AUDIE CORNISH, HOST:
It can be really hard to get help for a mental health condition if you live in a rural part of the country. Insurance companies don't seem to make it any easier. April Dembosky of member station KQED brings us this story of an 18 year old with depression living in far northern California.
APRIL DEMBOSKY, BYLINE: There's a hot pink suitcase on the floor of Shariah Vroman-Nagy's bedroom. She's packing for a trip to Disneyland.
SHARIAH VROMAN-NAGY: Let's see.
DEMBOSKY: There are porcelain dolls and stuffed animals tucked into every corner of the room, and she's got posters and quotes from Marilyn Monroe all over the walls.
VROMAN-NAGY: And then that one - those are the lyrics to a song called "Smile."
DEMBOSKY: They hang in a frame over her bed.
VROMAN-NAGY: My mom made me that when I was struggling because that's a song that I would listen to.
DEMBOSKY: She sings it to herself when she feels her depression creeping in.
VROMAN-NAGY: (Smile) If you smile through your tears and sorrow, smile and maybe tomorrow...
DEMBOSKY: Three years ago, it was in this room where Shariah tried to kill herself. She was a freshman in high school.
VROMAN-NAGY: Everything piled up and piled up and piled up until I just couldn't handle it anymore. So I had my antidepressants, and I took a handful of those. But then I thought better of it, and I told my mom. And she took me to the emergency room.
DEMBOSKY: There's no adolescent psychiatric hospital in Redding. So Shariah was taken from the local ER to a hospital in Sacramento, an hour and a half to the south. She was there eight days, and the doctors diagnosed her with bipolar disorder. They said they wanted to keep her longer, but they told her the insurance company wouldn't cover it.
VROMAN-NAGY: I didn't really feel like I was ready because I had just been put on new medications right when I got there, and I was like in the past I've had reactions to medications.
DEMBOSKY: After Shariah went home. The hospital helped her find a therapist, but the insurance company said no to that, too. They said the therapist wasn't part of their network.
VROMAN-NAGY: We spent quite a long time with the insurance company battling them trying to get them to cover visits with her.
DEMBOSKY: Shariah says the insurer Anthem Blue Cross wanted her to see someone on its list of approved in-network providers. At the time, that list was six people. And when Shariah called them they either said they were full or retired, so she stayed with the out-of-network therapist.
TOM NAGY: It was at that point. I mean, you're talking, you know, possible life and death issues.
DEMBOSKY: That's Shariah's dad, Tom Nagy.
NAGY: That was my approach to pay for it, you know - run up the charge cards and things like that.
DEMBOSKY: He ended up paying thousands of dollars out of pocket. Nagy is a teacher. His wife is a nurse, and they couldn't afford to keep doing that. He had to fight with the insurance company for a year, until he was finally reimbursed.
NAGY: As a parent, it's hard enough to deal with these situations. You're trying to be supportive, but then you get the whole financial thing. It just adds a whole other layer, and it's real frustrating.
DEMBOSKY: Anthem Blue Cross declined an interview. In a statement, the insurer said it's committed to providing access to high quality mental health care and a range of resources to help people find the best provider. Earlier this year, the company launched an online psychology service where patients can see a therapist using their computer or smartphone.
DEMBOSKY: It's Shariah's spring break.
VROMAN-NAGY: We're taking your car or mine?
DEMBOSKY: And she and her parents are getting ready for that family trip to Disneyland.
VROMAN-NAGY: They call it the happiest place on Earth, and I really do feel that. It really makes me happy when I go. So I'm glad we get to go this week because I have been having a little bit of depression kind of going on.
DEMBOSKY: Overall, Shariah says she has more good days than bad.
VROMAN-NAGY: Put on some music.
DEMBOSKY: She's in regular therapy. She works at In-N-Out Burger, and she's studying psychology and music at the local junior college. She'd like to be an adolescent therapist one day.
VROMAN-NAGY: (Singing) Can you show me...
DEMBOSKY: But first, she'd like to be a character singer at Disneyland. For NPR News, I'm April Dembosky in Redding, Calif.
VROMAN-NAGY: (Singing) Tell me more. Will you show me?
(SOUNDBITE OF SONG, "STRANGERS LIKE ME")
PHIL COLLINS: (Singing) Will you show me? Something's familiar about these strangers like me...
CORNISH: This story is part of a reporting partnership of NPR, KQED and Kaiser Health News.
(SOUNDBITE OF SONG, "STRANGERS LIKE ME")
COLLINS: (Singing) Tell me more. Will you show...
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