How to Get Mental Health Care

Donna L.
on 12/20/17 2:27 pm - Chicago, IL
Revision on 02/19/18

Getting mental health care is absurd even when you have insurance. Many people have PM'd and emailed me this week for advice on what to do, so here are a few tips that may help.

The Ideal: Psychiatrist, Nurse Practitioner, or PA.

Ideally, you would see a psychiatrist and get a diagnosis and the medication you need. If you have complicated mental health issues this is always the best route, as they tend to be most familiar with psychotropic medications. Psychiatrists can also link in with therapists easier. Ideally they would also have a focus or specialty in the disorder or disorders you may have. Sadly, some specialists are very rare. It's extremely difficult to find an eating disorder specialist, for instance. I was completely unable to find one who had less than a year wait. Yes, that's a year, as in 12 months. I also live near some of the biggest eating disorder treatment places in the country.

Cons: there is a national psychiatrist shortage so be prepared to wait. Here, if you have Medicaid, be prepared to wait 7-12+ months to see a general (non-specialist) psychiatrist. The agency I work at has an 8 month wait. And with private insurance, it's often 1-4 months.

Less than ideal but still works: PCP

PCPs are not the biggest prescribes of psych meds (that's actually the American prison system, believe it or not), however for many people they are the only solution. If you have a long wait for service otherwise, or can't find a psychiatrist (many rural areas do not have psychiatrists), the PCP is actually not a horrible option. While not ideal, many can effectively treat basic depression and basic anxiety, and provide temporary care for more serious disorders if someone is waiting to get in elsewhere.

Do not hesitate to see the PCP either if you're afraid of a psychiatrist. If you know you have an issue though, please make the psychiatrist appointment ASAP. The PCP can help until you are able to do so, though!

Not ideal at all, but sometimes necessary: the ER

Expensive, cumbersome, and time-wasting, the ER is another staple of prescribing. Most individuals I work with on Medicaid have waits for psychiatrists that are so long they are unable to see one for over a year. So, once a month, they go to the ER for their scripts.

It's far from ideal, and they often won't prescribe certain drugs, however it is better than the alternative.

Other Resources:

You can use this tool at Psychology Today to find a therapist with a specialty you need. It's pretty neat!

NAMI is an organization that does advocacy for individuals with mental illness. If you have issues finding assistance, check out your local chapter. They are great resources for referrals.

If you have Medicaid or private insurance, you can get a case manager if you call them and ask for one. Well, depends on the private insurance, but almost all Medicaid plans offer this free service. A case manager will help you find care you need. Here in Illinois, Medicaid is obliged to find this, even if they must pay out of network for it, whether it's fancy drugs or a DS. You must call and ask, though, as these services are not generally advertised. Regarding private insurance, it can also be helpful, especially if you feel overwhelmed or unable to cope. Heck, I hate coping with the healthcare system and I work in it!

Crisis lines can help too if you can't see a therapist or doctor right away. Ours provides referrals and basic counseling. Warm lines in particular are basically just for counseling - you don't have to be suicidal to call! If you have no alternatives please check this list out and find one that works well for you.

If you are in crisis or are suicidal, you can call the National Suicide Prevention Hotline for help no matter where you are in the US.

If you are LGBTQ, The Trevor Project provides awesome service and generally is staffed by people who are themselves in the community.

In the US if you cannot find care, also call your local county's health department. Often they prescribe basic meds as well as psych meds.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

Gwen M.
on 12/20/17 3:36 pm
VSG on 03/13/14

Great information, Donna. Thank you so much!

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
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Oxford Comma Hag
on 12/21/17 8:17 am

Good post, Donna.

Can I also add that many employers have an Employee Assistance Program (EAP) that is free to use and can provide referrals and also usually covers 3-5 counseling visits.

I fight badgers with spoons.

National Suicide Prevention Lifeline: 800-273-8255

Suicidepreventionlifeline.org

NYMom222
on 12/22/17 5:18 pm
RNY on 07/23/14

Also as a resource many areas have a Mental health Association connected Nationally with what is now called Mental Health America.

They also have a locator for your local association on their website. As president of our county's Mental health Association we are often the first contact people have with services and assist them in finding the help they need.

http://www.mentalhealthamerica.net/

Cynthia 5'11" RNY 7/23/2014

Maintaining a 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16

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