How to find help for mental health


The Affordable Care Act requires insurers to provide the same level of coverage - rates, co-pays and deductibles - for mental health as for physical disorders.
August 18

When you’re in the throes of a mental health problem, making the decision to seek help is hard enough. Then there’s the next step: figuring out where to go, a task that can feel daunting when you’re already overwhelmed.

The best way to find a provider is through a referral, says Beverly Palmer, a clinical psychologist in Torrance, Calif. If possible, ask your regular doctor, or seek a recommendation from someone you know.

At www.mentalhealth.gov, a site run by the federal government, you can type in your Zip code to get a list of providers in your area. The National Alliance on Mental Illness is another resource. NAMI chapters offer peer support groups, special programs for veterans and support for family members.

Some mental health conditions have organizations that can direct you to a qualified provider, Palmer says. For instance, Children and Adults with Attention-Deficit/Hyperactivity Disorder and the Depression and Bipolar Support Alliance offer lists of providers who treat those conditions.

Another good resource, especially if you don’t have insurance, is your county health clinic, Palmer says. You can also search on the Internet or in a phone book for “mental health” services in your city or county. Be careful, though: Anyone can call himself a counselor, Palmer says, but you want someone who is licensed so you know they’re properly trained.

There are several types of licensed professionals. Psychiatrists are medical doctors who have done a three-year residency in psychiatry. They prescribe medications and are trained to manage psychiatric medications, Palmer says. Psychologists have four-year doctoral degrees in psychology, plus two years of internship. “In some states, psychologists can prescribe if they go through additional training,” Palmer says.

Licensed clinical social workers have a master’s degree plus 3,000 hours of internship training. “They’re not only trained in psychotherapy, but they’re also good at understanding community resources and working with families,” Palmer says. Marriage and family therapists also have master’s degrees and internship training, and while the training emphasizes issues relating to marriage and family, some also have extra training to work with children or adolescents, Palmer says. Finally, a licensed mental health counselor or professional clinical counselor has a two-year degree and 3,000 hours of supervised training.

As long as you choose someone who is licensed, the type of degree the person has is probably less important than whether he or she has training in the type of problem you’re experiencing and feels like a good fit, Palmer says. (And you don’t necessarily need a psychiatrist if your treatment includes medication, because other professionals can arrange for a doctor to prescribe it, Palmer says.)

Before you start, ask questions so you know what to expect, says Ken Duckworth, medical director at NAMI. It’s okay to ask, “Do you think you can help me?” he says. Good questions, Duckworth says, include: What’s your approach? How will you communicate with my other medical providers? How many people with my condition have you treated, and how have they fared? Do you have measures so we can see if I’m getting better?

“Be an educated consumer,” says Paolo del Vecchio, director of the Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services in Rockville. “Do your shopping and ask questions: ‘What is your therapeutic approach? What’s your specialty? What is the cost?’ ” The cost usually increases with the amount of training the provider has, but it can vary greatly.

Before you make an appointment, contact your health insurer to make sure the provider you’ve chosen is covered in your plan. The Affordable Care Act requires parity for mental health coverage, which means that insurers must provide the same level of coverage (including rates, co-pays and deductibles) for mental health as for physical disorders, Palmer says. For instance, plans must cover preventive services such as depression screening and behavioral assessments without cost, and they can’t deny you insurance or increase your rates due to preexisting mental health conditions.

Whomever you choose, you should feel comfortable with the person. Trust your instincts, del Vecchio says. You want someone who really listens and has a plan for how your treatment will proceed.

A task force commissioned by the American Psychological Association concluded in 2011 that “The therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method.”

The group also found that certain factors seemed particularly valuable. An alliance between the therapist and client, a sense of collaboration and an active solicitation of feedback from the client seem to improve the chances of success, Palmer says. There should be a consensus about the goals of therapy. “The goals are stated,” Palmer says. “It’s not just talk, talk, talk. There are specific goals you create together.”

If you’re working with a licensed professional, you can be assured that your privacy will be protected, del Vecchio says.

“Recovery is possible,” del Vecchio says. Mental illness is not a life sentence, he says. “People overcome these issues to lead happy, productive lives.”

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