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This article contains descriptions of mental illness, alcohol addiction and suicidal ideation.
Early one morning in February 2023, before the sun rose over Phoenix, Ravi Coutinho went on a walk and, for a brief moment, thought about hurling his body in front of a moving bus. He had been feeling increasingly alone and depressed; anxious and unlovable; no longer sure if he was built for this world.
Several hours later, Ravi swiped open his iPhone and dialed the toll-free number on the back of his Ambetter insurance card. After navigating the automated voice system, he was routed to a friendly, fast-talking customer service rep with a slight foreign accent. His name was Giovanni.
“How can I help you today?” Giovanni asked.
“Hi, I am trying to find a psychiatric care provider,” Ravi said.
“So, you are looking for a primary care provider?” Giovanni asked.
“No,” Ravi replied, seeming confused. Ravi tried to clearly repeat himself. “Psy-chi-at-ric.”
“Psychiatric, all right, so, sure, I can definitely help you with that,” Giovanni said. “By the way, it is your first time calling in regards to this concern?”
Listen to this exchange.
Ravi paused. It was actually the sixth attempt to get someone, anyone, at Ambetter to give him or his mother the name of a therapist who accepted his insurance plan and could see him. Despite repeatedly searching the Ambetter portal and calling customer service, all they had turned up so far, he told Giovanni, were the names of two psychologists. One no longer took his insurance. The other, inexplicably, tested patients for Alzheimer’s disease and dementia and didn’t practice therapy at all.
“I’m a little concerned about all this,” Ravi said.
This had not been part of the plan Ravi had hatched a few months earlier to save his own life. Diagnosed with depression and anxiety, and living in the heart of Austin, Texas’ boisterous Sixth Street bar district, the 36-year-old former college golfer had become reliant on a dangerous form of self-medication.
His heavy drinking had cost him his marriage and was on the verge of destroying his liver and his livelihood. His therapist back in Texas had helped him understand how his mental illnesses were contributing to his addiction and vice versa. She had coached him through attempts to get sober.
He wanted to save his business, which sold dream vacations to golfers eager to play the world’s legendary courses. He wanted to fall in love again, even have a kid. He couldn’t do that when he was drinking a fifth of a gallon of liquor — the equivalent of nearly 17 shots — on any given day.
Ravi with a golf tournament trophy and playing a course in Scotland
When all else had failed,