For those that don't know me very well, I'm a veteran and currently the mother of four beautiful children. For the past five years, I've had to experience both Tricare Prime & Standard, which isn't a bad thing, but it can be a frustrating thing. You see, Tricare, especially Tricare for service-members and special-needs children, is broken. I'm not exactly sure how it became broken, or when, but I do know that the fact that service-members cannot bring forth litigation for malpractice is a big reason why it continues to be broke. (I'm not saying that we should be able to sue them all, but there needs to be a recourse for when things go wrong due to negligence.)
I could sit here all day and tell you about the time where I spent months in pain because I had micro-tears in my Achilles tendon and they refused to give me an MRI while I was in the Navy, or about how I'll never run on pavement again, or about how I had to threaten a Congressional hearing to get my own husband appropriate medical care, or the times I should have been given a referral and wasn't, or even the many times that I knew deep down something was really wrong but I thought I could trust the care I was getting at the naval hospital so I naively didn't speak up until it was too late.
But I didn't sit down today to talk about me or my husband. I came today to talk about my son Ryan. My son Ryan is an amazing kid. He's on the honor roll at his school, plays on the soccer team, loves to build Legos and play Minecraft, and thinks he might want to build robotic limbs for wounded veterans and animals one day. Oh, and he's highly functioning Autistic, like on the Einstein level. He gets bored easily, is super hyper, and you probably shouldn't feed him processed junk food if you want to get anything accomplished that day - in your life or his.
I have known since Ryan was a toddler that he was different. We have a genetic condition called MTHFR (which we did not know about when he was a baby), and I believe that his body reacted badly to environmental pollution, diet (specifically processed foods), and vaccines. I've seen research from Dr. Ben Lynch that states that 98% of Autistic children have MTHFR, and those with MTHFR are not able to detox properly from heavy metals (such as those found in vaccines - mercury, aluminum, etc.), and as a result, brain damage can occur in those individuals. Ryan also has asthma and allergies, which always became worse around the times he was vaccinated. I'm not saying vaccines are the cause of his problems, but I am saying that we decided the risk of vaccination is not worth the benefit they may provide when considering the health conditions he has.
The first time I sought help for Ryan was when he was a baby before I came into the military. I was concerned because he was not talking at all around the age of 2. He would make noises and point, and our doctor said that it was normal for him to be behind his peers socially because he was born a month early. He was meeting his motor skill development points, so my concerns were pushed to the back burner.
The next time I sought help for Ryan was in Pensacola, while I was a Reservist and his dad was Active Duty. We noticed that Ryan was having difficulties socially in school as well as different behaviors at home, and while his school was great at meeting his needs, we were concerned because at home he could become quite aggressive or emotional over seemingly minor issues. We got a referral to mental health for him, which turned out to be an officer who had been a doctor and in the Navy for about two seconds because she was about my age. She told us that she believed Ryan had ADHD, but I don't think she was even confident in her own diagnoses. She told us that since he was only in Kindergarten that it would be likely that he would grow out of it. She didn't send him for any additional testing, or recommend any additional appointments.
From there, life went on, but I wasn't satisfied. I became aware of our MTHFR status. I slowly started to remove processed foods and red dyes from the house. We started ensuring that Ryan was active in sports. And I also started reading about children with Aspergers - those that are high functioning Autistic. The more I read, the more I realized I was reading about my own son, and the more I could slowly change in my own behavior or in the way we ran our house to help Ryan along. During this process of three years, we saw Ryan go from B's and C's to being an honor roll student. We moved duty stations, and though Ryan was pretty emotional about it, we weren't overwhelmed with negative behaviors.
In fact, everything kept improving until we hit a plateau this year. Ryan will be celebrating his 10th birthday this year, and his hormones have him wound up more tightly than ever. Before Christmas vacation, I discussed his behavior at school and home with his teacher, and decided that it was time to once again seek help. This was also about the time when I realized that Tricare is broken - at this point, I still don't know when we can expect actual help.
It started out innocent enough. I took Ryan to the doctor in early December and explained what's been going on with him and why I felt that he was high-functioning Autistic. I explained that up until recently, we have a lot of success at home from making small changes to support him, but now I don't know how to help him effectively deal with life, and that I needed a lifeline myself so I could help him cope and deal. We were given a referral so that he could be tested to see where he falls on the spectrum, and I felt like a huge weight was taken off my shoulders. I had no idea that the weight I was relieved of would be replaced with a larger one.
A few days later, after the referral was approved, I scheduled his consultation for his test. Mind you, I was calling this office in early December, and they told me that they had no openings until February. I reluctantly scheduled, and called other offices to see if there were any other better dates available, and there were not due to the lack of doctors in our area that take Tricare. In the meantime, he started seeing the school counselor to talk about how to deal with cranky classmates and other general life issues. February would finally roll around and a week before he was scheduled to test, the medical office called me and stated that we could either come in and start the process or we could reschedule, but Tricare was not paying on any of their claims, and they could not release any results to us. We chose to stay the course and start the process, so we wouldn't have so much to do when Tricare felt like paying the claim to get the ball rolling.
The day of the appointment, I pulled Ryan and his brother out of school to go. We arrived, and after I filled out some paperwork, Ryan and I were pulled into a room with a cranky old lady to evaluate us. Her first question was, "Do you want him evaluated for Autism?" And of course, I said yes because that was why we were there. And then she asked, "Do you want him to receive counseling services?" And again I said yes. And then she said, "Well, which do you want? Testing or counseling? What are you here for?" as if I couldn't possibly want both. I asked her, "Well how can one possibly counsel him without all the information about his condition?" and I just knew it was going to be a very "wonderful" afternoon. She continued to berate me at every chance and make side-comments. I don't know if she was just having a bad day or if she didn't like moms that looked super young or what, but she did not like me and if my child ever has to talk to her again I will be finding a new office. She gave us papers to fill out - one for Ryan, and one for me, his dad, and his teacher. She told us that when we get our "insurance figured out" that we could bring them back and continue the evaluation process.
We have been waiting for two weeks now for Tricare to approve our claim so that we can move forward, finally have some closure for Ryan, and to get him the help he needs. This is his mental health! Children in his age-range have committed suicide over less! Why are they dragging their feet on this?! I should not have to go through outside entities to get someone that understands my son's condition to talk to him and help me teach him about life and how to make good choices and how to deal with his emotions. I should not have to rely on our school to help him because his insurance refuses to pay a claim - a claim that my husband and I have BOTH made sacrifices for. So many people believe that Tricare is "free" but let me tell you, it is far from free. We are paying right now - I'm watching my son drown in a sea of his own emotions because I don't always know how to help him. In our hour of need, we shouldn't have to go through Military OneSource to quickly see a doctor for mental health, or through the school. Tricare should be enough.
Please, contact your Congressmen and other representatives and ask them to fix Tricare so that children can promptly receive mental health services.