I have an eating disorder (EDO) that had become quite severe. When I asked my therapist what he…read moreknew about the condition, he honestly replied, "Not much." I give him points for being truthful, but it left me in a terrifying position.
I reached out to a manager in the Kaiser Adult Psychiatry department here in Fresno to request a therapist with specialized EDO knowledge. I quickly learned that KP Fresno has no therapists with a detailed understanding of EDO complexities, and they certainly have no formal EDO program.
I asked the manager to help me find a specialist in the community since they couldn't help me in-house. This is a Network Adequacy issue. Under the Knox-Keene Act (Network Adequacy), Kaiser is required to maintain a provider network sufficient to provide all covered services. Because they have zero specialized EDO clinicians in the Fresno area, their network is "inadequate" for this diagnosis.
Instead of a referral however, the manager insisted on blood work to check for malnutrition. When the results came back normal, Kaiser used that as a reason to deny treatment. To them, "normal" blood means you aren't sick enough--you practically have to be dying to get help. Outraged, I filed a formal grievance stating:
"My request for an eating disorder treatment referral was met with significant delays. When a response was finally provided, it indicated I was deemed ineligible solely based on the stability of my blood work. This disregards the comprehensive nature of eating disorders and the potential for severe health implications beyond laboratory values. Since KP Adult Psychiatry seems to know so little about EDOs, here is a fact: individuals with eating disorders have the highest suicide rate of all mental illnesses combined, with one person completing suicide every 53 minutes. It is disheartening, dangerous, and medically unsound that care is contingent on critically abnormal blood work rather than a holistic clinical assessment."
That letter got some attention, but still no referral. For two years, I fought. I wrote letter after letter citing SB 221 (Timely Access to Care), which requires mental health follow-ups within 10 business days. Fighting for two years for treatment of the deadliest mental illness is a blatant violation of those standards. They were also violating SB 855 (Mental Health Parity), which requires insurers to treat mental health conditions with the same urgency as a heart attack or a stroke.
The Director of Adult Psychiatry, Dr. Tamika London, refused to communicate in writing and wouldn't speak on the phone once she knew I was recording the conversations. Her silence was damning.
The turning point only came after a psychiatric crisis led to a month-long inpatient stay. The facility staff witnessed my symptoms firsthand--restricting to 500 calories or to Zero calories a day, chewing and spitting, and using diarrheals.
They alerted Kaiser that I belonged in specialized EDO treatment. Finally, after two years of hell, Kaiser gave in.
Yesterday, I finally received a referral to see an EDO specialist.
I am honestly surprised I'm still alive. Kaiser cut me off at the knees at every turn, broke laws, and humiliated me. One therapist, Paul Canosa, even told me I wasn't "emaciated enough" to have an eating disorder. He clearly didn't know that only 6% of people with an EDO are medically underweight. Their ignorance could have killed me.
During this battle, I struggled with suicidal ideation and self-mutilated on a few occassions; And, if I had cut just a little deeper, I wouldn't be here.
No one should have to go through this. Kaiser's behavior was shocking, egregious, and potentially deadly. If you have an eating disorder and Kaiser is "dicking around" with your care, leave me a message. We could file a class action lawsuit--and we would win.