Posts Tagged taft-hartley trusts

John Oliver: Rehab, Last Week Tonight Psychology of Performance #63

Robert A. Mines, Ph.D., Chairman and Chief Psychology Officer

Thank you John Oliver and your staff for a significant public service on your show this week! Your commentary and excellent coverage of a major problem in substance use disorder and alcohol treatment will have an impact far beyond what the insurance and professional communities have been able to do.

MINES has patients who have gone out of network, received poor care, the payors have received outrageous bills, the patients are stuck with bills that can only result in medical bankruptcy and as you noted, people die in these disreputable facilities.  A major component that you pointed out is patient brokering. When people Google substance abuse/use treatment, the top 20-30 are facilities, mostly in Florida and California, or are patient brokers. Reputable facilities in the person’s community do not even make the list. Then the facilities sometimes even pay the airfare to fly the patient to their facility and if the patient does not meet medical necessity for that level of care, the facility turns them out on the street to find their own way back to the state/community they live in.

You mentioned addictionologists as a resource for finding reputable care. In addition, Employee Assistance Programs as well as managed behavioral health services (insurance) are knowledgeable and informed about substance use and alcohol treatment. They know which facilities and programs are in network with the insurance and which ones do a good job.

Evidence-based treatment supports the use of a continuum of care from outpatient, intensive outpatient, partial hospitalization, residential and detox (medical and social detox). There are medications that also contribute to sobriety and health.

These are chronic illnesses/conditions that require the patients to cope with all their lives. Learning relapse prevention and adherence skills are essential.

If you decide to delve into this national problem further in a future episode, I would be happy to consult with you and your team.

The following clip may be not suitable for some work environments:


This is a link to a pdf of an article published by the Self Insurance Institute of America on predatory treatment facilities and managed behavioral healthcare strategies for helping the patients and the payors.


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Psychology of Performance – 40: Management of Chronic Illness

The expectations and beliefs we have about receiving a diagnosis of a chronic illness such as diabetes, heart problems, asthma, liver disease, addictions, depression, and so forth have a direct impact on how we manage that illness.  The beliefs may vary from “that’s not fair,” to “this is too much to handle,” to “I don’t have to check my blood today for diabetes sugar levels, I can get by,” or “I can have one drink or one deep fried snickers bar.” These beliefs are directly tied to how well a person follows their medical plan and how far they may fall when not adhering, otherwise known as relapsing.

I had the privilege and honor of facilitating a discussion group for Adult Type I diabetics. Some of them had been managing their diabetes for over 50 years. One member said, “I am so tired of shots and blood tests 4-5 times a day, I just don’t care anymore.” The member went on to say that her sugar levels were elevated on her A1C tests, were rising, and she was resigned.  This is a good example of a subtle, yet eventually serious, psychological impact issue related to her health and wellbeing.

If you or a loved one is diagnosed with a chronic illness, please pay attention to how they think about their illness as the psychological consequences, as well as the health and final consequences, can be overwhelming if they are not managed well. Depression and anxiety negatively affect health outcomes in most chronic illnesses.  A qualified mental health professional can be a very useful resource under these circumstances.

Exchange love and happiness with all those you meet today,

Robert A. Mines, Ph.D.,
CEO and Psychologist

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Psychology of Performance – 39: Legalization of Marijuana

The states that passed legalization of marijuana in all probability made a good decision for all the well known reasons such as quality control, lowering prison costs (half of our world highest inmate population are in for drug possession charges), increased tax revenue, and squeezing out organized crime in this area. The epidemiology incidence of people who use marijuana for self medication or recreation is not going to go up or down. They are using it regardless, similar to alcohol during prohibition. What does this have to do with the psychology of performance?

The evidence is clear that individuals do not perform most tasks or think clearly when impaired. Employers already have the right to drug test their employees and are required by law to provide a safe work environment. Just because alcohol has been legal does not mean that employees are entitled to drink at work or come to work under the influence of alcohol. The precedents are already in place and should also apply to marijuana. The rest of the story for marijuana users is that even recreational use will show up for a month in random or “for cause” drug testing. So until impairment levels can be defined by the enforcement side of these laws, it would be prudent for those individuals inclined to use marijuana to continue to refrain from such usage. Bottom line, both alcohol and marijuana will impair performance despite stories such as the one in the movie “Flight.”

Remember to exchange love and happiness with everyone you meet.

Robert A. Mines, Ph.D.,
CEO, and Psychologist

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