David Baxter PhD
Late Founder
How to Find Mental Health Care When Money Is Tight
By LESLEY ALDERMAN, New York Times
November 21, 2009
IMAGINE this situation. You fall into a deep malaise. Friends say you need help, but you don’t have insurance (or the insurance you do have has very limited mental health benefits), and you worry that extra bills will only add to your malaise. So you do nothing.
And that’s what many people do. According to a recent survey by the federal Substance Abuse and Mental Health Services Administration (Samhsa, pronounced SAM-suh) , the leading reason that people with mental health issues don’t seek treatment is cost. They fear the fees.
“There’s a misperception that care is always expensive, but that’s not the rule,” said John Draper, a psychologist and the project director of the National Suicide Prevention Lifeline (800 273-TALK), a free 24-hour service supported by the federal government. “There are plenty of ways to get help,” he said. “Some of them are very affordable.”
But while affordable mental care exists, it’s not always easy to find or get immediate access to.
Two weeks ago, I wrote about how people with insurance can navigate the mental health system to get the help they need at prices they can afford. This week, I offer advice for those without insurance, or with only minimal coverage, on how to find low-cost mental health care.
MILDLY STRESSED?
“Not all mental health problems require a professional therapist,” says Michael B. Friedman, a social worker and an adjunct professor at Columbia University’s School of Social Work in Manhattan. For instance, if you just lost your job and you’re worrying constantly and sleeping poorly, you may be in a transient state of unease that will abate once your job hunt gains traction.
If you’re feeling depressed or anxious, but still coping relatively well, try making changes on your own (rather than spending money on a pro).
“Committing to one small change a week, like getting an extra hour of sleep or walking for 30 minutes a day, can go a long way toward improving your state of mind,” said Karina Davidson, a clinical psychologist and director of the Center for Behavioral Cardiovascular Health at Columbia University.
The change itself, combined with making the commitment to change, can have a subtle but profound effect on your mental health, said Ms. Davidson, who conducts research on the effect that depression has on cardiovascular disease.
Another low-cost but very effective strategy, Mr. Friedman said, is to join a support group that addresses the problem you are struggling with, whether it’s job loss or an eating disorder. “People get tremendous benefit from interaction with others,” he said. To find support groups in your area, contact the local affiliate of the nonprofit group Mental Health Americaand ask for a referral.
If a close relative has a drinking problem, consider attending Al-Anon meetings where you can share your feelings and listen to the stories of others in a similar situation. Or if you yourself have a drinking problem, attending Alcoholics Anonymous meetings can be incredibly useful.
If time is an issue or you can’t find a support group near you, consider an online group.
If you want a more intimate therapeutic relationship, and you belong to a congregation, do consider seeing your pastor. Pastors typically take courses in counseling, and some even have counseling degrees.
“It’s not medical care, but it can be very therapeutic,” says William J. Hudock, a special expert at the Center for Mental Health Services, a division of Samhsa.
TROUBLE COPING?
How do you know when it’s time for professional help? “If you can’t get your act together,” said Mr. Friedman.
For instance, you should be job hunting, but you’re sitting in front of the TV all day. Other signs are symptoms like chronic insomnia, overeating or undereating, or lack of interest in your favorite activities or sports teams.
If you are employed and your company offers an employee assistance program, take advantage of it. It’s free, and they can typically set you up with three or so sessions with a therapist.
If you have a good relationship with your primary care physician, you could see him or her. Your doctor may be able to refer you to a local mental health center for therapy, and maybe consider medication to help you out of your immediate funk. Doctors may also know of psychologists who see patients on a sliding fee scale.
If you don’t have a doctor you like or you want an evaluation by a mental health professional, look for local universities that have graduate programs in social work or clinical psychology. You can often get treated by graduate students who are being closely supervised, at less than the going rates.
Some private counseling centers also offer variable fees. For instance, at the Ackerman Institute for the Family, a nonprofit counseling center in Manhattan, families with limited means are charged fees based on their income.
“We are not going to turn someone away based on their ability to pay,” says Lois Braverman, president of the institute.
If your child is having trouble, seek out the child psychologist at his or her school. This can be a great first-line treatment and it doesn’t cost a thing, said Mr. Hudock. Or talk to your pediatrician, who might know of affordable parenting classes or sources of low-cost care in your area.
If the problem relates to substance abuse, call 1-(800) 662-HELP, a federal help line for obtaining information on substance abuse treatment services.
IN CRISIS OR SUICIDAL?
When you or someone you know is in crisis, you can go to the nearest emergency room for immediate help. You can also call the National Suicide Prevention Lifeline (800-273-TALK) where you will be connected to the nearest crisis center in your area.
The Web site for Lifeline also has valuable information on how to cope with mental health crises, like how to arrange for an involuntary psychiatric evaluation or spot warning signs for depression.
You can use the Lifeline for any type of mental health crisis — not just suicide, says Mr. Draper, who adds that “70 percent of callers are not suicidal.” The people answering the calls can determine what help you need and also refer you to a facility for treatment, whether it’s a local hospital or a government-run mental health clinic.
In New York City, callers are referred to LifeNet (800 LIFENET). LifeNet answers about 10,000 calls a month.
In some areas of the country, dialing 211 can connect you with mental health crisis services in your area or help you find where to seek immediate help.
A word of warning: When you are looking for low-cost care, you might face longer waits than when you are paying full fare (or your insurer is). But don’t let this deter you from staying the treatment course. Untreated mental health issues can very often lead to serious (and even more costly) medical problems.
By LESLEY ALDERMAN, New York Times
November 21, 2009
IMAGINE this situation. You fall into a deep malaise. Friends say you need help, but you don’t have insurance (or the insurance you do have has very limited mental health benefits), and you worry that extra bills will only add to your malaise. So you do nothing.
And that’s what many people do. According to a recent survey by the federal Substance Abuse and Mental Health Services Administration (Samhsa, pronounced SAM-suh) , the leading reason that people with mental health issues don’t seek treatment is cost. They fear the fees.
“There’s a misperception that care is always expensive, but that’s not the rule,” said John Draper, a psychologist and the project director of the National Suicide Prevention Lifeline (800 273-TALK), a free 24-hour service supported by the federal government. “There are plenty of ways to get help,” he said. “Some of them are very affordable.”
But while affordable mental care exists, it’s not always easy to find or get immediate access to.
Two weeks ago, I wrote about how people with insurance can navigate the mental health system to get the help they need at prices they can afford. This week, I offer advice for those without insurance, or with only minimal coverage, on how to find low-cost mental health care.
MILDLY STRESSED?
“Not all mental health problems require a professional therapist,” says Michael B. Friedman, a social worker and an adjunct professor at Columbia University’s School of Social Work in Manhattan. For instance, if you just lost your job and you’re worrying constantly and sleeping poorly, you may be in a transient state of unease that will abate once your job hunt gains traction.
If you’re feeling depressed or anxious, but still coping relatively well, try making changes on your own (rather than spending money on a pro).
“Committing to one small change a week, like getting an extra hour of sleep or walking for 30 minutes a day, can go a long way toward improving your state of mind,” said Karina Davidson, a clinical psychologist and director of the Center for Behavioral Cardiovascular Health at Columbia University.
The change itself, combined with making the commitment to change, can have a subtle but profound effect on your mental health, said Ms. Davidson, who conducts research on the effect that depression has on cardiovascular disease.
Another low-cost but very effective strategy, Mr. Friedman said, is to join a support group that addresses the problem you are struggling with, whether it’s job loss or an eating disorder. “People get tremendous benefit from interaction with others,” he said. To find support groups in your area, contact the local affiliate of the nonprofit group Mental Health Americaand ask for a referral.
If a close relative has a drinking problem, consider attending Al-Anon meetings where you can share your feelings and listen to the stories of others in a similar situation. Or if you yourself have a drinking problem, attending Alcoholics Anonymous meetings can be incredibly useful.
If time is an issue or you can’t find a support group near you, consider an online group.
If you want a more intimate therapeutic relationship, and you belong to a congregation, do consider seeing your pastor. Pastors typically take courses in counseling, and some even have counseling degrees.
“It’s not medical care, but it can be very therapeutic,” says William J. Hudock, a special expert at the Center for Mental Health Services, a division of Samhsa.
TROUBLE COPING?
How do you know when it’s time for professional help? “If you can’t get your act together,” said Mr. Friedman.
For instance, you should be job hunting, but you’re sitting in front of the TV all day. Other signs are symptoms like chronic insomnia, overeating or undereating, or lack of interest in your favorite activities or sports teams.
If you are employed and your company offers an employee assistance program, take advantage of it. It’s free, and they can typically set you up with three or so sessions with a therapist.
If you have a good relationship with your primary care physician, you could see him or her. Your doctor may be able to refer you to a local mental health center for therapy, and maybe consider medication to help you out of your immediate funk. Doctors may also know of psychologists who see patients on a sliding fee scale.
If you don’t have a doctor you like or you want an evaluation by a mental health professional, look for local universities that have graduate programs in social work or clinical psychology. You can often get treated by graduate students who are being closely supervised, at less than the going rates.
Some private counseling centers also offer variable fees. For instance, at the Ackerman Institute for the Family, a nonprofit counseling center in Manhattan, families with limited means are charged fees based on their income.
“We are not going to turn someone away based on their ability to pay,” says Lois Braverman, president of the institute.
If your child is having trouble, seek out the child psychologist at his or her school. This can be a great first-line treatment and it doesn’t cost a thing, said Mr. Hudock. Or talk to your pediatrician, who might know of affordable parenting classes or sources of low-cost care in your area.
If the problem relates to substance abuse, call 1-(800) 662-HELP, a federal help line for obtaining information on substance abuse treatment services.
IN CRISIS OR SUICIDAL?
When you or someone you know is in crisis, you can go to the nearest emergency room for immediate help. You can also call the National Suicide Prevention Lifeline (800-273-TALK) where you will be connected to the nearest crisis center in your area.
The Web site for Lifeline also has valuable information on how to cope with mental health crises, like how to arrange for an involuntary psychiatric evaluation or spot warning signs for depression.
You can use the Lifeline for any type of mental health crisis — not just suicide, says Mr. Draper, who adds that “70 percent of callers are not suicidal.” The people answering the calls can determine what help you need and also refer you to a facility for treatment, whether it’s a local hospital or a government-run mental health clinic.
In New York City, callers are referred to LifeNet (800 LIFENET). LifeNet answers about 10,000 calls a month.
In some areas of the country, dialing 211 can connect you with mental health crisis services in your area or help you find where to seek immediate help.
A word of warning: When you are looking for low-cost care, you might face longer waits than when you are paying full fare (or your insurer is). But don’t let this deter you from staying the treatment course. Untreated mental health issues can very often lead to serious (and even more costly) medical problems.
