How to Get Mental Health Care in US

The health care system in the US is in a state of crisis that leads many analysts to call it "broken". This is even more true of the mental health system, which is often (under) funded as a separate system from physical health. People with chronic mental health problems are especially at risk of receiving little or no care. This is a primer for receiving the best care in a broken system.

1

→ Determine the nature of the problem. In many cases, physical or biological causes of mental problems need to be ruled out first if this is a new problem. Seeing a physician, nurse, or other primary provider is important to start the process. However, most primary providers have limited knowledge and training in recognizing and treating mental health issues. Doctors who specialize in mental health are called psychiatrists and psychologists. Psychiatrists evaluate the biological causes and prescribe medications. Psychologists will evaluate behavior and suggest the ideal behavior for the given situation.

2

→ Consider whether the illness is an emergency or not. If they are a danger to themselves, others or are gravely disabled then the situation is an emergency. Threats, overdoses (substance abuse suicide), reckless endangerment of self, or jokes about suicide is life threatening, especially if you tried talking the person out of it for up to an hour (and they aren't feeling any better), catch them mid act, or after an attempt. Threats, violence, or troubling jokes about homicide is life threatening to others, so is carelessness or loss of contact with reality to the point it could threaten those they care for (leaving a baby in the bathtub and thinking imaginary friends are watching him or thinking others could hurt their safety). Losing contact with reality such as not listening to facts destroying their delusions, talking to people who aren't there and not coming out of it after trying to reason with them. Gravely disabled to the point where they are no longer able to care for themselves in so severe a way that it puts their life and health in danger. Get this person to an emergency health care facility, a primary health care provider, or call the authorities for assistance as soon as possible. If it is you, go there asap, going to help is more pleasant than help finding you and you'll have more bargaining power if they see you are proactive.

3

→ Do not be afraid of asking the person for more information on how they are doing and feeling, especially in an emergency situation where their life might be in danger. Understand it is a medical issue, so be calm and caring. Keep someone with the person if possible, if you are seeking help see if someone can escort you to care, such as an ambulance or family member. If you must involve the police carefully brief them both on the phone and in person before they meet the affected person. Some policemen are much better with the mentally ill than others...ask for a supervisor if you think things are not going well. Most medics are better at de-escalating a crisis situation than police, though there are exceptions.

4

→ Refer to the insurance plan. If the person is insured, most insurance companies have lists of providers who are local who can be contacted for care. Get as many referrals as possible and contact and interview a number of them if possible. Find out if there are any specialists in your problem, and treat these people as resources, asking if there are other special programs or centers they are aware of near you. Most insurance companies have clinical mental health experts on their staff, as opposed to the less trained customer service personnel. Ask to speak to one of these clinicians for information and referrals. Remember to write down the information, names and phone numbers in an easy to find place. These people can be your advocates with the insurance company to make sure you get the care you need and makes sure the care facility get paid for their services through insurance.

5

→ Contact your state's department of mental health and ask for help and referrals. Some states have far better services than others, particularly for the chronically ill. Most states have toll free central hot-line and referral services. It is better to contact a higher level state representative as they often have years of clinical experience and knowledge of local resources, including government and non-profit agencies (many of which receive some measure of local and state funding).

6

→ Get in touch with any non-profit agencies in your area Try starting with the local United Way or other local umbrella non-profit agency, and ask for referrals from every agency you contact. There are a wide variety of local and national toll free hot-lines and crisis lines.

7

→ Try university counseling departments and teaching hospitals where you can get information and services. They often are running research and trial programs that offer free or sliding scale services. Try to speak, if only briefly, with professors or doctors and ask for advice and referrals.

8

→ Call the intake or social service departments at mental health hospitals for advice and referrals. Regardless of your finances, tell them that you can pay whatever fees they have, and are thinking of becoming a customer. This is a good source of information and referrals since these professionals jobs are to assess and refer the patient to the local area.

9

→ Consider reputable alternative and non-traditional providers, such as pastoral counselors, Osteopaths, acupuncturists and so forth, but be sure these providers are experienced, educated and have practice treating other people with your problem. Ask for references and evidence of success in treatment. Non-traditional providers are often less expensive than mainstream treatment, but be sure it works by studying peer reviewed articles or conducting library research.

TIPS

→ There is an increasing body of scientific data on the effectiveness (or lack there of) of herbal and nutritional treatments for a variety of common mental health problems.

→ If you are uninsured (or under-insured) like a large minority of Americans, (and an even larger number of persons with mental illness) then government and non-profit agencies will be important to you. This system is ad-hoc and hit-or-miss more than the for profit system, so navigating it takes organization and persistence (which many with mental health problems do not have). Get help from friends, family and the local community in your search for care.

→ The Internet is a great source for information and support, but do not trust everything you read. The U.S. website of the National Institute for Mental Health is a good site to visit.

→ Medication is not necessarily the first treatment of choice for many problems, and medication alone seldom is so. Counseling and exercise (if appropriate) often make medications much more effective.

→ Taking responsibility for your own care is important. You are the best expert on yourself. Make sure you are well informed on the nature of your condition and the options for treatment.

→ Understand the risks of leaving it untreated, taking medications or treating it how you see fit.

→ Ask your care provider or pharmacist for information on the medications you may be taking, let them know of any questions or concerns you may have.

→ Keep track of your symptoms and track your progress. Since mental health is so subjective it can be hard to see without a record or journal.