Child psychiatrist for ADHD
Our 10-year-old daughter was recently diagnosed with ADHD, inattentive type, after a neuro-psych eval back in March. The diagnosis was no surprise as her dad also has ADHD, and we were thrilled to have figured it out now so we can address at a young age, unlike her dad who didn't get a diagnosis until age 40. We've seen one psychiatrist that was recommended by her school therapist. He flaked on our first appointment, but then we still saw him b/c it's so hard to find any openings with anyone. He is out-of-network, so we basically paid the guy $1200 for a prescription that we can't even fill because he has been MIA as far as getting back to us, except when he wanted to charge us more for working on the pre-authorization for the medication he prescribed. My husband is irate because his psychiatrist is in-network, responds to his emails in a day or two max, and has worked hard to make sure he gets the right medication. So I'm at a loss and would love some recs from folks. We live in Berkeley and are open to anyone in the area as long as they actually care about their patients. And btw, is mental health a luxury? Like does everyone around here just pay $300-400/hr to see a psychiatrist? It's been mind-blowing to find so many of them don't take insurance. We're both self-employed and pay A LOT for insurance, so spending even more money for a psychiatrist really hurts.
Parent Replies
ADHD is very commonly seen by a child’s PCP, until they reach age 18 and switch to adult psychiatry. Pediatricians are very accustomed to treating ADHD in children. Best of luck.
I can empathize. My experience with child psychiatry has been pretty similar. My child was diagnosed at 11 with a mood disorder and ADHD. We've been when the same doctor since then because it's so difficult to even find one. They all seem to be out of network and don't file insurance.
My child sees Dr. Bradley Engwall. I have a somewhat mixed review for him. As a doctor, he has been very capable, thoughtful and approached medication and treatment in a holistic and well-reasoned way. My child is doing well from a treatment perspective, after starting from a place in crisis. However, it is by far most challenging and disorganized practice I have encountered in medical care. The office manager is terrible, communication is terrible. There have been several times were we spend half the session re-discussing what we covered in a previous session because he didn't remember or write notes on that (for example, previous medication trial outcomes or events and how they were handled). Considering it costs essentially $40/5 minutes of time spend with him out of pocket, this is ridiculous. We have had to chase down expected medication refills last minute multiple times because they weren't sent in after appointments, including for the medication that my child must take everyday and ramp down off if my child ever goes off. The office manager enforces strict policies, but then also doesn't respond until you've called/written communicated several times over a week or two. It's very hit or miss with the operation of the practice overall, but Engwall is a good doctor.
Following this because I'd love to have a better experience with this, but yeah, we end up paying $450/hr out of pocket (I have PPO so I get reimbursed for some of it). Treatment-wise we reached a good point and mostly just need to get medication refills, which are hostage to paying for a visit every few months, so despite the frustration, I haven't wanted to rock this boat at this point. It's insane how hard/expensive it is to get mental health care, but especially for children. Our pediatrician had suggested earlier in his life when discussing the symptoms he seemed to be having, that we try a developmental pediatrician (when we were just considering their issues might be ADHD alone). We waited too long and reached a crisis point before getting him medication, but a developmental pediatrician (Unfortunately I don't remember the referrals), might be a good option for your child.
Good luck!
I hear you! We had a psychiatrist who sounds a lot like yours. Super frustrating and expensive. We ended up finding a psychiatrist in Concord, Dr. Philip Shein, who seems to be in network for almost every health plan. Dr. Shein is a very traditional doctor who focuses on medications and a little bit of cognitive behavioral therapy. He did manage to get the right medication cocktail for my kiddo with ADHD and some other behavioral issues. My child has stabilized a lot - they are managing school situations that would have been impossible prior to working with Dr. Shein. If you primarily need an in-network Dr. for med management, I'd say Dr. Shein could be a good bet.
Our child sees Dr. Robert Epstein (510) 848-0900. He was referred by our pediatrician, as well as family members/friends in the medical field. I suggest calling him, leaving a message, and setting up a time to chat to see if he's a good fit. We've found him to be cautious and attentive. He's located in Berkeley and although he's pretty busy, he's always been punctual and worked to accommodate our changing schedules. He's also been very patient with explaining and talking through issues with us when requested. We have a very high deductible that we had to meet before our insurance coverage began and because he's out-of-network for our provider, we receive less coverage than an in-network provider. We reached our child's deductible quickly as each visit is quite costly, so at least all medical visits are covered (at in-network or out-of-network rates depending) for the remainder of the year for our child. I agree, mental health does seem to be a luxury and our experience was that most providers are out-of-network for our insurance and/or not taking new clients. The steep cost is another hurdle, but in my limited experience, these visits fall within a similar range. We file our own insurance claims and receive a reimbursement from our insurance, which means we have to pay up front and wait for the reimbursement.