When Fishbein moved to North Carolina from Rhode Island in 2006, the situation got much worse. Her previous insurer refused to cover her there, and the insurance offered with her job had no mental-health benefits at all. "It was, 'Can I buy food this week, or do I fill my medication?' " She starting skimping on prescription refills without telling her family. She didn't realize that she was in trouble until concerned relatives talked to her about the fact that she hadn't gotten up from the couch for days. Fishbein and her husband have since found new insurance through his job and hope to save $450 a month on out-of-pocket costs as a result. And Fishbein has started her own business: Helping families and organizations in North Carolina find appropriate mental-health care.