Thursday, January 9, 2014

Accessibility to Services and the Great Disservice

As I near the (temporary) end of my American Art Therapy Association membership due to financial hardship, I wanted to talk a little about access to services and social justice.

With Healthcare reform in flux, I was eager to see more people gain access to medical care, including mental wellness services. If you fall in the right income bracket, you're good to go. If you are blessed with a job that covers you, you're good to go (though in my case my premium doubled). But...like many things in this world...if you do not belong to the right "group," in this case financial "group," you lose that access almost entirely. I know many people who make a few hundred dollars a month over the limit for medicaid or medicare, and after they spent time on the insurance hub, find that the $300-$600 per month range is about where they are going to land. And for coverage that is a limiting HMO, with high deductibles and co-pays. Who can afford that if they are really in the low-income range or barely above?

Despite the recent increase in my insurance rates, I'm sitting pretty good and I feel blessed. At nearly 40, for the first time in my life, I have good coverage, though at 40, it might be a little too late for preventative care. A lot of people are seeing increases in payments, or decreases in hours. And my own personal finances need to be restructured in the next couple of months for sure, thus my temporary membership lapse (I will be back).

We've talked about white privilege recently, and access to services from a counselor perspective; i.e. who is willing to give a little more in gratis sessions? And we've talked about stigmas. But I'd like to say something about the sense of being a socioeconomic "other."
Sign Outside the Greenbelt4; a wealthy shopping and living community in metro Manila, Philippines

This is not a new thing, wealth status. It's something those of us who are more socially minded would love to see disappear. But there's also something to be said for earning what you have. When I first took over the blog I "labeled" myself according to my otherness. I feel like the "other" all the time. Otherworldly. Otherwise. Otherguess. Recently, while conducting some business for the Social Justice Caucus, I received words that were non-maliced in their intention, but left me feeling as "other" as I've ever felt. In short, I was asked to disassociate from the caucus based on the lapse of my membership. By mere virtue of not "belonging" to the organization any more, I was marked as no longer necessary. And frankly, at the time, that hurt. So I voiced this hurt, rather publicly via a "reply-all" e-mail and as diplomatically as possible expressed how I felt.

My current socioeconomic hardships were keeping me from engaging in important work that played to this very problem. It seemed like the ultimate dichotomy. I remember, as a student, how lucky it felt to have a discounted rate to AATA. And yet I couldn't afford that half the time either. Suddenly, I was fantasizing about standing in front of a country club in baggy jeans with my mohawk, being told I didn't belong, even if I had an Al Geiberger golf game of 59. (If you don't get that reference, don't worry. It was a clever stretch.) But I betcha they'd let me cut the grass!

At the end of the day, my tantrum was heard in a very gracious way by a couple of very important people, which included a personal phone call from someone in the most unlikeliest of positions, and a donation offer from a colleague, who I respectfully declined in service of motivating myself back into financial health over the next couple of months.

I envision a world without memberships, and cliques and clubs. A place where we all have something to gain by experiencing things with one another on all fronts. I understand that organizations need to be funded, I really do. And I understand membership fees. But I'm wondering if there isn't room to create some hardship funds for memberships, or in these economic times drop the rates just a little so that the membership can grow. Above all else, be careful how you wield your words. As therapists, we are reminded of this over and over and over again.

Do no harm. When you wake up every morning, believe these words and live them.