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Specialized behavioral healthcare can help individuals and families adversely affected by the possession and pursuit of wealth. 

By Orenda at Futures Recovery Healthcare | February/March 2021 | Personalized Treatment for Behavioral Healthcare needs. We are a luxury residential treatment center.

ORENDA at Futures Recovery Healthcare embraces the complexity of addiction, co-occurring mental health, and primary mental health conditions to empower recovery and improve outcomes through evidence-based practice, coordinated care, and mission-driven culture. Futures Recovery Healthcare is a licensed behavioral healthcare organization accredited by The Joint Commission located in Tequesta, Florida. Futures operates evidence-based, holistic dual-diagnosis treatment programs that emphasize individualized approaches to recovery. Please contact a member of our admissions team at (866) 897-5701 or visit us online to request information or make a referral.

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Concierge Medicine, contrary to what some may believe, is not accessible only to the rich. A survey conducted by Concierge Medicine Today finds that the vast majority of concierge patients are insured and are not in income brackets that qualify them as wealthy. Some patients surveyed even reported that they chose concierge doctors to reduce their total healthcare spending. As with any demographic, there are exceptions. Some concierge practices treat a higher number of wealthy clients than others. Being located in an affluent area of the country and other factors may play a role in the client population’s rate of wealth.

Karen Flannery, M.D., Attending Physician, Orenda | Please contact a member of our admissions team at (866) 897-5701 or visit us online to request information or make a referral.

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Wealth, for all its advantages, can pose risks for mental and behavioral health problems. Caregivers may better tailor prevention education, therapies, and treatments by understanding how the possession, pursuit, and influences of wealth can affect health and well-being.

The inverse relationship that sometimes exists between wealth and wellness is well documented. The maxim “money cannot buy happiness” was substantiated by a widely-cited 2018 Purdue University study. It found that for individuals earning between $75,000 and $95,000 per year (somewhat higher for families), “…further increases in income tended to be associated with reduced life satisfaction and a lower level of well-being.” The means to occupy a perceived station and purchase the education, housing, healthcare, professional and wellness services, and life experiences that increase our feelings of security, well-being, fulfillment, and belonging can come at a high cost. Wealthy individuals and family systems can be more prone than others to potentially adverse power dynamics and enabling behaviors, intense career stress, traumatic personal interactions, insulation from negative consequences, difficulty acknowledging problematic substance use, and feelings of neglect, artificiality, and isolation. Certainly, not all wealthy people are negatively impacted by their wealth, and the effects differ.

Four Pillars of Care

A niche of treatment providers specializes in clients for whom wealth and its trappings cause or exacerbate behavioral health problems. As with care providers specialized in any cohort, those who primarily treat high-net-worth individuals, top executives, celebrities, and athletes deeply understand client needs and make treatment relevant and practical. These caregivers are skilled at establishing authentic and productive therapeutic alliances by recognizing and breaching the veneers of public persona and privilege that may be used by their clients as defensive coping mechanisms.

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The fact that people can live with diagnosable behavioral health conditions while maintaining a high level of function can make it difficult to accept that they have a problem that needs treatment. Dr. Karen Flannery, an addiction medicine specialist with more than two decades of experience treating wealthy individuals, regularly encounters this dichotomy in her patients. “Business leaders, doctors, and other high-functioning professionals who can operate at the top of their game often find it very hard to believe that their substance use or mental health disorder is a problem. It is easy to think that if substance use or a mental health problem is severe enough to necessitate treatment, that it would stop them from being performant.” Flannery, who operates a private concierge practice and serves as an attending physician at Orenda at Futures Recovery Healthcare, also finds that clients fear a lack of control or ostracization if they seek care. “People are afraid that admitting to having a problem and seeking treatment will jeopardize their career, change the way people think about them, or alter their personality. To break down barriers to treatment, we explain the facts — that these conditions are potentially life-threatening, that they have legal protections to receive healthcare, and that they can drastically reduce their suffering, feel better, and live longer, happier lives by getting help.”

Behavioral health problems associated with wealth can be especially disruptive to family system dynamics. Parents may suffer from feeling caught between the desire to parent and the demands of high-pressure careers and other obligations. Children may feel pressured to follow their parents’ footsteps rather than pursue their aspirations, live up to high success or performance standards, or compete for attention and financial resources. Perceived unfairness related to the use of wealth and its distribution among family members can cause stress and estrangement. In short, wealth, whether generated by sole breadwinners, family-owned businesses, or inheritances, can create conditions that expose generations of family members to long-term emotional distress and trauma.

Money’s ability to insulate family members from the negative consequences of their actions can allow substance use or mental health problems to persist and worsen. Using influence and donations to protect children from high school or college suspensions and expulsions may prevent young people from receiving critical early intervention. Hiring high-priced lawyers, making quiet settlements, and calling on well-placed friends and associates to mitigate the legal ramifications of drunk-driving, drug-possession, property damage, negligence, and other criminal offenses, may prevent jail-time or other penalties. However, these interventions can also prevent family members from recognizing their conditions’ seriousness and getting the help they need.

Amy Effman, LMFT, CAP | Therapist & Family Services | ORENDA | Please contact a member of our admissions team at (866) 897-5701 or visit us online to request information or make a referral.

Family Programming

Amy Effman, LMFT, a family therapist at Orenda at Futures Recovery Healthcare, works primarily with wealthy clients and their family members. Effman often encounters clients whose problematic substance use or mental health conditions are negatively impacted by enabling family relationships. “The negative effects of wealth can cut both ways. Family members who generate or control wealth can feel isolated. They may feel that they cannot fully trust their closest relatives because of the influence of wealth. Money has the pernicious ability to infiltrate entire family structures.” Much of Effman’s work focuses on helping clients and family members identify and reduce enabling behaviors. “Enabling can affect many identified family member relationships. Family members, especially dependents, can feel pressured to allow other members to engage in problematic substance use or self-medicate for an untreated mental health disorder or other health problem. Being afraid to confront family members or enforce healthy boundaries can lead to worsening conditions and prolonged suffering and ramifications.”

While some wealthy people may face relational challenges from within their family system, they may also feel endangered by those outside it. Insularity and provincialism can be problems for wealthy people who feel isolated from or even threatened by people outside of their family or social circles. Dr. Paul L. Hokemeyer J.D., Ph.D., is a practicing marriage and family therapist, a foremost expert on the specialized clinical complex needs and cultural attributes of the ultra-wealthy, and author of “Fragile Power: Why Having Everything Is Never Enough.” Hokemeyer cites the problem of tribalism and isolation among prominent families in an article for CampdenFB. “While cultural, political, and economic tribalism may feel protective in the short run, in the long run, hyper-tribalism has a pernicious impact on the financial and emotional well-being of our international community and the individuals and families who comprise it.” Becoming generally suspicious of others’ motives and intentions can lead to deep feelings of isolation and, in some cases, paranoia. The fear that one cannot trust anyone but their most trusted allies can become an intensifying and traumatic cycle. When planning an intervention or recommending that a family member seeks treatment, Hokemeyer finds that identifying the most trusted contact often means looking outside of the family. “…The first-line intervention should come from within the family system by identifying the person or persons in the family’s orbit who have the most trustworthy relationships to the person struggling. This could be a family member, but very often it’s a person outside the family such as a trustee, the person managing the family’s finances or some other adviser.”

As Dr. Hokemeyer’s experience suggests, helping wealthy individuals seek care and improve long-term outcomes sometimes requires broadening the circle of professionals supporting the cause. While treatment can address clients’ health needs, it cannot reduce risks associated with continued access to unchecked financial resources or tackle legal challenges. Increasingly, wealth managers, fiduciaries, and other financial and legal professionals who work with wealthy clients are learning how to spot problems and refer clients to help. They are also being enlisted to support the recovery goals of clients and families. John Egan, an outreach professional at Orenda at Futures Recovery Healthcare, educates wealth managers about behavioral health disorders and how to help clients find appropriate care. Financial advisors, estate managers, and family attorneys can be important resources to patients and families by protecting financial resources and reducing risks to people in recovery. They are often called upon to implement powers of attorney, trust stipulations, contracts, and other means to help ensure that people in recovery are adhering to treatment plans and remaining substance-free.

Learn more about the Orenda at Futures Recovery Healthcare program at or speak with an informed representative at (866) 683-1538.

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