caught up with her. The HR welcome packet she had filed away on her first day mentioned an Employee Assistance Program, a “wellness portal,” and something called “Spring Health” she had never opened. After her … Read more

The Courage to Ask for Help You have been struggling for a while now. Maybe it is the constant worry that keeps you up at night. Maybe it is the heaviness that makes every small task feel impossible. Maybe it is the anger that bubbles up for no reason, or the numbness that makes you … Read more

Priya was a software engineer in Austin, Texas, with an Aetna PPO through her employer. After eight months of waitlists and rejected directory listings, she finally booked a therapist through Headway who said she took Aetna. The first session went well. The second session went well. Three weeks later, Priya got an Explanation of Benefits … Read more

Elena got COVID for the third time in February 2023. The acute illness was mild — a sore throat, three days on the couch, back to work the following week. By April she could not finish a sentence without losing the thread. By June she was crying every morning, sleeping eleven hours and waking exhausted, … Read more

The Mental Health Infrastructure That Costs Nothing and Predicts the Most The longest-running study of human flourishing in history, the Harvard Study of Adult Development, has tracked hundreds of men over more than eight decades. The single most consistent finding from the study is that the quality of close relationships, more than wealth, fame, intelligence, … Read more

The intake counselor in Boca Raton sounded confident on the phone. “Cigna is one of our best payers,” she told the family of a 34-year-old software engineer in Charlotte who needed residential treatment for alcohol use disorder. The family handed over the insurance card, signed the admission packet, and watched their son walk into a … Read more