It’s no secret that mental health is just as important as physical health, but how do you seek help in a healthcare system that can be tough to navigate? Managing mental health is even more important for people who deal with substance use disorders, eating disorders, overspending, and a host of other behaviors. Experts now agree that things that used to be labeled as “addictions” are also mental health conditions as well.
Getting treatment can be tricky for those who are uninsured or have insurance with high copays and deductibles. Even the best health insurance plans may not cover everything you need, or you may find a therapist or facility you like that is out of network.
Mental health resources are valuable to everyone. Therapy, support groups, and access to mental health care is instrumental for people in recovery, their family members and loved ones, and people who’ve been through traumatic experiences.
Barriers to finding mental health treatment
In a perfect world, everyone would be able to access the physical and mental health advice from a professional whenever they need it. Sadly, there are significant barriers to obtaining effective and affordable mental health care. Some of these are:
Lack of standardized care. Healthcare systems in the United States can vary drastically. Having the right insurance, network, or even living in the right location can make or break access to quality mental health services.
No access to health insurance. Studies show that people without health insurance fare the worst when attempting to get treatment for mental health issues. Without insurance, it is hard for people to get the resources they need. Even if care is found, it’s hard to stick to a treatment plan without insurance, because costs add up quickly.
Restrictive health insurance plans. The Affordable Care Act was supposed to improve coverage for mental health issues by making some mental health services compulsory for any marketplace plan. For instance, health insurance companies can no longer deny coverage to patients with a substance use disorder or preexisting mental health diagnosis, such as anxiety or depression.
Recent reports show that it is still a challenge to find quality mental health care because many plans don’t offer “mental health parity” or mental health coverage that is equal in quality to coverage for physical issues. Patients who have some coverage may have a tough time getting their insurance company to pay for certain vital treatments.
Demographics or socioeconomic status. Mental health issues affect everyone regardless of age, sex, gender identity, race, or socioeconomic status. Studies show it’s harder for people of color to access quality mental health care. Asian-Americans, Latinxs, African-Americans, and Native Americans all face additional hurdles when it comes to finding the right mental health resources. Communities of color face cultural and economic barriers. Discrimination also often leads to misdiagnosis or even implicit bias.
Stigma. Attitudes about mental illness are slowly changing, but erroneous beliefs about a diagnosis, mental health, and its significance can also make it challenging to seek care. Caring for your mental health doesn’t make you weak, and having a diagnosis isn’t a character flaw.
Dealing with these obstacles doesn’t mean you can’t have access to the counseling you deserve and need.
How to Find Mental Health Services
If you have insurance, ask about the services provided in your network
Look through your health plan’s services and see what your network offers. If you’re having a tough time, the law is on your side. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was created to ensure that your healthcare plans respect parity. This protects access to mental health care whether you buy your own plan or it’s provided by your employer. Under the MHPAEA, the quality of your mental health services cannot be of lower grade than what you would get for surgical or medical assistance, and your health insurance plan must offer comparable service, restrictions, and rules.
Seek state or federal groups that can connect you to mental health services
Not everyone has health insurance or can find an in-network doctor they like. You can turn to federally qualified health centers for a variety of mental health services. These health centers must meet strict requirements and guidelines. Some of these centers focus on serving vulnerable groups, such as immigrants, the homeless community, or people who live in public housing. They have the ability to charge on a sliding scale if this is something you need.
Talk to reputable non-profits
There are quite a few nonprofits that can help you find assistance. Some organizations are all-encompassing, while others focus on helping individuals who struggle with eating disorders, depression, anxiety, post-traumatic stress disorder, and other commonly diagnosed mental health conditions.
These non-profits may not directly provide you with therapy or services, but they can make suggestions based on your needs. Some reputable organizations are To Write Love On Her Arms, National Eating Disorders Association (NEDA), and Mental Health America.
You may be eligible for Medicaid
Medicaid can help you take care of costs associated with healthcare if your income falls into a certain range. Unlike Medicare, you don’t need to have a disability or be a senior citizen (age 65 or older) to have access to it. According to its official website, Medicaid is the largest payer of mental health services for Americans at the moment.
As attitudes about substance misuse change and people begin to see the benefits of treatment, Medicaid has also stepped up to the plate and increasingly paid for patient bills if they require help during recovery from issues such as substance use or eating disorders. The MHPAEA also influences this program, and your Medicaid coverage must be comparable to what is offered for your physical health needs.
Seek a sliding-scale therapist
This may require a bit more sleuthing, but you can call private therapists and ask for their rates. If you can’t afford a provider’s standard rate, many are willing to work with you on a sliding scale. Depending on the agreement you come to, you may work with a private therapist in their practice, or their intern may act as your therapist under supervision. In any case, counselors are often able to meet you halfway and make sure you have access to therapy.
Your therapy doesn’t have to be individual
Group therapy may be an option if you cannot find affordable individual sessions. Group therapy is a good option if you are comfortable in this type of setting. It also might be an option if you and your therapist think it would work well for you. You will want to ask as many questions as necessary to make sure you feel comfortable and that the dynamics of the group fit your needs.
One or more therapists may lead a group of up to 15 people. Unlike support groups (which are often led by volunteers or people who have been through experiences similar to yours), group therapy is more structured, led by a mental health professional, and may be open or closed.
Closed groups are for people who are expected to start at the same time so you can make progress together. Open groups allow people to enter at any time. Groups are encouraged to be confidential and provide a safe space for vulnerability. Group therapy will generally allow you to open up and share experiences with both a counselor and others who understand you and your struggle.
Check out your local universities
University teaching hospitals are a great resource as well. They can offer quality care at a reduced cost, may have federal funding, work with Medicaid, or be able to offer their services at a sliding scale as well
Don’t go to the ER
There are some exceptions to this, but the emergency room shouldn’t be the first thing you try. Emergency rooms are sometimes necessary during serious events, such as a panic attack, or substance or alcohol misuse that threatens your health and well-being.
However, you shouldn’t visit them if you know you need a therapy session, don’t feel seriously ill, know that you have your current situation more or less under control, or have a less serious problem. The ER can be expensive, especially for the uninsured.
When In-Person is Not an Option
Seek phone or internet therapy sessions
With the advent of COVID19 many counselors are only booking phone or online appointments. Sometimes called distance therapy or e-therapy, this means that you will talk to your counselor over the phone or through an online app, such as Skype, Zoom, WhatsApp, or even Facetime.
Online therapy sessions are not without their challenges, but if you’ve been working with a counselor for a while, now is the perfect time to take advantage of telepsychology and practice social distancing. In some cases, telepsychology sessions may be cheaper. Even if you don’t get a discount per-hour, you will save money on commuting, parking, and other expenses associated with visiting your therapist at their office. Once the coronavirus is under control, you may decide to continue receiving your therapy online because it’s more convenient.
If You are Still Stuck
Call these hotlines, which can refer you to low-cost or no-cost services
There are several government-funded hotlines you can call for referrals.
Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline – 1-800-662-HELP (4357) or TTY: 1-800-487-4889. Available 24/7, this hotline is free and confidential. Services are also available in Spanish as well. The SAMHSA National Helpline is a great resource for people with mental health disorders or issues with substance misuse. They can refer you to counselors, facilities, support groups, and community health clinics as well.
National Suicide Prevention Lifeline – Also available 24/7 at 800-273-TALK (8255) or here. The line is confidential and offers services in Spanish, for those who are deaf or hard of hearing, and offers a confidential chat room if you feel uncomfortable speaking over the phone.
Veterans Crisis Line – Especially tailored to the needs of veterans, many those who answer the VA crisis line are also veterans. You can reach them online or at 1-800-273-8255 (press 1) or via text at 838255. The Veterans Crisis Line also has a chat room and a phone number for those who are deaf or hard of hearing 1-800-799-4889. The line is for veterans, those in active duty, the National Guard, and is also available to family and friends of current and former members of the military.
Finding mental health services can be daunting, and it’s hard to deny that there are many barriers. Still, options are available and hopefully, this guide helps ease the process.