If you’d met Barbara Watson when her daughter was growing up in New Mexico, you probably wouldn’t have predicted the struggles that were coming their way.

Barbara’s daughter seemed like a grounded, happy child. She was well-behaved and had stable relationships with other people. All through high school, she maintained close bonds with her friends and even had a boyfriend.

But something changed when she went to college. She started having difficulties with her roommate, her friends, and coworkers, which escalated to dangerous heights after a breakup a few months after graduation in 2014. Unable to tolerate the emotional pain of the separation, she attempted suicide and was admitted to her first residential treatment center, Life Healing Center. It was here that she was diagnosed with borderline personality disorder, and the Watson family was given their first hefty bill.

Barbara was working at the time and had Blue Cross Blue Shield insurance through her employer, which should have covered the stay. When she realized she was being asked to pay in full, she was confused. What she didn’t know was that, due to a clerical error on the part of the treatment center, the reason for the stay was miscoded as a substance abuse issue, something her daughter did not struggle with. When Barbara called her insurance company to solve the issue, the agent was less than helpful.

“Look at page 27 of your plan,” they said. “It clearly states substance abuse recovery is not covered.” That was it.

Barbara was shocked. Weren’t these people supposed to be there to help her? While she was eventually able to get BCBS to cover the stay, it took a year of consistent phone calls and back-and-forth between the insurance company and the treatment center to get it sorted.

This was only the beginning of Barbara’s struggles with insurance.

After leaving the treatment center, her daughter got a job as a nurse and managed to stay afloat for about six years. But when COVID hit, her mental health rapidly declined. Four years later, in 2024, Barbara was trying to help her daughter get back into a residential treatment center.

The problem was, at that point, Life Healing Center had closed, and there weren’t any other viable options in New Mexico. There were a lot of rehab centers for substance use, but there was nothing available for BPD.

Barbara and her daughter had to look out of state and found a residential treatment center in Los Angeles, California. By then, Barbara was retired and on retirement insurance, which wasn’t quite as comprehensive as Blue Cross Blue Shield. It was Humana, and they would not cover anything out of state. Barbara had to pay $125,000 out of pocket.

The treatment center was really good for her daughter. They focused on helping her make goals and on how to follow through, which gave her some confidence going back to work. But Barbara’s daughter hadn’t worked for a few months, and when she got a job as a travel nurse in December 2024, she was quickly overwhelmed again. Although she tried several times to make travel nursing work for her, she ended up quitting, and by the end of 2025, it was clear to Barbara and her husband that their daughter wasn’t going back to work anytime soon. They couldn’t cover her on their insurance anymore, so they found her a policy through Presbyterian. At $600 a month, they were able to get her health insurance.

Barbara’s daughter saw an individual therapist, which seemed to help a little bit, but she was still struggling. In January 2026, her therapist strongly recommended that she go back to residential treatment. While the Presbyterian plan covered the therapist, they, like Humana, would not cover anything out of state, and there had been no improvements to residential treatment centers in New Mexico since the last time Barbara’s daughter went.

Unfortunately, the nearest option was in Tucson, Arizona. It was a treatment center that came highly recommended. When Barbara was helping her daughter get signed up, she asked,

“You know, my daughter hasn’t worked for several months. Is there some kind of payment plan available?”

I don’t want to have to pay another hundred thousand dollars, she thought.

The attendant said, “Oh yeah, we used to have a program like that. It was the scholarship program, and she would’ve qualified because she’s not working. But we don’t have it anymore.”

And so Barbara signed a contract for $1,500 a day for 30 days. At the end of the 30 days, her daughter called her in tears because she wasn’t stable enough to go home and needed another couple of weeks. Barbara paid. At the end of those two weeks, it happened again, and it went on for three months. The total bill for the stay was $104,000.

The only thing Barbara’s $600-per-month Presbyterian plan would cover during that stay was the time her daughter had some abnormal blood results and had to stay in the hospital over a weekend.

The residential center tried to bill Barbara for the time her daughter was in the hospital, and Barbara had had enough. She told them,

“My daughter didn’t get your services for three days. I don’t pay for room and board. I pay for therapeutic services. I’ve paid you $104,000. I’m not paying for days she wasn’t there, especially since she was in the hospital, which costs us money, too.”

Although several of the people she talked to tried to give her the runaround, Barbara stood her ground and ended up not having to pay for that time.

That money was only a small win in the face of the over $200,000 Barbara and her husband had spent at that point. The only reason they could afford such an exorbitant sum was because of inheritances from Barbara’s father and mother-in-law. Barbara had worked as a CPA, her husband had had a good job, and they had a pension and Social Security, but without the inheritance money they could not have afforded their daughter’s treatment.

Today, Barbara is a leader in BPD Alliance’s Family Connections course, and in every class she hears similar stories of insurance companies refusing to cover treatment.

“I just feel sorry for a lot of people who have no insurance at all, no savings, no job,” she says. “There was one couple in my class whose daughter is really struggling, and insurance won’t cover treatment, and they can’t afford it out of pocket. Some people go bankrupt or take out loans. It feels like we are lower-class citizens when we don’t have coverage. But even when you do have coverage, you get the runaround. They think if they make it hard for you, you’ll just give up and pay them, and a lot of people do.”

At BPD Alliance, our advocacy committee is working through several channels to address the lack of care. Stories like Barbara’s help us make our case to legislators, insurance companies, and spread awareness so the general public is informed. Have you had struggles with insurance? Share your story here