Taking matters into our own hands, my mother called our insurance company to find a treatment center and booked an intake appointment. Finally receiving a diagnosis at the age of 17 validated the years of turmoil I endured. Yet, my struggles were far from over as I was being referred from my program’s partial hospitalization program to a residential facility. Unfortunately, the waiting list for my specific program’s residential was long and I was asked by my team to call other facilities, as they no longer felt outpatient treatment was adequate. After calling all the programs in neighboring states, we found that none accepted our insurance. If I wanted to access residential treatment, I was told that I would need to travel across the country – a cost not feasible for my family. It seemed like I would have to wait months for an opening at the only residential covered by my insurance or that I would not be able to access a higher level of care.
We learned that we could appeal to our insurance for a network gap appeal, which can be used to cover out-of-network treatment as if it were in-network. We found a residential facility that our insurance agreed to partially cover several states away and were put on a payment plan for the difference. This difficulty in accessing adequate care led to decreased motivation and feeling as if I was not “sick enough” to be taken seriously. These financial barriers and insurance gaps are some of the top reasons that ethnically diverse populations do not receive treatment. This treatment gap, barriers to even receiving a diagnosis, and other reasons personal to Latinos such as a family history or stigmatized views on mental illness, internalized stigma, a desire to protect family’s privacy, and a fear of being misunderstood, point towards a need for a more culturally competent process in evaluating Latino clients for the presence of disordered eating.
This need for increased cultural competency is not exclusive to diagnosis or accessing care, but also to the way treatment is approached. Being able to recognize intersectionality (defined by Oxford as “the interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage”) within eating disorder treatment is crucial in gaining the full scope of a person’s eating disorder.
