Head Inside
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #Head-Inside formerly Mental Health Matters. Interviewing doctors and therapists, treatment professionals, organizational leaders, and other members of the mental health community about the importance of mental health awareness, treatment and the future of addressing mental health in the US. Discussing trends in the field and how to support mental health in our communities from hospitals to the dinner table.
Head Inside
The Voice of Recovery with Attorney Jordan Lewis
Tragedy and triumph define the deeply personal journey of Jordan Lewis, an attorney who has made it his mission to champion mental health parity. Listen as Jordan opens up about loss and the journey of a parent with children in recovery from alcoholism and substance use. The episode offers an intimate glimpse into the complexities of family, the resilience needed for recovery, and the relentless pursuit of advocacy in mental health.
Join us as we confront the often frustrating realities of navigating healthcare systems for mental health treatment. Witness the challenges Jordan faced when advocating for his daughter after a miraculous coma recovery and his intense efforts to secure proper care against the odds. Through stories of self-advocacy, we explore the importance of questioning medical professionals and emphasize the empowerment that comes from informed involvement in the recovery process, including the difficult yet vital task of setting boundaries.
Jordan dissects the intricacies of the Mental Health Parity Act and the legal battles for insurance coverage of non-traditional therapies like wilderness and equine therapy. His insights into redefining therapeutic approaches and the societal biases against mental health treatment offer a fresh perspective on the ongoing fight for legislative and insurance support.
Hello folks and welcome back to Mental Health Matters. I'm Todd Weatherly, your host, therapeutic consultant, behavioral health expert, with me today. I have a colleague and now friend, mr Jordan Lewis, attorney and mental health parity advocate with JML Law. Jordan is a 1979, we're going to try not to date him too bad 1979 graduate of Williams College in Williamstown, mass, where he was an All-American swimmer. After years in the daily news world, he started law school at the University of Minnesota. Post-graduation he worked for Robbins, kaplan Miller and Cressy, now one of the most successful plaintiff's law firms in the country.
Speaker 2:That's true.
Speaker 1:In 1992, jordan started working with a small Minneapolis-based commercial law firm known as Siegel Brill and honed his practice over the next 20 years until moving to Fort Lauderdale, florida, with his family in 2012 to work with Kelly Ustall, a preeminent plaintiff's law firm there in Southern Florida. This was a complete circle for Jordan, leading to opening Jordan Lewis PA in 2016, jml Law. But the specialty of his practice is what we're here to talk about, and his personal story connects him to the world of recovery in an incredibly profound way, which I am grateful that I got to sit and listen to just in an intimate lunch setting and connect with you, jordan. Welcome to the show and thanks for joining us.
Speaker 2:Thank you, todd, appreciate the introduction you nailed it.
Speaker 1:Absolutely Well, I tell you parity law and kind of the denials, management and just the whole world of people being able to go to treatment and get their insurance and do what they're supposed to be doing and pay for it is kind of one of my big advocacy points. I try to help families navigate that as much as possible and do things like set a budget for how much they're going to pay for recovery. But, um, you know, I think that the real special part of your story is your personal journey, um being connected to recovery and the family members, and that you know we could. I want to talk about the practice and some of the things that you're doing today, but I also want to, if, if you care, to share it. Um, I'd love for you to tell at least a little bit about your personal story and how it relates to recovery.
Speaker 2:Sure, it's a story that is married to my professional practice. It's why I opened my own little law firm and it's why 90% of my practice, at least, focuses on helping families get insurance or have mental health challenges. My youngest died in 2016. She had really profound mental health issues, really profound mental health issues anorexia, suicidiation. She had a very, very complicated imaginary world that kind of dominated a lot of her adolescence. She did not die directly from her illness. She was living at home with us and at the age of 22, you don't get to have any say in medical care. So she was. She had a pain in her leg that she went to see urgent care about three times. We didn't even know about it and it turned out to be a blood clot that eventually got loose and entered her lungs and killed her within seconds. And after we died. After she died, we found a script for an MRI in her bedroom that she never went to, she never used. And so that you know, your life flips when you lose a child.
Speaker 1:And certainly ours did.
Speaker 2:It's hard it is. You know there are. I'm not unique in this story, but it's still a hard story. My middle daughter is a recovering alcoholic. Of my three kids, she's the only one who served time.
Speaker 1:A lot of crying, right, you know that's true, she, but she.
Speaker 2:she has completely turned her life around. She's been sober for more than a decade. She's married to a great guy who she met in recovery. She is seven months pregnant. She is a practicing lawyer here in Florida and kicking ass and taking names. She has really found herself and is a huge resource for me. I lean on her more than I should. What is?
Speaker 1:her law practice. What kind of law does she do?
Speaker 2:She. I think this is pretty interesting. She went to the University of Miami Law School. She went from there and worked for three years as a public defender and the reason she did it is that she understood what it was like to be on the other side of the table behind bars and that's. That's a real tough job emotionally and she left after three years. She's now doing personal injury work for a boutique, really high end law firm in in southern Florida really high end law firm in southern Florida and finding it's really fun talking to her because she is the growth curve for her is, as it's, like a rocket ship. She's learning so much so fast and she's getting really good and you can watch it and she's seven months pregnant and just as excited as can be. The big debate is what I will be called as grandfather.
Speaker 1:Right, right, you know you have to settle that ahead of time right, right.
Speaker 2:My kids loved to call me J.
Speaker 1:Lou.
Speaker 2:And I've offered that, as maybe that's what the I should be called as a grandfather, but no. I.
Speaker 1:I think that was vetoed.
Speaker 2:Anyway, my oldest is uh uh has a 21 year drug use problem. Uh, she, and it's been an absolute terror-filled roller coaster. It culminated a year ago. She was kind of bumping along doing, okay, she is a medical esthetician by trade and had her own practice.
Speaker 2:She was living with a young man who she met in recovery. They both relapsed sort of in slow motion together. He ended up dying in her apartment in their apartment, july of 2023. And you could see her spiral. She just gave up and we this isn't textbook parenting but we brought her home and required very little of her. We'd go to meetings and help us around the house, but until you can figure out how to process this grief, we are your soft landing. And so it's now almost exactly a year ago. On Friday, january 5th of 2024, she said that she was going to go to a meeting. I called her at about eight o'clock on that night and she immediately answered the phone and said I'm in a meeting, I can't talk. And I said just remember, we have some errands that we had agreed to do together the following morning. And she said that's fine, dad, do you mind if I have pizza with some of the people at the meeting afterwards?
Speaker 2:And I said she's a 33 year old kid, it doesn't not a kid grown up and I that's not my job to regulate when she has pizza and with whom. So I said just, let's just remember that we need some. We need to be productive the next morning, anyway. So she wasn't home at 10 o'clock and she wasn't answering her phone. And she wasn't home at midnight and she wasn't answering her phone. She wasn't home at midnight and she wasn't answering her phone.
Speaker 2:And, given the last, the previous seven months, both my wife and I knew I I actually bumped into a text message that I sent to her that night where I said goodbye, um, uh.
Speaker 2:So my wife and I got up and walked the same walk. We walked the night we lost my youngest, the step-by-step, because we thought we had lost my oldest, and we were out on the beach. I live six blocks from the beach, at about two 30 in the morning, and I get a phone call from a number I don't know and there's a male voice, somebody I don't know, and asked me whether I was jordan lewis, and I said yes. And he asked whether I was father of alana lewis, and he I said yes and he said I just dropped her off at the hospital. I think she's dead. They were, they were um, they were giving her CPR in the parking lot and ripping her clothes off and I have her car and I said thank you and it was a very as I relive that. None of it surprised me. It was horrible, but I was expecting the call.
Speaker 1:Outside of yourself, watching yourself receive a phone call right.
Speaker 2:Exactly outside of yourself, watching yourself receive a phone call, right, exactly, yeah, exactly this. And and wondering, praying, uh, wondering how this can possibly be my life. So I wasn't in a hurry to call a hospital and I I didn't for probably 12 hours. And when I did, the hospital said that she had been in cardiac arrest for 15 minutes minimum. That's what they knew about. They didn't know about how much longer before she got to the hospital, but they knew that she was at cardiac arrest for 15 minutes. She was still alive. But they told me not to come to the hospital. They said there's nothing for you to see here and she won't know you're here. And I actually thought that was generous advice, charitable advice, and so we didn't go.
Speaker 2:We the next day again this weird feeling that you're watching yourself make this call. I called the hospital and I asked whether my daughter was still alive and the answer was yes. So we as a family went and she was in a coma. She, her body temperature had been reduced to 80 degrees to preserve the organs. She was on a respirator. Her eyes were sometimes open, sometimes not. Sometimes it felt like she was making eye contact, but then the eyes would slip away and the doctor came in and he said the most likely outcome was that she would never breathe without assistance again because she couldn't voluntarily control her body and if we took out the assistance she would literally suffocate on a cough. She couldn't expel mucus, right, would she?
Speaker 2:want to live like that, of course the answer for yeah right so the next this is now monday morning.
Speaker 2:by this time, my entire extended family was in my kitchen and we gathered around and and decided that we were going to have to remove the respirator, and we talked among ourselves about who had to be there to watch her go, knowing that it could last 30 seconds or hours, maybe even longer, I don't know, maybe even longer, I don't know.
Speaker 2:Um, and it that was, when you talk about sort of an otherworldly moment. That was the worst. You, you having a conversation about who needs to sit at her side to wait her, wait for her to die, um, and uh, ultimately, ultimately, everybody decided to be there, uh, at least at the start, um, so we went there to the hospital, which is about a 40 minute drive, and we walked in and Alana's head perceptibly turned towards me and our eyes made contact and I looked at her and I I said do you know who I am? And she nodded yes, and I said do you know what happened? And she not not to know, uh, and you could see her trying to talk the. The intubator is in her mouth, right. You could see her lips trying to form words around the mouthpiece and the nurse is watching this and said how about if I take out the intubator? And I we said, is that safe?
Speaker 1:and her answer was who knows.
Speaker 2:Um, she said, go to the waiting room and I'll come get you. And 15 minutes later, uh, she came and got us and uh, she said your daughter would like to talk to you. And at this point we're just swimming. We can't believe. We had already decided to put her remains next to the remains of my youngest. And just this amazing moment. We walked in and it was like there was a hundred pound weight on her chest. She could barely move and her arms were extended and her hands were sort of clawed and her hands were. Her arms were extended and her hands were sort of clawed, but she was talking and she was talking in a weird monotone high pitched Happens when the innovator is in the yeah.
Speaker 2:But she was talking and there was no. You know, one of the questions that is is she, is she all there mentally? And there was no obvious deficiency at all. And in the course of about eight or 10 hours on a day, when we thought she was going to die, she came completely back to the point where she got up on her own and went to the bathroom and then came back and sat down on her bed.
Speaker 1:It was just this, this they declared her dead, though too right they like she was actually declared dead. Is that right well?
Speaker 2:she. She was in cardiac arrest for 15 minutes. They didn't stop working her um. But you know, if you're, if you and I are in cardiac arrest for 15 minutes, there's nothing left. And I told you sort of her off-color joke I hope you don't mind if I repeat it which she said as she was coming out of this mess Is it okay? Yeah, absolutely, please, all right. So we're all gathered around her and she's trying to make and she's emotionally a complete basket case. She's up and she's down and she's crying and weeping and laughing happily and then hysterically, which all makes sense to me, given her past 48 hours. So, anyway. So she looks at me and said wait a minute, I was dead.
Speaker 2:And I said yeah, for 15 minutes at least you were dead. And she said and now I'm alive, looks like it. And she said was I resurrected? And I said suppose, I suppose that's what this is. I said I suppose that's what this is. And she said am? I Jesus and I said no, you are not Jesus, not sure what you are, but that's not it.
Speaker 2:That's not it. Yeah. And she said no, I'm 33, just like Jesus, from now on, my pronoun is Jesus and my middle daughter is watching this exchange and she looks at me and she said she's back. And she was back, it's, it's. It's still probably the most amazing. 24 12 hours of my life to watch my daughter literally come back from.
Speaker 1:To give her up, yeah, and to bury and and bear in your mind at least barrier, yeah and decide where and make the plan and then turn around and walk into the hospital. It'd be like what is going on, yeah um I mean, I've heard this story now this is the second time and I can't, like I keep waiting for the punch line. You know what? I'm still right now. Yeah, it's.
Speaker 2:It's just a crazy story. The the number of doctors and nurses who filed in to her room just to see it, because everybody thought she was gone. You know, and that was sort of validation for me. This is not normal. This is a freaking miracle that I'm watching, and one of my takeaways is that she's probably of alien birth.
Speaker 1:I think all parents feel that way sometimes, but you might be onto something I don't know.
Speaker 2:So at that point, you know, I'm not just a lawyer practicing in this area, I'm a parent living with this, and so I know about a law in florida that permits, uh, a judge to order somebody to an involuntary treatment, and at the beginning of that day, I wasn't thinking that I needed a lawyer to to do that.
Speaker 1:I was you're talking about the marchman act, now the baker, and which is just yeah plain old commitment. But marchman is like you got to finish, you know right uh.
Speaker 2:So on monday morning, I didn't think I needed the marchman act. I thought I needed to worry about how she was going, what her remains were going going to go. So, uh, the hospital ended up discharging her on wednesday, that's two days after she came out of the coma. And they, they wanted to discharge her the following day. They said there's nothing for her to, nothing we can do for her now, which just seemed insane to me. But, um, anyway. So we had, we had a day or two to get a marchman act in order and we decided this is, you know, this is a line. Once you cross this, once you die, everything is different.
Speaker 1:Was she resistant even then to say no, I don't need treatment Like you got the Marchman Act to be safe.
Speaker 2:But you know what was her, what was her disposition toward treatment at that time she knew her disposition was that it was going to be just like all the 20 plus other times she had gone to treatment. She's an expert and she knew how to game the system. She knew the answers that people wanted. She knew that. She knows very well that treatment is is segmented into 30, 60, 90 days. She felt that she could handle 30.
Speaker 1:And that's all she needed.
Speaker 2:Right, right, right, and we knew that we were talking about years. Once you die, 30 days. I don't know that 30 days ever makes sense. I happen to know where the 30 days comes from. It's a complete contrivance. It has nothing to do with science or treatment efficacy.
Speaker 1:It was invented by insurance companies. This is around numbers. It's the early 90s managed care. We're still operating within those timeframes to this day.
Speaker 2:Yeah, correct, even though it makes no sense and I think all the practitioners know it. But in any case, we were not interested with a 30, 60, 90-day model. This obviously was different and maybe she was in this. She probably needed much, much longer term care before this event. But here we are. So anyway, we managed. We found a great lawyer, we got the Marchman Act in order. She was discharged to a sheriff's deputy on Wednesday night, two days after she came out of the coma, and she stroked while she was being discharged. Yeah, I mean to the point where she couldn't talk, she couldn't move her arms. In some ways she went right back to where she had been Sunday. Her eyes were open. She was obviously conscious.
Speaker 2:She was not there, right, but she was not there. So she was discharged by the hospital while this was happening, released to detox. The detox called us the next day and said they had brought her back to the hospital. Um, and because they said there's, she's not right and we I ended up back in the er and caused a tremendous scene because she had been reassigned to the doctor who signed her discharge and I thought tell me about let's, let's spend a minute on that, because that story, here's what I.
Speaker 1:Here's. What leads me to be in the role that I'm in as therapeutic consultant is ultimately, um, and one of my favorite things to do is to is for a hospital to realize that there's a person. They, the hospitals, typically refer to me as an advocate as opposed to a consult. I'm an advocate and one of my favorite things to do is to sit in a room full of doctors when they know an advocate is watching and run circles around them because they don't know jack about treatment. They know how to stabilize a person in a hospital setting. They know how to prescribe meds. You know I'll give them credit for their practice where practice credit is due.
Speaker 1:But outside of that, knowing about treatment and honestly just having an investment in the longer-term outcomes for a person's care it's not there. They're not, and I'm not talking about all of them, I am talking about many, and certainly in hospitals it's worse than pretty much any other setting. But you find doctors and nurses and clinical professionals and social workers and case managers and the whole nine yards that have either very little knowledge or very little investment or some level of both with regard to a person's long-term care outcome. They don't know how to manage it. They're just trying to get. You know they need. They got. Beds are full.
Speaker 1:They got to get them out the door and everything else and you've got a doctor who's signing off on orders you know the thousandth that day, I'm sure, whatever right and they're not paying attention. And then and this is the part that really gets me I get that people kind of you get to a job and you can paint by numbers, a bit like that. That doesn't. That makes sense to me, that that can happen. But you get in front of a doc and a parent is standing there, right, and you're standing there and you know your daughter, and you know something's not right, you know something is happening right, and they're not listening. They dismiss you. You're being dismissed at the door and the thing that you have to do please tell this story. What you did. I really want to hear.
Speaker 2:Well, relating to that if you and I were being discharged and couldn't speak and couldn't feed ourselves, we wouldn't have been discharged. My oldest has told me many, many times that hospitals treat addicts differently and I and I dismissed that I thought no way, that's just. That can't be true. But I watched it she was discharged and that her nurses knew that she was, that she couldn't speak and that she couldn't move her arms and that wouldn't have happened to to you or to me. So when I got back to the hospital, she was on a gurney in a hallway. Nobody was. If anybody was touching her, it was by accident, because they would bump into her in the hallway and I couldn't. Yeah, by accident, because they would bump into her in the hallway and I couldn't right, yeah, I and I couldn't find anybody who, who owned her, much less, was treating her right. Um, I and uh, I made a scene I would have too.
Speaker 1:I mean, you know, come on, man.
Speaker 2:I made a scene to the point where I had a security guard fumbling for his taser and I looked at him and I said unless you plan on advocating for my child, I'm not leaving, I'm not leaving. But this was, I think, an act of dumb luck or inspiration. The administration building was next door to the ER and it was after hours. I didn't expect to see anybody there, but I had to do something. So I stormed into the administration building again. Security should have stopped me, but I think they saw the that the crazy look in my eyes and just let me in. And I asked, as I fly past the security guard, I said where's the hospital administrator? And he said down the hall. And then he said but he's gone for the day. And I said, okay, where are the lawyers?
Speaker 2:And he said oh, they're down the hall next to him, and I said all right. And I said, are they there? And he said yes, so I figured that's, that's a pretty good place to start, right. And I'm flying down this hallway and as I as I'm flying down, I see a door and the door says chief medical officer.
Speaker 2:And I think oh, that might be a place to start. And I put my hand on the door handle, assuming it would be locked, but it wasn't, and I opened the door and walk, walk in this tiny little room no windows, and there was a doctor sitting there at his desk and looked at me with complete terror. Reasonably, at that point I was out of my mind, crazy-eyed dad is just standing there.
Speaker 1:you know you might have come off the psychiatric ward, who knows?
Speaker 2:Right. And I said to him you can call security, but just give me two minutes. And as I was talking he went onto his computer and dug her up and looked at her vitals and looked at at least a cursory look at her history to see that she had been discharged 12 hours earlier, at least a cursory look at her history, to see that she had been discharged 12 hours earlier. He was the first doctor to lay hands on her and he had, you know, that's not his job but he changed the entire trajectory of her care. She was considered a special, given special treatment.
Speaker 2:I was given special treatment because in the first few weeks she was, she was readmitted. She couldn't call for assistance at night, right, and she certainly couldn't get to the bathroom without assistance. And I watched nurses treat her poorly. And so I said to the doc I'm spending the night with her every night. And I did for a month, eight to eight, and that was against hospital rules. By the end of that month every security officer in the building knew me and knew I had permission, special permission, and the fact is I helped her because there were times when you know she would try to eat. And the fact is I helped her that because there were times when you know she would try to eat and the food would fall out of her hands and there was no, no, nobody was going to help her if I wasn't there, and it's. I belong to a support group that that focuses on parents enabling children and and the problems, and I'm certainly guilty of it, but this didn't feel like enabling to me. It still doesn't. She was discharged from there.
Speaker 2:She got proper care. Yes, she was discharged from there to a hospital that specializes in short-term stroke recovery. She did great. She was returned to detox and this is really when Marchman kicked in, because she assumed that she was going to sort of graduate from detox and then return to the world. And at this point we're probably 60 days beyond her death and she's nowhere near I mean a million miles away ready for for that. So we found a and I don't should I give the name of the program, Please. There's a long term, because, because my daughter has been at this so long, I am pretty familiar with lots of programs because we have been customers of lots of programs. But I had never heard of Burning Tree, which is outside of Dallas, Texas, and it is self-described a program for late-term addicts, meaning addicts who are on the verge of death, and certainly my daughter qualified for that multiple relapses and multiple treatment experiences and complex behaviors and co-occurring mental health issues.
Speaker 1:The whole nine yards burning tree.
Speaker 2:That's where they specialize, yeah uh and, and I spent a week I assumed that they would automatically admit her because she was so obviously uh, just she so obviously fit their profile spent a lot of time on their website. Uh, and they wanted. Basically, I had to qualify not just her but but me in particular in the family, because the the the ethos there is is this is a family disease. She didn't get there alone and if she's going to get better, all of you need to get better and you need to commit. And I signed a contract with them that I am honoring that says I'm doing my own recovery. I'm doing my own 12 step, which is never really fit for me personally, but I'm doing it and there are things that I'm learning and benefiting from. And they had a. So it was very frustrating because if Burning Tree didn't take her, I had no idea what was going to happen.
Speaker 1:I'm going to want to put a cap on the hospital experience a little bit. I'll share a personal one that I have, part of what led me to get into this work though at the time I did not. I was pretty young, got hit by a car while on my bike and and ended up in a pretty small hospital in Virginia and the you know it was anemic when I was a teenager, so my blood count was pretty low. So I just had an accident. I'd gone to the hospital. My mom drove immediately up. My mom's a nurse and um or was at the times and and walks into the hospital and they're going to do exploratory surgery because they're uncertain as to why my um blood count is so low. And my mom walks into the hospital and I this is one of the things just salient in my mind she just snaps the clipboard out of the doctor's hand. If you knew my mom, you'd know like that's. That's her. In a nutshell, it's like he's anemic. That's why stupid blood counts low. You're gonna kill him. Sign me out, ama, and rope me home and I. I recovered like I was not. I was not as injured as they thought I might be, thank god another miracle but literally saved my life because she did. She pulled kind of what you pulled. You know this.
Speaker 1:Like I work, I demand satisfaction and I demand it right now and I think that part of the story, that that is beautiful about what you're telling and something I think that people need to hear, is that just because you're faced, just because you're with someone who is a quote-unquote professional, just because you're with someone who's got credentials and the doctorate and everything else, does not mean that they know everything, that they've paid attention to what is going on, and that you shouldn't advocate for yourself. You need to walk in prepared to know what is needed, to talk to an administrator, to tell the doctor that this is not right and I want better care, and if you don't, then I'm going to call my attorneys. Do whatever you got to do to get the care that you need, because it can go south, and it can go south quickly, um, and then, of course, you know. The other thing I'd like to point out is you know something that people, uh, they end up finding us and thank goodness they do, but not everybody does.
Speaker 1:You were a person who'd been through treatment experiences and you'd been through this many, many years at this point and became aware of the field of residential treatment, became aware of what quality programming looked like and found something that was a resource for you. And thank God you know what I mean, Because so many people are out there just shooting in the dark and I know that you've run into it in your experience but there are bad actors out there and one of the indicators that you found a good actor is like no, no, you're the parent and you're going to be in on this recovery process, and that is a key factor to a to a good program that knows what they're doing, that makes sure that family involvement is there.
Speaker 2:I've never been. I'm I'm a veteran of at least 20 different programs I have. I have never had so much demanded and expected of me. And it's correct. As I think about it, it's appropriate and it actually in some ways is a relief because, rather than a bystander, I get to participate, and that's I want to, I want to, I want to participate, even even though that my level of participation is saying no over and over and over again.
Speaker 2:Saying no has been hard for me, and Burning Tree correctly ascertained that in my family I'm the weak link. They spent a lot, they had no problems figuring that my wife would say no and they had no problems figuring that I would have trouble with it. And in fact they had what they call a post-admission intervention where they called us down to Burning Tree. They did not let us enter the. It's a campus, it's a ranch. They did not let us enter the grounds's a campus, it's a ranch. They did not let us enter the grounds. There's a building right at the gate and she didn't know we were there and we sat with an interventionist who spent two hours finding out and really really pushing us about where our boundaries were. They explained that if she walked. It was not realistic to think that she would actually physically walk from Burning Tree because it's not in the middle of nowhere, but you can see it from there.
Speaker 1:It's down a dirt road connected to it? Yep, I know exactly what you're talking about All right. So she is not going to physically walk out, but she can demand to leave and even if you do, it's a long walk to anything else.
Speaker 2:That's not my daughter, but she could demand to leave and after 48 hours they would oblige her by taking her to Dallas's toughest homeless shelter and dropping her off. And that's got to be a pretty tough homeless shelter Not that any are not tough, but that's got to be really tough. And so I was. They pushed me. What happens when you get a call from the homeless shelter and it's your daughter and she wants $20 for dinner or an airplane ticket home or something in between? No, and do you number one? Do you take the call Right? And uh, I, I was.
Speaker 1:I was the weak spot because I said you know after a month in the hospital and strokes and things like that you know, I think I want to take that call, right, exactly.
Speaker 2:Yeah, I think my wife said she wouldn't. Um, uh, I said I have no problem saying that the only only thing I would support is return to treatment. Um, but I think I'd take the call and take the call, and I think they wanted me not to take the call, but I said I don't think I can do that. And so at the end of that two hours and it's very skillfully done, a guy who knows what he's doing they went and got her and she didn't know we were there and we were not even permitted to hug her. We hadn't seen her in months and not permitted to hug her.
Speaker 2:She sat down at one end of the conference table and we sat on the other and her instruction was to listen to what each of us had to say and to repeat it after each one of us spoke, which I thought was again just brilliant, because it's different to repeat it than just to listen. Knowledge that you've heard. Yeah, right, yes. So each one of us took turns and my middle daughter participated over Zoom of us took turns and my middle daughter participated over Zoom. She couldn't be there and my daughter, my oldest accurately repeated everything that was said. And then the interventionist turned to her and said do you commit to staying the entire length of the program, which can be two years? And she said her response was you know, for all my life I I can say something and not mean it. And he said we know that. Answer the question.
Speaker 2:And she said she said I I commit to staying the entire program and and everybody, everybody in the room, understood that's. That's not a guarantee that she doesn't leave that afternoon yeah, there's a special magic to that moment.
Speaker 1:I think you know there's, you read about it. Um, you know, there's uh fiction stories and stories that have magic in them, and stories that are, you know, talk about when two people sit down and make an agreement and there's, you know, there's something, uh, maybe there's some ceremonious piece by it, or they drink something to like, and that seals the deal. And I think that there is a moment in a person's recovery and they they've lied to the cows, come home many, many times, said things that didn't mean and yet there still exists within them and in connection to their family and the people that they're working with that moment and others that follow it that are. I just said something that I meant and it sticks.
Speaker 2:Well, she's still there and over the last nine or 10 months which gives you a sense of how long she's been there, and she's got a long way to go, but she's better. She's better today than she was. She has twice made some noise about leaving and twice rescinded that noise within about an hour, so it was a blow up.
Speaker 2:Yes, and at this point it feels she's far enough along in the program that we're sending her non AA books. She's a reader and she loves it. She loves a good murder mystery, so we're, we're sending her books. And now I'm thinking, boy, if she leaves, she has to. She has to leave the books that she likes so much at the burning tree. She's not leaving her libraries there.
Speaker 1:So yeah, I think that I think that you're also talking about. The one of the things that occurs to me is you know she almost died, she died and you know she was like you know, aren't the consequences? Don't they aren't? They don't they occur to her. It's like no, for a person who suffers from addiction is certainly at these kind of complicated and pervasive levels, they don't observe consequences.
Speaker 2:The same way everybody else does they don't. They don't register the same way I have a friend who has been in recovery for 40 years and, uh, he's, he has seen it all. And what in the way? He helped me understand this. He said when I, when a heroin addict sees somebody overdose and die, what they think is I'll have, I'll take what he just had just a tiny bit less so I won't die. But I want, I want that high up to the point where it just shy Right.
Speaker 2:Right and my daughter certainly understood. She doesn't want to die. One of the best in a 21 year odyssey. One of the most important bits of information I received was, a year into it, one of the therapists who said to me all acts are well-intended. She doesn't want to hurt herself, she doesn't want to die. She is medicating herself not doing it right, not doing it properly, doing it dangerously but she is doing what she can to try to feel better. And that has helped me understand the endless number of bad choices. She's not trying to screw up her life. She's not trying to screw up our lives. She's not trying to drain us financially. She is trying to medicate the pain. And I also know that because she started at such a young age, she sort of that locked her in in terms of her emotional maturity. She's still a kid, even though chronologically she's not, and she's got a long way to go to catch up. This actually sort of turns me to about 10 years ago I bumped into the mental health parody act.
Speaker 1:Um, and I was going to say let's, let's get the script a little bit and talk about the other expression of this recovery story that you've got as it lives in the world, because I'm really interested to hear about that as well.
Speaker 2:Well, I can't, like I said, I can't tease them apart.
Speaker 1:They're all it's all part of the same story. They do, at least for me.
Speaker 2:So I bumped into the Mental Health Parity Act, which I didn't know as a consumer, I didn't know as a parent. But I bumped into the Mental Health Parity Act, which I didn't know as a consumer, I didn't know as a parent, but I bumped into it as a lawyer and I thought well, isn't this the keys to the castle? And for your viewers who don't know, in a nutshell, the Mental Health Parity Act is a federal law. It applies to most health insurance plans in the same way or in parity with the way they treat insurance for medical and surgical services. Different rules, particularly rules that disadvantage mental health coverage or chemical treatment coverage. You can get away with it still, but that's the law. That is the law.
Speaker 2:The problem is that the devil is always in the details. So, as a lawyer, the devil is always in the details. So, as a lawyer, you are stuck in trying to interpret it. And the first question is well, how do you make that comparison? Because, as an example, treatment for an ankle sprain can't possibly be compared to an RTC treatment. Where's the comparative Right? Right, If I've got an apple in one hand, what's the apple in the other? And the statute only gives one example, and that is that residents, for example. The statute does not mention wilderness therapy and over the last 10 years I've had lawyers argue wilderness therapy is not covered by the Parity Act, which can't possibly be right, but it's not. The service itself is not mentioned in the statute. The example that the statute gives is residential treatment is comparable for purposes of the act to skilled nursing or rehab hospitals and the statute says you go having this sort of wonderful and horrible experience with my daughter. Uh, I had a case involving a parody act and I'll give you the Very brief background.
Speaker 2:A kid was in an RTC in Arizona. The RTC focused, among other things, on equine therapy, but otherwise conventional types of therapy individual, family, group, things like that.
Speaker 2:The insurer said that it did not recognize equine therapy as an accepted form of therapy and, as a result, it was going to deny everything Room and board, individual, all of it. And I thought about it in the context of the statute and I thought about skilled nursing and I know a little bit about skilled nursing because I've had family members who needed it and there are things like art therapy or even visits to theaters that they offer. And I thought it would not be unreasonable for an insurance company to say we're not paying for art therapy, that's not medicine. Whatever that is, that's not medicine. And we don't, we don't, you don't insure against that. And it would be, you know, reasonable for an insurance company to say we don't cover that, but we cover the rest, we cover the rest, right, right, we cover the room and board, we cover the other services that skilled nursing provides. So if that's the one side, that's the apple on your right hand shouldn't the apple in the left hand, the place that offers equine therapy, be in parity?
Speaker 1:We're not going to pay for the equine part, but we pay for the rest, right?
Speaker 2:Right, right. So I brought a case along with a couple of other law firms in the Northern District of New York federal court and the case ultimately was not resolved on the merits. But we had a series of good decisions to the point where the insurance company decided we ought to settle and we brought this as a class case. And it turned out there were hundreds of people in the company database whose entire coverage request was denied because a component of it was considered experimental. And so it sort of fit in the rough model that we had created and we have tentatively settled a class case, that where, if the judge approves it, checks will be issued and go out to a few hundred people. Nobody's going to get rich off of it, but it is.
Speaker 1:It's a feather, it's a notch in that belt.
Speaker 2:Well, it's more than that. It's better than a sharp stick in the eye and for some of them, they're going to get a decent amount of money. We figured out a way to sort of do it in grades, depending upon the service that it's almost always a child received. Uh, so for some they'll get a decent, decent sized check, a check that will surprise them. Um and uh.
Speaker 2:This was all happening at the same time. My daughter was in this extreme crisis and I I don't mind you, you've already sort of provided the math for everybody I'm 67 and I thought I was ready to to call it a day and, being the sole owner of a one person law firm, that's pretty easy to do Just turn off the lights and walk away. And I, sort of re-energized by these two combined experiences, this case result. I've been like I said, I bumped into the Parity Act 10 years ago and I've been mostly litigating Parity Act cases since then and it's a hard statute and I have not. Well, I've lost some cases and I've lost some cases and I've won some cases, but this is by far the best result I've had and I feel like at this point I can identify a winning theory. In my experience.
Speaker 2:A winning theory is not. You should cover wilderness therapy, because it's just like skilled nursing, because you cover all of skilled nursing, that's not a winning theory. But if, if you, if you sort of cut it up in the way I did with this case and and I have to tell you that when the case walked in, I didn't immediately appreciate the theory this is this has happened over a matter of time, in part because my other theories lost. This is this is the theory that that stuck Right. Right, and I think there's something there, and I think that there's something there that could be used by. Because of what I'm living with at home and what my daughter is going through. The idea of helping others is sort of more important to me than it was even just a few years ago, and as a lawyer, you get to do that. If you're lucky, you get to help people occasionally.
Speaker 2:And the idea that my practice can.
Speaker 1:I want to try and give you some crisps for the mill, as we say in the field. My background and my master's degree is in outdoor ed, so I spend some time doing work in the field and wilderness therapy specifically, and I'm a huge advocate.
Speaker 1:I don't send a lot of clients actually to wilderness therapy. Many of my clients are too unstable to benefit from that, at least initially. But I had a conversation with a gentleman who's the executive director of a wilderness program that was recently shut down, not because of anything that happened that was bad, but because the company decided it doesn't make enough money.
Speaker 1:So we're closing this expression of our you know, large equity, decided to go with all residential style practices and nothing and get out of the wilderness therapy business and that's why I closed and that's why many of them these days close actually is because of money. And I said you know what if we stopped telling them the context of how therapy occurs? Now I'd love to tell you that there's a fair number of attorneys that I have sent messages to talking about their lack of qualification to assess therapy or how it's conducted or where it should be best placed. So I would also say that of courts and judges and law firms and everybody else, like you guys are not therapeutic professionals with a few, with a few exceptions, present company included You're not therapeutic professionals.
Speaker 1:You don't know how to do treatment, you don't talk a lot, and I would say this is true of insurance companies, though they bring doctors and therapists in to say, hey, these things are aren't validated because they don't have a document that says, or even the APA. The APA and I Dr Lee Gillis is a graduate professor of mine, a friend and colleague and a mentor of many years wrote his most recent book, tried to produce some of the results and put it in front of the APA to have it professionally journaled, and they told him we can't accept these results with regard to wilderness therapy because they cannot be replicated in a lab Exactly.
Speaker 1:Exactly exactly, exactly. And the thing I said to my, my friend who was the executive director. I said you know what, if we stopped worrying about where it happened, let's stop calling it willingness therapy and let's just call it therapy, because the the the premise of therapy is that there's an experience that you've had negative or positive or what have you and it has some meaning. And it's going to and and through that meaning. We're going to start talking about the ways in which you'd like to better conduct your life and experience mental wellness. That's. That's a very broad stroke right there, but that's pretty close to the kind of the base premise you have experiences, maybe they're traumatic, but they're, um, we're going to kind of the base premise you have experiences, maybe they're traumatic, but we're going to work through some of that. We're also going to find places in your life where good things have happened and we're going to try to assemble a life that can cause you to experience mental wellness and go about your life without being interrupted by this condition, right? So if I'm doing that in wilderness therapy, the whole context of experiential work, which is the premise under which wilderness therapy is conducted, therapeutic use of wilderness and experiential practices is that I'm giving you an experience that has meaning and then we're going to process it so that it's beneficial to you in this march, in this journey that you're taking towards emotional wellness. And if I stop trying to make a case for the context in which those experiences occur, you know, in a residential program they happen in group rooms, right, or maybe they happen in an individual therapy in somebody's private office. They might happen outside for a walk, they might happen at night when you're having a hard time and one of the techs comes by. But treatment happens not just in these small moments but over the course of a period of experiences and time, and that's the benefit and value of residential experiences. Will and his therapy and, for that matter, equine therapy and any other practice that is designed to augment the therapeutic experience. If I stop worrying about telling them that horses are cool and the outside is cool and we can do these things out there because there's value in it, it's like this is therapy and we're qualified, as people who are licensed therapists, to know what therapy is and we're qualified to work with our clients, regardless of where we work with them.
Speaker 1:There's the argument. You and I have talked a little bit about agencies that go out and do advocacy toward claims advocacy, claims denials, management claims advocacy and everything else. What they'll do, especially for a wilderness program, is wilderness program is like look, they have this many hours of therapy and this many hours of group and this many hours of thing. We're going to take all the hours of that. We're going to turn it into a bill and you've got to cover that because that coverage. You say you do that coverage for this kind of care and it's not a lot of money a lot of times but it does end up translating to a benefit that insurance companies are responsible for. Do you hear that tact when you do these cases? Is that kind of where you're going through, or does that open a whole new kind of insight for what you think is the process in doing this level of advocacy in mental health and in courts?
Speaker 2:Well, I do think that the term wilderness therapy is not helpful. I agree when it gets to judges because judges hear that and they think outward bound Right.
Speaker 1:You just hand them outside for camping, right Right.
Speaker 2:And and you're absolutely right you don't get to take a judge and say let's spend a couple of days at this program. Let me show you Right. Yeah, spend a couple of days on the trail and see if you think the therapy is happening. We don't get to do that. Another thing the goal, I think, at least in terms of insurance coverage and that is a way of expanding insurance coverage opens the door to a larger group of people who need this sort of treatment, because otherwise you can't afford it. This is $1,000 a day roughly, and it's a two or three-month program.
Speaker 1:And I think that people hear $1,000 a day and they're like, wow, that's really expensive. They're like, well, if you went to the hospital, that's over $2,000 a day. If you're in an emergency, if you're in an acute care unit, that's even more than that. Residential care operates at the level, at least from a psychiatric standpoint, of almost hospital-level care, because it's 24-hour supervision, there's all these things going on. $1,000 a day is actually not a bad rate.
Speaker 2:Except if you're well, I agree. But the difference is that there's self-pay and you pay up front.
Speaker 1:It's not an unfair charge for the kind of services that you're receiving. The problem is getting insurance companies to pay it so that the larger public can have access to what I would call substantial and appropriate therapeutic care, which they cannot find in hospitals or community services. Stuff that's basically Medicaid-based. Most of it doesn't do very well, it's not designed, it's not staffed, it's overrun with clients and you know there's people waiting at the door. Anyway, there's all kinds of problems. We won't go into that. But you know this level of care and I'd love to know your opinion about this because I was.
Speaker 1:I was at a train, I was at a conference training, um, uh, that was put on by Silver Hill hospital and I was talking, um, I was talking to their CEO and I said look, we're all talking about the insurance problem, right? Um, uh. And I said look, if insurance companies will learn how to just pay for it and do that and take it on the chin for a year or two, you'll see fewer people and fewer claims and people getting well and like you'll stop having to pay. But we got to pass through the threshold where you start paying for actual care because what you're doing is trying to dodge it and he said it's like you'll never get insurance companies do that because the average subscriber only stays a member for like two years. So whatever, whatever benefit they're trying to achieve with this, with their subscribership for the members, they're not going to see the benefit on the other side of it.
Speaker 1:And I said, look, I hear you and that's not a bad point, but this person does it for this subscriber. In two years they become somebody else's subscriber, but that person's subscriber is switched around and they become theirs. And if everybody gets on board at the same time, everybody gets the benefit. And I, you know, I wonder in in your experience which, frankly, in terms of getting claims, getting claims covered by insurance companies and fighting for these things is, is, is more than mine. What is it that you like? What's the thing that turns the tide? What do you think is going to turn the tide?
Speaker 2:So there are a few things and I've thought about this a lot. If I ran the world, how would? And I'll focus on wilderness programs because I think they're great I've had. They're obviously not for everybody, but for the right person they're a fantastic experience and personally I think almost all of us should go to wilderness for a little bit Agreed.
Speaker 2:If I ran a wilderness program industry, what would I do to improve the prospects of coverage? Do to improve the prospects of coverage? Number one I change the name because there's all sorts of biases out there and they're reasonable, that what you're talking about is a hike in the woods and that may be beneficial, but that's not medicine and we cover medicine. We cover medical services. I would insist that all states that have wilderness programs set up a licensing system for those programs. There are many wilderness programs that are in states that are not licensed.
Speaker 1:Theyially licensed, and I'll tell you why. The reason why it's the same problem is that in North Carolina and many other states the same problem exists, and it is this. It is this A wilderness program does not operate inside of a building Right, and thusly it cannot be licensed as residential.
Speaker 2:So you could insist that set up a different sort of name nomenclature, yep, but still, and I think wilderness programs would be delighted to be subject to those requirements. Among other things, it's a way to have any problem meeting them. I don't think that's right and they wouldn't have any. It would be a way to differentiate them from summer camps, as an example.
Speaker 1:Well, you know just the amount they have to do to maintain, like you know, operating license in wilderness, feel you know you've got to pay a fee and you've got to have a license license and wilderness, feel you know you've got to pay a fee and you've got to have a license, you've got to do all. There's a ton of stuff that they're doing administratively that's over and above even residential programs at times. I mean, you know they're really handling it.
Speaker 2:Most health insurance companies' definitions require services provided by a licensed provider and that disqualifies all wilderness programs in states where there's no licensing structure, and that's something that could be fixed and that would require governmental advocacy, but that's something that I would think the industry could force or could make happen, and it would be to the industry's advantage. It wouldn't impose any additional burden because they're all way above any sort of minimum licensing requirement, but it would be a recognition of that and I think that would be helpful.
Speaker 1:Well, so you didn't have to keep playing these differentiated state games. That's why Utah has so many other programs, because it's a different set of rules. But I think you know you and I have talked about it. I don't know if you're familiar with these guys, but the National Association of Therapeutic Programs and Schools, natsap, and the incoming president, derek Daly, who's the executive director, ceo of Legacy Outdoor out there in Cedar City, utah, has made this switch. They're doing a good job with insurance reimbursement. They are an experiential program. They could theoretically be dubbed as wilderness because they do a lot of great outdoor work, but they are maintaining these definitions. He's also part of an initiative they call the Golden Thread, which is just providing outcomes data on. You know these are our clients, this is how they were treated and these are the outcomes that we've had with them, even long-term outcomes and trying to join other entities in to make sure that they get as much numbers as they possibly can.
Speaker 1:We're on the precipice of making a good case for what you're talking about. You and I have talked about having you guys get connected, of course, but I think that we're scratching at the surface of what you're saying and maybe that's part of it that turns the tide From a legislative standpoint, being the person who's you know, knows the law and has fought this before. What is it in the minds of people in the courts Obviously, some definitions need to be tweaked and things like that what is it that turns them towards understanding? That's like hey, we're really serving people here. Can't you just get on board, like, what's the message that you think they need in order for that tide to turn?
Speaker 2:So this sounds like a summary point and again I have. I've been litigating this for 10 years and there's a bias against coverage for this sort of service. And I think at the bottom is this it's hard to justify insurance coverage to protect somebody from making a bad decision or to protect somebody from the consequences of a bad decision. And if you're outside of this world just look at my daughter as a great example world just look at my daughter as a great example. My daughter's made a ton of bad decisions, which has led her to where she is today, but at the bottom of it, the thing that animates all those bad decisions is an illness, is an illness that should be covered under an insurance policy. You don't deny coverage to a diabetic who gorges on strawberry shortcake because that was a bad decision of that diabetic. There's an illness at the bottom of that bad decision and that's what triggered the bad decision. Right? You don't deny coverage for somebody who's got lung cancer Because they smoked, because they smoked Every time they lit up.
Speaker 2:That was a bad decision, but they still get treatment and they still get coverage for that treatment. And I think that this bias or sort of lack of understanding that ultimately this is an illness and not an endless cascading series of bad decisions and it certainly is that, but but there's something at the bottom of it, there's a, there's something, there's a cause that it triggers all right, yeah well, yeah, I think Right, yeah Well, yeah, I think that, um, I mean, I, you and I can sit here and make comparisons.
Speaker 1:like you know, we don't do this for this group. Why are we doing it for this group? But part of that revolves around stigma, obviously, that we have a oh, somebody did drugs, um, and that means they're a bad person and I shouldn't help bad people. You know, honestly, there's, there's a, there's a lot of inference there about that Mental health. The stigma is different. But I think people, I think the stigma revolves around people not having a connection to it.
Speaker 1:You know you got the baby. You got the like the baby boomers who's like yeah, you just, you know you handle your problems, you don't get help like it's fine. You know you got the baby. You got the like the baby boomers. He was like yeah, you just, you know you handle your problems, you don't get help Like it's fine. You know, if my dad was one um and the kind of like that, and I've even seen it you know I've seen people on a, on a you know a social feed, where it's like you know this person, some event happened and the person was had psychiatric issues, but they committed some crime. It's like this person needs help. It's like you just want to give this person some therapy and pat them on the back. I'm like, no, no, no, you don't understand. You have no clue.
Speaker 1:First of all, what you're talking about. I'm talking about residential care and, uh and and. When I say residential care, I'm talking about 24 hours a day supervision. I'm talking about groups and therapy sessions and everything else. And if you think for a second, I could go to any person who considers themselves normal and say here's what I'd like you to do. I want you to go away for anywhere from 30 to 90 days while a team of psychiatrists days, while a team of psychiatrists and doctors and therapists circle around you and look at your greatest deficits and examine you. You know from from, from head to toe, and your psychiatric and mental well-being. And if the thought of that doesn't terrify you, you're an alien, and I think there are many people who would, and I ran into them as adolescents. They would much rather go to jail than they would have to endure the dive into the reason why their life is a mess and what accountability they have for it, into the reason why their life is a mess, and what accountability they have for it.
Speaker 2:That's an extremely unbelievably hard challenge to be that honest.
Speaker 1:The stigma is that I don't want to touch it. It makes me uncomfortable. You know what I mean For mental health. Yeah, you know what.
Speaker 2:I mean For mental health. Yeah, I think this relates. Maybe not, you'll tell me. My youngest, who was mentally ill and saw all sorts of specialists, at one point had an MRI taken of her brain and they found what they call. This is great. They found what they call the UBO in her brain. Do you know what that is? No, an unidentified bright object. She thought that was fantastic.
Speaker 1:Unidentified bright object.
Speaker 2:Yeah, yeah, that they detected in her brain, uh, and, and she said, that's, that's it, that's the cause of all of this, and a ubo in my brain and, and maybe that's true with all of the, the people with this illness, maybe there's a ubo ubo in your brain, an identified bright object?
Speaker 1:Maybe it's an identified dark object. I think we can go a lot of places with that. Oh my gosh, jordan, it has been a real pleasure having you on the show today. I really appreciate the work that you're doing. I certainly hope to put you in front of people and help you do it and everything else, but I think it's really important. This has been Mental Health Matters. I'm Todd Weatherly. I've been with Mr Jordan Lewis today. Jordan, thank you for being on the show. Thank you very much for your time, todd, absolutely, take care. I'm sorry. Thank you. Oh, you should be lost in here. In here, I'm a little power. Oh, Power.
Speaker 2:Oh, you should be lost in here. In here I'm a little power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh Power, oh.
Speaker 1:Power. Oh, I need to find my way home. Bye, I need to find my way home.
Speaker 2:I feel so lonely and lost in here. I need to find my way home.
Speaker 1:Find my way home.