[00:00:00] Welcome to the Health Policy Podcast. I'm Brian Hyde, and today I'm joined by Ellen Lubensky. She's an attorney and mental health reform advocate. Ellen, welcome to the show. Could you take just a moment to tell us a little bit about yourself and, and your background? Sure. So I am a Stanford educated attorney. I mean, I a Stanford graduate. Um, I am an attorney for, um, I went to Rutgers Law School. My bar has never been in jeopardy and I aim to spread awareness about the detrimental effects of psychiatric medications. Alright, um. Let's, you know, let's, let's set the stage here. Um, when, when people think about psychiatric medications, um, I mean, I think most of us know someone who is on, you know, mood elevators or mood regulators or that kind of thing. Uh, is, is there is a very broad spectrum here, or are we talking about a, a more narrow range of psychiatric medications? Well, no, there's a whole wide range of psychiatric medications. You know, there is antidepressants, there is, um, [00:01:00] benzodiazepines. There is, um, there's, I was on antipsychotics. Um, you know, there's a whole wide range of mood altering substances and, you know, I firmly believe that doctors should have transparency, um, when they're prescribing them. You know, most doctors, most psychiatrists are given 15 minute appointments. In which to, um, medicate people, no. They have 15 minutes in which to say, um, here's a pill, and that's the easiest solution. I firmly believe that this is because of big pharma, because big pharma pushes you to take, take pills. No, um, I knew nothing, um, as an attorney about the warnings and I was not given informed consent. I did not have the a sit down with my psychiatrist telling me that, um, what the risks would be. [00:02:00] Um, I have suffered tremendously, but not nearly as much as people without resources. Um, the things that I thought might happen have not happened. No, there are many. Um, suicides. Many people go to seizures. Um, many people have akathisia, which is an inner restlessness. These are things that know are highly unlikely to happen to me unless, you know, I tip my D Valium. Um, I am lucky because I have doctors who trust me and know that I am not an addict that have never misused a substance. Um, you know, I, I firmly believe in advocating for your rights that people can report psychiatrists when they 'cause psychiatrists do do wrong. Um, many people feel that they cannot speak up about mental health issues and that they need to hide in corners. [00:03:00] I firmly believe that this is not the best way to handle things. Um, I firmly believe that people should be given therapy. And, um, no sunshine and taking a break instead of pushing to, um, to be successful, to, to be perfect. Um, no, you need to take care of yourself. Number Cardinal rule is. Choose yourself first. Um, I have actually filed suit against a psychiatrist. Um, this is not something that most people can do. I am representing myself as an attorney. I can do that. Most, um, attorneys will not take suits against psychiatrists because it is something that is very hard to win cases over. Um, but I firmly believe that these are things that people need to take into their own hands. And advocate for themselves. [00:04:00] Um, you know, I knew I worked at the SSI project at Legal Services of New Jersey. They there, they, the attorneys I firmly believe, and the staff knew almost nothing about the detrimental effects of psychiatric medications. Um, they have taken, um, the attorneys. I offered them a free training to educate them on the detrimental effects of psychiatric medications, and it was refused. It was very disturbing to me that people on TikTok know more about the detrimental effects of psychiatric medications than the attorneys and staff at the SSI project. Um, these are things that if I had known. About the, the risks of psychiatric medications, I would never have ingested them in the first place. Ellen, you mentioned, um, informed consent [00:05:00] as we were beginning. Yeah. And let, let's talk about the role that that plays, uh, especially when it comes to someone who's being prescribed psychiatric medication. Um, first of all, can we get kind of a working definition? What, what do we mean by informed consent? Informed consent means, you know, telling you the risks, telling you no, what may happen if you ingest. Psychiatric medications telling you that, um, the warning is two to four weeks, or they may, you may become physically dependent. There is a warning on the side of, on, on the package that says two to four weeks, or it may, but it says, may I firmly believe that. No, the doctor has, uh, a, a duty to transparently. Now, um, speak with you openly about whether the may will happen to you. Um, informed consent, I, no, I mean, I asked questions and I was told that no, um, [00:06:00] benzodiazepines were not going to cause physical dependency. I was told that high dose benzodiazepines would be no issues, no problems. Um, and I was up to, you know, five milligrams of Ativan, which is an extraordinarily large dose. Um, I knew nothing flat. If I had had a sit down, um, and been had informed consent, been told that I could become physically dependent and know, suffer for, for years to come, I would have asked questions. I would have said, you know, maybe there's another way besides taking. Um, taking benzodiazepines for me, it was for insomnia. Um, so, you know, these are things had I known I would not be, um, suffering and I know the things that I have suffered are far less than many people. Almost nothing is covered [00:07:00] in, um, psychiatric medication withdrawal. Um. Almost all my bills this year are unreimbursable medical expenses. Um, there are many people who have to lie to their doctors in order to be able to, um, be taken off of psychiatric medications. I believe that this is, oh, Otter is saying they're in the waiting room. I believe that this is something that you need to spread awareness about. Um. You need to tell people beforehand because I was not told this, I was told nothing. Um, you know, you call 9 8 8, no, this is this the suicide and crisis prevention line. Mm-hmm. And those operators do not know, many of them do not even know what Benzodiazepine withdraw is. I post public on six platforms.[00:08:00] And nobody in my community will even admit that they are in psychiatric medication withdrawal. What would, and I think these are things mm-hmm. What would it take to, to make, uh, informed consent, you know, the, the standard, the norm? I mean, where, where does that type of reform have to begin? Does it start with the patient's, you know, assuming more responsibility, or do we need to put some more responsibility on the, on the doctors, the, the psychiatrists who are, are attending to them? Um, I think we need to put responsibility on, you know, the psych. Firstly, the system needs to try change, um, because of funding. I firmly believe that, you know, big pharma gives psychiatrists 15 minutes, uh, appointments and this is not enough to, um, allow them the time to openly discuss, um, psychiatric issues. Um, these are things that no big [00:09:00] pharma, no additional funding would allow, um, more time for those things to happen. Um, and um, so there needs to be better funding sources. There needs to be better funding to allow people to, um. To know, to, to be able to tell what is going on. Um, and these are things I was not given awareness about. Talk to me about, uh, the rising mental health spending that, that we're seeing, you know, with the Medicaid expansion and, um, and, you know, basically the, the spending is going up. How are the outcomes? Are, are they, are they being positively affected or are we seeing some lag there? Uh, you know, due to some of the, the disconnects that, that you've just outlined? Well, I mean, I think that there's many people who are suffering unnecessarily, um, that know this. Unlike cancer, this is [00:10:00] almost a hundred percent preventable. Um, with, with information you provide people with information and they can, um, they can make their own decisions. And these are things that, you know. Um, they need, doctors need to speak openly about, um, and funding should not be the, the, the bad part about it. Um, in terms of the, the amount of time that, uh, for instance, a psychiatrist spends with a patient, um, this is, I mean this is something I've seen firsthand too. It's, you know, there there's a lot of, uh, a lot of paperwork, a lot of waiting, but the actual time sitting and talking with the, the care provider, the physician is, is pretty minimal. What needs to happen in terms of, of. Improving the, either the quality of that time that is spent there, or actually extending that time to where, uh, you know, the, the patient [00:11:00] can come away with some, some meaningful understanding. Well, firstly, I think that there needs to be shifts in funding, um, so that, you know, psychiatrists are given time for longer appointments. Um, no, I firmly believe that a psychiatrist should not be the first resort. It should be a. Therapist, you know, you should first go through a therapist before you medicate somebody. Um, medications should never be the first resort. Um, you know, given what I have been through, none of my friends would take benzodiazepines for more than the recommended two to four weeks. Um. That may, that may cause physical dependency. Um, so no, these are things, if there's greater funding, um, they will be able to, um, talk more openly about what's going on. And, and [00:12:00] where is the, the most reasonable or likely source for that funding? Is it, is it going to be through Medicaid or, or are there other resources available to to help? I don't know. I mean, I'm not that knowledgeable about Medicaid. I sincerely doubt that Medicaid is going to be funding, um, longer visits. Um, the social security disability system is pushes people, um, to take med psychiatric medications in order to be able to get, um, disability. And I view this people, I saw time in and time again that people did not get disability benefits because they would, um, they would, um, they wanted to use holistic means to heal, such as using ice packs or, um, you know, [00:13:00] breathing through panic attacks. So I don't, I think there has to be significant additional funding. For Medicaid in order for there to be, um, people to have better options. Because often therapy even is expensive. Um, you know, right now I pay I think $15 an hour for therapy. I, for some people, you know, that is not even accessible. Um, I believe that Medicaid will now offer, um, therapy. But no. $15 even can be difficult for some people to pay. Um, I am not certain of the exact criteria under Medicaid to for funding, but these are things that, you know, need to be raise awareness on. Um, and the system, you know, the system needs to change so that people do not struggle as I have struggled. [00:14:00] I am curious as well in insurance, you know, particularly health insurance companies, um mm-hmm. When we talk about, uh, mental health parody regulations, um, does, does that, does that help to, to level that playing field a little bit? I understand there, there may be, uh, disparity, you know, uh, in, in how they cover mental versus physical health conditions. Um, how have those regulations worked out? So, I mean, I think that there is greater parity now, but for a long time. You did not get coverage for mental health conditions in the same amount as you did for physical ailments. And I think that that's very concerning. You know, there should be no, these are people who are struggling. We should not differentiate between people who are struggling. Um, you know, with mental health issues and physical issues, there should be, um, access to care for any of these things. These are not things that people should feel ashamed about.[00:15:00] And if there was, if there's one takeaway that you would like our listener to come away from this conversation, um, remembering what, uh, what would you like to stick in their mind as, as far as, uh, this issue? Sure. No, ask questions. If your psychiatrist does not give you the time to ask questions, then you should, should, should find another psychiatrist. Find somebody who. Um, we'll take the time for you. Um, and these are things that you know, we need to tell people. You can ask questions, ask questions. Um, if somebody does not have time to ask questions, you find somebody else. And also I'd like to ask where, where would you direct people who would like to, uh, sink their teeth a little deeper into this issue? Do you have a website that they can go to? Yes, I do. Um, it's ellen lubinsky.com. [00:16:00] E-L-L-E-N-L-U-B-E-N-S-K y.com. Um, I currently post public on six platforms. I currently do lives at 8:30 AM Eastern Standard Time. Eastern daylight time on LinkedIn on Thursdays, and I do two lives a week generally on TikTok. You know, people can be feel, to feel free to private message me. Um, I, you know, I can't give medical advice and I can't give legal advice, but, you know, I can, um, offer any support that I can. Well, you, you definitely bring an informed viewpoint to, to the issue. So if, if your hands are tied on the medical and legal stuff, at least you can, you can say, look, here's, here's what I've, I've gone through. Um, Ellen, thank you so much for, for bringing some light to this topic. I know, um, like you had mentioned earlier, oftentimes people don't want to talk about, uh, mental health. Um, there still is a, is a stigma attached. You know, when someone is seeing a psychiatrists, there's a lot of discrimination against people. Who [00:17:00] know, who admit that they have mental health issues. Um, and I think that that is extraordinarily concerning. Any suggestions for, for what people can do to, uh, to not fall into that trap? I mean, if you hear, oh, so and so is, is, you know, on, on some kind of, of medication, um, I mean, we all think something, but, uh, what's a, what's a healthy way to approach that? Oh, someone is on medication instead of making a judgment. Oh wow. They must have lost it somewhere along the way. What, uh, what, why, what might we think of instead? Okay. You know, you're human. Um, I mean, if you know what you're getting, if you know the risks, I have no problems with your taking psychiatric medications. Um, you know, somebody who is taking psychiatric medications. No, that's fine. You know, it's not something that somebody should be ashamed of, you know, speak openly with your friends. This is not something that you live in. Shame over. It is not something that, um, should be disguised. It's not something you hide in corners over when [00:18:00] you're struggling, and I think that would translate well into, you know, that would also provide the necessary courage to, to get the answers that you need out of, uh, the, the psychiatrist or, you know, the, the doctor attending to them. Exactly. Exactly. Alright, I completely agree. Again, we are talking with Ellen Lubinski, she's an attorney and mental health reform advocate. Ellen, thank you so much for joining us today on the Health Policy Podcast. Thank you so much for your time. I greatly appreciate it.