It’s okay to admit you need help: Overcoming the stigma of mental health treatment

Image

Dec 17, 2018 | Elizabeth Payne-Maddalena

Broken bones. Whiplash. Concussions and TBIs. Slipped discs. Busted knees. Juries expect these kinds of injuries from a car crash or a slip and fall. These injuries are easy to diagnose: there are diagnostic tests for them, like x-rays and MRIs. Doctors can press on a muscle and feel it spasm, look at a person and see them limp.

But a person isn’t just a collection of body parts. That’s not what makes you you. When I ask people what drives them in life, they tell me about their families, friends, faith, work, passions, hobbies and dreams. Those are the important little pieces of a person that makes up a soul.

To pursue these things, these passions that make up a person, people have to be physically able to do them. When someone gets hurt in a car crash, it’s like throwing a stone into a calm pond – the ripples spread out and touch each part of their life. The outgoing PTA mom who’s always willing to help out suddenly withdraws, in too much pain to paste a smile on her face. The young accomplished athlete feels like a failure, struggling with frustration, anger at the recovery process. The office rockstar misses work, meetings, falls behind.

Juries aren’t surprised to hear about these kinds of damages from car crash or fall victims. After all, jurors are people too, and this makes sense to them that injuries do more than just hurt. But sadly, some attorneys choose to ignore these impacts on their clients’ lives, even when the emotions become so great that their client needs professional help to recover. These injuries, some say, are too “hard” to prove. After all, there’s no MRI to show depression. X-rays don’t show driving anxiety.

However, these are crucial losses that you’ve suffered because of someone else’s negligent choices, and you deserve to be compensated for them. So today, I’d like to talk to you about how to make sure all of you gets the healing you need after you’ve been injured. This is an important topic, and I know there are lots of stigmas around “mental health issues” that we’ll get into. Most importantly, remember that there’s nothing wrong with asking for help when you need it.

What kind of emotional or psychological injuries do you normally see in your cases?

First of all, I try not to call them “psychological injuries” because there’s a lot of baggage with that term, and I don’t want clients to feel judged or uncomfortable.

The situation I described above is very common with my clients. Injuries suck. I’ve had my fair share of them, and the healing process can be a long and arduous road. The pain alone can cause someone to want to isolate themselves or feel weak, humiliated. Clients may lash out unintentionally when they’re hurting, affecting their relationships with others. But some feel robbed when they miss out on important life events, or even everyday life events. When the injuries are life-changing, its a higher chance that they will never truly, fully recover. This makes some people very depressed. Some people get angry, as they did nothing wrong – after all, it was the defendant who made the choice that caused them to get hurt. Sometimes, these feelings of depression, anger, or anxiety become a festering wound that drags a person down.

Other times, the event itself may trigger anxiety or post-traumatic stress for a client. For example, imagine you’re sitting at a red traffic light, minding your own business when BAM! A drunk driver rear-ends you at full speed. You have to be taken to the ER from the scene by an ambulance. It’s out of nowhere. Next time you’re sitting at a red light, how do you think you’re feeling? Nervous? Anxious? You bet. Your sense of safety’s been completely shattered, and now, you trust no one. Many people confess to feeling like they’re just waiting for the next negligent driver to hit them – and they’re scared that the next one will be a lot worse. For a majority of people, this driving anxiety goes away after a few weeks. But for some, it clutches into their brain and refuses to let go. When those people get behind the wheel, they may start to feel their heart racing or have flashbacks. Nightmares might plague them. They avoid driving. When it starts to interfere with all the things you have to get done, that’s when you need to ask for help.

For assault and abuse survivors, the trauma surrounding the event itself leaves long lasting scars that require counseling to help them overcome their fears. Getting a client into immediate supportive treatment is necessary in these kinds of cases in order to help give the client the support they need to fully recover from their abusers.

What should I be doing to protect myself?

Again, each client is different – no two people are alike. Some people may recover without needing any professional help, but others will. It’s important that you’re talking to your medical doctors, physical therapists, and your attorney about your frustrations, anger and anxiety, so that way, if you do need help it is well documented. This means you’ll have an easier time getting treatment if you need it. This also helps build your case by having a third party that can back up your testimony if the case goes into litigation.

What are some of the major roadblocks that keep clients from getting treatment?

Stigma

Let’s face it: the US has a major problem when it comes to our views on mental health issues. The Association for Psychological Science cites this stigma as one of the main reasons why people don’t get or complete mental health treatment. Getting counseling or therapy is seen as something “crazy” or for people with serious psychological disorders. Some see it as an admission of weakness.

The simple truth is that the people I know who are willing to seek professional help when they need it are the strongest people I know. They’re anything but crazy. In fact, they’re some of the sanest people I’ve met. Think of it this way: you have a brain injury, you see a neurologist. But if your psyche is injured, you’re not gonna go see a doctor to heal that?

Insurance and money

The next big hurdle is finding a way to pay for treatment. Under the ACA, insurance companies must cover mental health treatments. This is great news, and something that hopefully Congress sees and keeps this requirement.

But many providers are out of network, meaning there are high copays or deductibles. Finding in-network providers can be time consuming, or worse, involve long waitlists. But there may be solutions you and your attorney can come up with if you ask and explain the issue with them. Let them be your ally! After all, we can’t help you if you don’t tell us what roadblocks you’re encountering.

Jagged little pill

With apologies to Alanis, medication is another big issue that makes many people shirk away from seeking help when they need it. There’s an additional stigma around taking psychiatric medications that’s pervasive. Some people fear they’ll become zombies or someone different on medication. Others worry that they’ll experience significant side effects. Still others fear addiction or dependency. But these feelings, while valid, shouldn’t stop you from getting the treatment you need.

First of all, medication is not always a requirement for treatment. It’s a tool that can be used as part of your treatment, yes, but it’s not a required one. Your mental health professional should be willing to work with you if you’re uncomfortable taking medication, and you should talk to them about your fears and concerns. You may also want to focus on treating with Licensed Professional Counselors (LPCs), Psychologists, and/or Licensed Social Workers (LSWs). These providers typically focus more on non-medication therapies versus psychiatrists. However, psychiatrists also offer therapies and methods that couple well with medication, or fall outside of it, and can be just as beneficial. They can be especially helpful if you do end up needing prescriptions to help manage your symptoms while you’re in treatment.

Additionally, your treating provider should work with you to find a medication that doesn’t result in significant or massive side effects or turn you into a zombie. While it may take a couple of adjustments or trying different drugs, your provider will work with you to find something that manages your symptoms while allowing you to still be you.

Finally, even if your provider recommends prescription medications as one of the tools to help you recover from your emotional injury, that doesn’t mean you’ll have to take that medication forever. It’s just like taking a course of antibiotics for a sinus infection: after you’re cured and you’ve completed your dose, you don’t keep taking them forever. Many people end up tapering off their medications completely once their treatment has resolved. Keep in mind that you should not just quit taking your medications, and stopping any psychiatric medications should be done at the recommendation and under the supervision of your treating provider.

Finding the right provider

The last big struggle I hear about when it comes to getting treatment for emotional injuries is finding the right provider. This boils down to two categories: experience/specialty and fit.

With experience and/or specialty, I mean finding a provider who’s treated people with the same trauma as you, and/or offers the kind of treatment you want. You don’t want to go to a counselor or therapist for driving anxiety whose never treated someone with post-crash driving fears before! When you’re calling around, ask your potential doctors, counselors or therapists if they’ve ever treated someone in your situation before. You should also ask what therapies they offer and prefer (including any concerns over medication, as I discussed above). If you’re not familiar with the therapies they offer, Google them! Google can be very helpful with explaining what therapies benefit what symptoms the best. For example:

By fit, I’m talking about finding a provider that you’re comfortable with. This is incredibly important when it comes to any medical provider that you’re seeing, case-related or not, but even more so for mental health treatment. You’re trusting and talking to someone about the thing that most people struggle opening up about: your feelings, your thoughts, your emotions, your fears. If you don’t feel comfortable (or like you can get comfortable) with a potential provider, your treatment won’t be as successful as it’ll be hard to open up. It’s not a bad thing, and a provider won’t take it personally. (As a lawyer, I tell potential clients all the time that they should feel comfortable talking to me, and if not, they shouldn’t choose me to be their attorney for the same reason).

Remember This

No matter what, people deserve to be compensated for the emotional damages they’ve incurred as a result of someone else’s negligent choices. Even if they don’t end up needing psychological treatment, as those damages still matter. Make sure you’re talking to your treating providers in order to build a record of these damages and ensure you get the treatment you need. Find an attorney who cares about all of you, not just your bones, muscles or organs. And don’t let the stigmas keep you from being compensated for all of your injuries. After all, it’s what you’re entitled to and what you deserve.


When It Happens In Your Town: What Survivors of Mass Shooting Events Should Know About Their Rights

Jul 10, 2018 | Elizabeth Payne-Maddalena

This post was co-authored by Benjamin Boscolo.

Recently, a mass shooting event happened at the Capital Gazette in Annapolis, Maryland, not far from our Greenbelt office. Five Marylanders and committed journalists lost their lives when a gunman opened fire on the newsroom, and two more were seriously injured. Our hearts go out to the reporters who were simply doing their jobs when the shooter targeted them.  ChasenBoscolo stands with the Capital Gazette, Sun Newspaper Group and the Annapolis community.  

As of the posting of this blog, there have been 168 mass shooting events in the U.S. just this year. Unfortunately, as Americans know all too well, these events can and will happen anywhere. This number will continue to go up as long as lawmakers choose to ignore the root cause of the problem. In the meantime, those who are left behind – survivors and family members of those lost – have a long, arduous road to recovery that goes on long after the cameras leave and the attention of our leaders moves on to the next tragedy.

Many people do not know are their legal rights in the wake of these events. These rights vary from survivors left with physical injuries and mental scars, to the families left behind. Our hope is that this blog helps people understand what their rights are as they try to cope and heal. This isn’t just meant for those impacted by the Gazette shooting, or the Great Mills High School shooting, or the survivors in Parkland; but also the people who’ll be targeted in the inevitable next one.

Red Flags Ignored

When I was in college, back in 2007, I did a research project focused on the psychological mindsets of mass school shooters. One thing I discovered, which still rings true today, is that there are almost always warning signs of the coming violence – warning signs that many people, including people with the power to prevent the attack, knew about. In all of the mass shootings I studied, I learned that for a variety of reasons, these red flags are ignored. When the people in power ignored the warning signs, the result was the shooter being allowed to carry out his plans uninterrupted.

While these institutions or businesses may not have actually pulled the trigger, their choosing to turn a blind eye to the threat make them civilly liable for their negligence. That is what creates the legal right for survivors and family members of victims to bring civil lawsuits in order to be compensated for the damages they suffer as a result of the shooting.

Who has the right to sue?

The law only gives certain people the right to recover in these kinds of situations. Generally, the only people with the right to sue are those survivors directly impacted by the event, and certain surviving family members of those killed in the shooting. For those unfortunate people who were at the place where the shooting occurred, they can only recover if they are in the “Zone of Danger.”

Survivors of the Shooting

People who were actually present when the event occurred rarely walk away unscathed. They either suffer physical injuries from being shot or, more significantly, emotional and mental trauma, such as post-traumatic stress; or both. Survivors have the right to file civil lawsuits for damages to help pay for:

  • Hospital treatment
  • Rehabilitation and medical treatment
  • Psychological counseling and treatment
  • Expenses related to permanent injuries, such as making a home handicap friendly
  • Lost income due to injuries
  • Pain and suffering – both physically and mentally

Anyone with a physical injury has a right to be compensated for these injuries. This includes any mental or emotional distress, trauma, and treatment needed. Survivors have the right to be compensated for the previously mentioned costs and effects of the shooting.

But what about people that only suffered mental distress as a result of the shooting?

This is much more complicated. Generally, D.C., Maryland and Virginia first require that that the person was in the “Zone of Danger”. This means you were there, in the immediate area of the shooting (same room/floor/office) and were actually afraid of being shot.  Whether or not a survivor of a mass shooting is in the zone of danger is a very fact-specific determination.  To make things more challenge there are little differences in the law in Maryland, D.C. and Virginia that make it very hard to really break down the Zone of Danger here.  For example, each state and the District of Columbia have different rules about whether or not a person has to display physical signs or symptoms of their mental trauma to recover.  That’s why it’s absolutely essential for a survivor left behind with mental scars from trauma to talk to an attorney who is experienced with mass shooting cases.

Physical Wounds and Medical Treatment – Who Pays?

For many physically injured mass shooting survivors, the types of injuries they suffer require immediate emergency medical treatment. They’re taken from the scene straight to the hospital, by ambulance, helicopter, or, the backseat of emergency responders’ cars. For those with only minor injuries – broken bones and concussions from trying to escape the gunman – they’ll be quickly released. But survivors who suffer gunshot wounds face a long road to recovery, one that may take months, or even years.

Either way, a trip to the hospital alone costs thousands of dollars, money most Americans simply don’t have. Survivors who needs extensive treatment are faced with tens or even hundreds of thousands of dollars in medical bills.  So who pays for it? And who should pay now?

If you’re lucky enough to have health insurance, you should absolutely use it to cover the bills now. Many people think if they think they use health insurance, they can’t claim those medical bills paid for by their insurance in their cases. That is untrue. You can still claim those medical bills. Ultimately, the negligent party should pay for the medical bills, but in order to protect yourself in the meantime, health insurance can step in and pay for the care needed for recovery.

The Scars of Trauma – Getting Psychological Treatment

Immediately after a mass shooting event, local charities and organizations do a great job offering survivors grief counseling and making sure mental health hotlines are available. But for many, regardless of whether they were physically harmed in the shooting, the mental and emotional aftereffects last far longer than a few weeks – and require more help than what these resources can offer.  Victims deal with everything from survivor’s guilt to flashbacks, nightmares, and panic attacks. Some survivors find that the mental effects can be even more devastating and harder to heal than their physical injuries.

Luckily, grief counselors and crisis hotlines are incredibly helpful for finding mental health providers that specialize in helping trauma survivors. Be sure that whoever you see is experienced in dealing with post-traumatic stress.  It is even better if they’ve helped survivors of mass shooting events before. Either way, getting help as soon as you can is extremely important to help you process and recover from the trauma you’ve endured.

Just like with medical treatment, if you have health insurance, mental health treatment should be covered.

For Those Left Behind – Wrongful Death and Survival Claims

Unfortunately, many mass shooting events result in the loss of innocent lives: children, parents, friends, co-workers, brothers and sisters taken far too soon in an act of violence. Left behind are heartbroken family members and loved ones struggling to fill the holes left in their lives. They’re suddenly planning for funerals, which, according to https://www.parting.com, cost between $7,000 and $10,000. Many victims of mass shootings are young people, meaning they hadn’t financially planned for their deaths, leaving their loved ones shouldering heavy costs. When a parent is killed, the loss of income can devastate a family. This financial loss is magnified by the sudden and violent loss of their loved one and the accompanying public attention.

In these situations, there are two kinds of claims certain family members can bring: wrongful death claims and survival claims.  Let’s briefly explore these together

Wrongful Death claims:

A wrongful death claim is a claim brought by certain family members of the departed person which allows them to be compensated for the loss of their loved one. Only certain family members have the right to bring these kinds of claims. Those who have these right depends on whether or not the victim was married and has children, as well as surviving parents, brothers and sisters.  Finally, the people who have these rights differs between Maryland, Virginia and the District of Columbia. This is another reason it is important for surviving family members to talk to an experienced, knowledgeable attorney.

Wrongful death claims allow the family to be compensated for the following losses:

  • Any medical bills for treatment to the departed person as a result of the shooting
  • Funeral expenses
  • The loss of current and future income the victim would’ve earned
  • Grief, pain and suffering that the family endures from the loss of their loved one, both past, present and in the future.

One particularly tricky part of wrongful death claims is that (generally), the law only allows one claim to be made for all the family members who have the right to bring these claims. That means that everyone who wants to bring a claim, or wants to bring a claim, needs to be part of one action. Maryland requires all of the family members with the right to be a named party in the case, even if they do not want to participate or bring a claim at all. It’s important for close family members to discuss this option together, and keep the lines of communication open. Some families pick one person to be the main point of contact for any discussions with an attorney.

Survival Claims:

The other kind of claim available are survival actions. This is for the actual pain and suffering the deceased victim suffered during and after the shooting but before they pass away. This includes their fear as they realized what was happening, as well as when they realized that they were not going to escape unscathed. If the victim was unfortunate enough to survive after being shot – even if it was for just a few minutes – these claims also allow damages for their pain, anguish and suffering during their last moments.

Unlike wrongful death cases, survival claims are brought on the behalf of the victim’s estate – the legal entity that exists after a person dies. Any compensation is then paid to satisfy any of the victim’s outstanding debts, and then to any people who get to inherit from the estate. Who runs the estate (the “personal representative” or “administrator”) and who gets to inherit depends on a couple of things. First, whether or not the victim had a will. Second, if there was no will, who the law allows to serve as a representative. The family members who can inherit again depends on the law of the state where the mass shooting event occurred and whether or not the victim was married or a parent.

The Challenge of Proving Negligence in Mass Shooting Cases

These cases aren’t easy. There are a lot of weird legal nuances, as well as factual, evidentiary, and societal hurdles that survivors and the families of the victims have to face. We do not want to discourage anyone from exploring their rights, we just want to be completely honest and candid.

We’ve already hinted at some of these problems: proving that the survivor was actually in the zone of danger; overcoming laws limiting the kinds of actions survivor with only psychological injuries can bring; making sure all the right people are named and involved in wrongful death lawsuits. But there are a couple other big issues that we haven’t talked about.

Notice

Ok, so, as we mentioned above, these cases center around the ignored red flags around the shooter and his behavior before the shooting occurred. This brings up an obvious point: we not only have to prove that these red flags existed, we also have to prove that the entity we think is responsible knew about these red flags. Then we need to prove that the responsible entity chose to ignore the red flags, allowing the shooter to take his plans and turn them into a tragic reality.

We also have to prove that the responsible entity that knew about the red flags had a legal responsibility to protect the people who were eventually targeted. Not a moral responsibility, but a legal one. This is a very fact-specific determination (like so many other things in these cases) and is something an experienced attorney can definitely help you figure out.

Suing the Shooter Directly

There’s a very obvious party we haven’t talked about yet: the shooter. After all, he’s the one who pulled the trigger, he’s the one who chose to take the lives of innocent people.  Why aren’t we going after him?

The very simple reason is that these cases – meaning civil cases – only allow us to get our clients monetary damages. That’s the way the law works. Period. So, when there’s no money available to get – these cases are just simply not worth our clients’ time. It is not worthwhile for them to go through years of litigation (yes, we do mean years) to get nothing but a piece of paper in the end saying they won. There’s no question of who was in the right or the wrong here: we all know the shooter did something unspeakably evil.

So when we sue a shooter, unless they were a multi-millionaire, there’s nothing for our clients to collect. Homeowner’s insurance doesn’t cover these cases. Their contracts specifically deny coverage for intentional crimes like this.  That’s why we’re not talking about suing the shooter themselves: because we don’t want to force survivors and grieving family members to go through all this for nothing in the end.

The other reason is that when an entity picks to ignore a red flag, they are responsible. They made a choice, and then decided for some reason not to warn anyone, not to do anything to try to stop the shooter, limit the risk he prevented, or add extra security or safety to keep people safe. They didn’t pull the trigger, but their silence makes them complicit.

Immunity

One of the most important things to remember is that depending on the situation and where the shooting took place, there may be laws in place that shield those at fault from civil liability. This is called “immunity”, and who has immunity depends on what state the shooting occurred in. This is a very fact-specific determination, and is why it’s important for survivors and family members to talk to experienced lawyers who know what to look for.

One group of companies that families and survivors often believe should be held responsible are gun manufacturers. Unfortunately, Congress passed a law giving gun manufacturers total immunity from civil lawsuits, meaning these companies are legally shielded from responsibility. The only way that will change is if the law itself is changed.

If you have been the victim of or lost a family member to a mass shooting, it is important for you to contact a trial lawyer who is experienced in handling cases arising out of mass shootings. No matter what, we hope this blog has helped you get a better idea of what rights you have, legally, as you begin the long process of picking up the pieces left behind.