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Anonymous inquired What are some of the options available to people who can't afford mental health treatment? People who have zero income and no transportation in states that do not have expanded medicaid?

mentalillnessmouse:

Hi Anon,

Here is what I found on psychcentral.com:

One of the biggest reasons people don’t seek therapy is money. People look at a therapist’s hourly rates — which might range from $100 to $250 — and immediately assume they can’t afford professional help. So they stop there.

But you do have various helpful options. Below, clinicians share, in no particular order, what you can do if you can’t afford treatment.

1. Check with your insurance.

“If you have insurance, ask your insurance plan to give you a list of providers who are either in your geographic area or who specialize in the issue you are seeking help with,” said Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School. You might only have to pay a small co-pay, he said.

However, even if your insurance doesn’t cover therapy, get the details on what they do cover, said Julie A. Fast, a coach and author of Get It Done When You’re Depressed. For instance, your policy might still include the words “social worker,” she said.

2. Try a training clinic.

Training clinics offer clients a sliding scale. They’re typically located in universities where graduate students prepare to become clinical or counseling psychologists, said Kevin L. Chapman, Ph.D, a psychologist and associate professor in clinical psychology at theUniversity of Louisville. There, he said, students are “trained and supervised by licensed psychologists who typically have years of experience with specific mental health conditions.”

3. Try a community mental health center.

“Community mental health centers provide free or low-cost therapy options and services covered by Medicaid insurance,” said Julie Hanks, LCSW, a therapist and blogger at Psych Central. To find a center, search using Google or look at your state government website for the Department of Human Services, she said.

4. Read self-help books.

“Books are my first recommendation,” Fast said. Along with her book,Get It Done When You’re Depressed, she also suggested “the rather esoteric The Four Agreements for personal development [and] The Idiot’s Guide to Controlling Anxiety.”

You also can contact a local therapist for book recommendations for your specific concern, Olivardia said. “It can help narrow down the options and allow you to focus on quality resources,” he said.

5. Attend support groups. 

Support groups typically are free or at least more affordable than individual therapy. They may be run by mental health professionals or peers. Always ask a therapist if they also offer lower-cost group sessions, Fast said. (“Groups can be a lot less expensive if they accept cash,” she said.)

She suggested attending moderated support groups. “I always stress that groups that are run by the people in the group rarely work. It should be a structured system where a dispassionate person runs things. Otherwise it can just be a complaining session,” Fast said.

The great thing about groups is meeting other people who are struggling with similar issues, which can create “a safe, validating space,” Olivardia said.

Learn more about support groups in your area by visiting NAMI and the Depression and Bipolar Support Alliance. Also, consider organizations such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

Consider, too, online support groups, such as one of the 180+mental health support groups here at Psych Central.

6. Ask about discounted rates.

“Cash is often more lucrative than going through the whole paperwork insurance thing,” Fast said. As such, some therapists might offer discounts. For instance, Fast’s therapist typically charges $200 an hour, but she worked with Fast for $50 an hour for a year.

Fast suggested asking clinicians the following questions: “If I don’t have insurance, do you have a cash policy?” Or, “I’m looking for a therapist but am on limited funds. Do you have any discount programs or a group available?” If they don’t, they might be able to refer you to a practitioner who does, she said.

7. Re-evaluate your expenses.

“There are some situations where ‘can’t afford’ is really about priorities,” Hanks said. Consider if you can reorganize your budget to accommodate therapy.

“I’ve worked with clients who ‘can’t afford’ my services but highly value therapy and choose to go without other things because they “can’t afford” not to be in therapy,” she said.

8. Check out podcasts and videos.

Fast also recommended self-help podcasts and videos, such as TED talks on YouTube. “They are very inspirational and have good advice,” she said. When searching for podcasts on iTunes, consider terms such as therapy or personal growth, she said. “I know this is not like seeing a therapist, but I believe that self growth requires personal time as well. It doesn’t all have to be about psychology either,” she said.

9. Visit websites for your particular concern.

“When an individual is privy to their mental health needs — [such as] ‘I’m having panic attacks’ or ‘I think I have OCD’ — landing on an association’s website can be ideal,” Chapman said.

For instance, he said, if you’re struggling with anxiety, you can find valuable resources at the Association for Behavioral and Cognitive TherapiesAnxiety and Depression Association of America and theInternational OCD Foundation.

There is also a wealth of information at Psych Central about self-help techniques, treatments, and books to check out. You can start by looking-up your mental health condition here.

10. Consult your congregation.

“If you belong to a religious congregation, talk to your preacher, pastor, or priest about your need and see if your church offers therapy services or is willing to help pay for therapy,” Hanks said.

11. Consider body therapy.

“Don’t forget body therapy… including chiropractic and massage,” Fast said. Schools usually charge small fees for services given by their students, she said.

As Olivardia said, “Nothing is more important than your physical and mental health.” If self-help resources and groups aren’t working, consider the price of not seeking professional help – because that might be steeper.

“Consider that there are costs for not getting treatment such as lost wages for missing work, strain on family relationships, and quality and length of your life,” Hanks said.

Best,

Lena

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