How To Find Mental Health Treatment Without Health Insurance
It’s recently become trendy for celebrities to talk about how much they love therapy, which is a major win when it comes to destigmatizing mental health care. We wouldn’t hesitate to visit our PCP if we had a broken bone, but taking care of the bumps and bruises inside of our psyche is still seen as a want and not a need, even in our 21st-century society.
A 2018 study showed that lack of access to treatment is the leading factor in today’s mental health crisis, citing limited options, long waits, a lack of access to information, and enduring social stigmas leading to more than half of adults with mental illnesses not receiving treatment. Mental Health America learned that over 5.3 million Americans with mental illnesses are uninsured, making access to this necessary treatment that much harder, and even more individuals suffer from a lack of coverage or no usual source of mental health care. And don’t even get us *started* on Big Pharma and the astronomical prices of life-saving prescriptions that cost next-to-nothing to produce, kids who are trying to get help without the support of their parents, or the ongoing shortage of mental health providers. We’ve talked to mental health professionals and patients about their biggest tips and tricks for finding help when you need it because everyone can benefit from therapy.
Rebecca Newman, Licensed Clinical Social Worker and psychotherapist, explained that even if you’re successful in finding a mental health provider who’s willing to charge for appointments on a sliding scale based on your income, it will be a lengthy process that doesn’t take into account whether that provider is a good fit. Search fatigue can lead patients to maintain a relationship that isn’t really helpful. Even Brad Pitt had to try multiple therapists before finding a provider he liked and trusted because therapy isn’t a one-size-fits-all practice. As such, Rebecca suggested a few unconventional options that give individuals more wiggle room to find their perfect match.
If you’re employed, you might have what’s known as an Employee Assistance Program (EAP) benefit. Rebecca explains that this benefit will cover 2 to 8 free sessions with a network of providers, giving you a chance to explore multiple relationships before settling down. After your free sessions dry up, you can see if your chosen professional would be open to a sliding scale payment method. This is also a great option for people who haven’t tried therapy before and are exploring if it’s right for them or for individuals suffering from what Rebecca calls an “acute issue” that might be resolved within a couple of visits.
A longer-term option is training institutes. While it may seem scary to let a student psychoanalyze you when you won’t even trust a Paul Mitchell School to give you bangs, Rebecca holds that training institutes are one of the better options for individuals looking to pay less than $50 per session. These can be found at some YMCA facilities, through the Association of Psychology Training Clinics, or with a quick Google search.
“A student, intern, or extern will be immersed in studying the newest modalities and interventions,” Rebecca explained, adding that these students will receive active supervision from a seasoned professional. It’s not like they’re flying blind with the status of your mental health hanging in the balance.
We know that even $50 sessions can be impossible for people in need of regular treatment, but Rebecca believes that less frequent visits are better than no visits at all.
“I often ask to meet with people once a week for the first month of treatment to perform a thorough assessment and build rapport, and then am happy to work with people every other week,” Rebecca said. “This often more manageable for scheduling, and in this case, price, if the patient is uninsured.”
High schools and colleges often offer in-school services for young people looking for help, whether it’s through peer counselors, training centers, or a campus health center. Naturally, these resources are only available to current students, and in the case of larger universities, it can take a while to book an appointment. But again, it’s better than nothing, and these services can help hold you over until you find a more permanent solution to the problem.
Another program that can help provide free therapy is Medicaid. Dr. Jesse Matthews told NBC News that most providers who accept Medicaid work at clinics, community mental health centers, or university training sites. If you qualify for Medicaid, there will be ~someone~ in your network who’s available free of charge. Medicaid eligibility is determined primarily by income and has to be applied for through the official Health Resources & Services Administration website, which can take a hot second. If you need help RTFN, you might need a 21st-century solution to your problem: apps.
The cheapest model for regular mental health treatment is digital support services like Talkspace, Teladoc, or BetterHelp. These apps are usually offered with talk or text option, making your clinician available for both longer sessions and quick questions. Rebecca cautions that the missing element of face-to-face human connection can be challenging and that these apps could benefit from more thorough screening practices, but the Anxiety And Depression Association of America and the NHS both offer guides to help you find apps that they have determined are effective and worthy of their endorsement.
If you’ve recently lost your insurance but already have a bomb AF therapist you don’t want to lose, Rebecca suggests asking if they do Telehealth, which is essentially remote treatment using technology like live video or mobile services. These practices are usually cheaper than in-person visits and can help you maintain the relationship with your therapist or hold you over between less-frequent IRL sessions. It’s not exactly ideal, but a good therapist can be hard to find and this is an infinitely better option than terminating your mental health treatment altogether. First, ask if your therapist is open to switching to a sliding scale plan instead, which can cut costs down to as low as $10 per session.
A whole other issue is affording prescription drugs after they’ve been prescribed. Loyola Marymount University graduate Kiri Schawalder lost her insurance in Fall 2017 after her mother, Donna, was forced out of her job due to what we now understand were symptoms of Donna’s burgeoning dementia. Kiri’s mother tried to get Kiri insurance through Loyola but failed due to her illness — and neglected to inform Kiri. When Kiri needed to pay for anti-depressants, she found that the cost of her medication was prohibitively expensive without health insurance.
“You don’t have to be a Costco member to go to the pharmacy, and their prices for medication are unmatched,” Kiri shared. “This month I paid $24 for my anti-depressants instead of $300 at Walgreens.”
Outside of Costco, the ADAA suggests contacting your pharmaceutical company directly to see if they offer patient assistance programs like AstraZeneca, Forest, Lily, Pfizer, and Takeda. There’s also the option of asking your doctor for drug samples, which is shockingly both legal and totally safe. Walmart offers a program that can cut costs on generic medications to four dollars for eligible patients, or the Partnership for Prescription Assistance can help qualified applicants find patient assistance programs to cut pharmacy costs. In a world where it costs six dollars to make insulin and $300 to buy it, there are plenty of ways to negotiate your medication prices down to something closer to a reasonable rate. For all your prescription drug needs, check GoodRx to see if you can get a coupon! Yeah, there are coupons for pharmaceuticals which is wild but also super helpful in cutting down your generic Lexapro from $100 to $7, depending on where you go.
It was an LMU doctor who led Kiri to the Costco pharmacy after “four hellish months” of being off her medication, and she was only charged $25 total by the university for the visit and two subsequent follow-up appointments that semester. Kiri also suggests tagging along to a parent’s doctor’s appointments, if at all possible.
“This tip is more dependent on the specific doctor as well as your parents, but oftentimes doctors will see and understand a person that is struggling with the system and their health and want to help,” she said. “I was able to do this a few times with my mom, and the doctor would grant me about 5 minutes each time to ask questions and talk about my own health, and even gave me a free B-12 shot once.”
Kiri has since had trouble with Medi-Cal, but currently has what she describes as a “meager plan” to get her to Affordable Care Act open enrollment in November.
“A small terrible policy can be better than no policy at all if you can swing it,” Kiri explained. “If you are in a state like California that has low-income health care, keep applying if it is applicable to you, no matter how many times you get denied — I’ve been denied four times.”
Finding mental health treatment without insurance isn’t easy, which is a travesty in and of itself. It might take time for you to find the help that you need, especially if you’re looking to do it for a reasonable cost, but never give up. Your mental health is too important to compromise or ignore, and everyone deserves to be the happiest and healthiest version of themselves, not just the one percent. This is a battle worth fighting, and there are plenty of well-meaning people who want to help you emerge victoriously.