The announcement of Kaiser Permanente’s acquisition of Group Health will change how many in our region receive their health care. One family has a message they want you to know about Kaiser.
Brennen Smith is best described as young and vibrant. He was also slowly losing a battle against drug addiction and depression.
“My son was in his deepest despair,” said Brennen’s mother, Rachel Smith-Mosel.
Brennen’s calls for help to his health care provider were not denied but instead delayed. Eventually he found help where it was available – in the form of a 12-gauge shotgun.
Brennan was raised in Seattle. At six-foot-seven, his mom said he always looked out for the little guy.
“He was the one who made everyone feel welcome. He was the one who reached out to the kid on the side and kept him close,” recalled Smith-Mosel.
After graduation Brennan moved to Portland to attend college and work at a concert venue. A mother’s intuition caused Rachel moved from Federal Way to nearby Beaverton. Shortly after, Brennan admitted that he may be addicted to cocaine.
“I said, ok son. I’m here and we are going to get through it and I know I’ve got addiction services through my insurance, we’ll check it out when we get home, what do we need to do,” said Smith-Mosel.
On August 17th Brennen called Kaiser asking for a mental health appointment. The therapist’s notes said he had difficulty controlling his spinning thoughts, he could be impulsive and had an extensive family history of anxiety and depression. When asked if he had thoughts of killing himself, Brennen said ‘no’.
The clinical urgency listed was routine. According to Kaiser Chief Operating Officer Susan Mullaney, Brennan was supposed to see a therapist in person in 14 days.
“14 days for a mental health exam is a national standard that most health care organization prescribe to,” explained Susan Mullaney with Kaiser Permanente.
But Brennan’s appointment was set for September 15th – 29 days later. A wait that’s double Kaiser’s own standard.
“I asked Brennen, should we just go into an emergency room early on. He said, no mom it’s ok. I’m at home somebody’s with me all of the time,” recalled Smith-Mosel.
Brennan phoned Kaiser multiple times and his father even made a desperate call explaining that his son was living in agony and asking for an appointment as soon as possible. He was told no appointment was available.
“What we did for Brennan at that point in time was put him on a list to call in if we had a cancellation,” explained Mullaney.
Kaiser has a history of not reaching its own 14 day standard. An internal document shows from April 2013 to March 2015, Kaiser’s Northwest region only reach its goal 43% of the time. It was one of the worst in the national Kaiser network. Now compare that to an average 90% rate in Northern California. Mullaney said recent new hires have sent the northwest region’s number up.
“Currently we are meeting that about 60%,” said Mullaney. “It won’t be good enough until it’s 100% of the time.”
Complicating matters is that Kaiser doesn’t have a system to track calls about a particular member.
“Right now we don’t have a way to bundle and flag phone calls coming in from members if they are calling in multiple times and that’s what we need to develop,” said Mullaney.
On Septemeber 10th Brennen’s mom tried again to encourage her son. He was five days from his appointment.
“I took his face in my hands, I said, ‘Son I love you so, so much and tomorrow’s a new day and it’s ok to rest.’ I didn’t know that would be the last thing I’d ever say to my son,” recalled Smith-Mosel.
It was on the next day Brennen walked into that pawn shop and walked out with 12-gauge shotgun. The appointment took 29 days to get. The gun, just minutes.
“We will leave no stone unturned, no fact unexplored, to really look at what his interactions with our entire health care system look like how could they have gone better,” said Mullaney. “She deserves answers and she’ll get them and she will get our sincere apology.
After Brennen’s suicide, Rachel went through his belongings collected by the police. There were the shotgun shells, a suicide note where Brennan wrote “please don’t let my mom identify me”. She also found a Kaiser mental health intake questionnaire Brennen was supposed to bring to the appointment he couldn’t make. He checked almost every symptom including the question “Have you actually had thoughts of killing yourself?”
“I thought, wow. I got the best insurance Kaiser could offer. I’ve got the Cadillac. There’s nothing I can’t get for my kid to help him right now. I was wrong and now I don’t have a kid,” said Smith-Mosel.
Kaiser said Brennen did not call its emergency help number he was provided. The company also said it has been affected by a national shortage of mental health care providers. It has recently hired 37 counselors to help meet the growing need.
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