Finding mental health help on a budget

The Senate may be debating health care reform, but passing legislation is far from a slam-dunk. For Americans who need help now with mental health issues, there are many low-cost options that can be found, if you know where to look.

Finding treatment

Whether you're suffering from stress or fighting with your spouse, there's a mental health expert trained to handle your issue. So put a call in to your local hospital, settlement house, charity, community mental health center, or psychotherapy or psychoanalytic institute. Many will provide care on a sliding scale -- some even for free. For example, rates at New York City's National Institute for the Psychotherapies start at $45, but for students, they begin at $30 and for the unemployed, $35. Adds board of director member Erika Nagy, "We are very flexible depending on a client's needs."

Another low-cost resource is a medical school or university with a mental health clinic. While many of the practitioners are being trained, they are closely supervised so quality of care remains high, says Dr. Jenn Berman, an L.A.-based psychotherapist and bestselling author.

You should also check to see if a nearby treatment center offers any affordable plans. Terri Hayden, director of Hazelden in St. Paul, says their out-patient programs can cost $20,000 less than the in-patient ones. Hazelden also offers some financial assistance for patients who can't afford the insurance co-pays. In addition, the center, which has locations in New York City, Chicago and Naples, FL, operates a 24-hour phone line -- 800-257-7810 -- to help people figure out what kind of assistance them may need and what they can afford.

Life coaches who are overseen by a psychiatrist or psychotherapist may be another inexpensive option, says Dr. Keith Ablow, a psychiatrist and bestselling author.

If you're in the military or have family in the military, check out the page for military families on the American Psychological Association Web site, for a list of places you can turn to for help and other resources.

But if someone comes highly recommended to you, it doesn't hurt to reach out and see what you can work out. Dr. David Palmiter, a public education coordinator for the American Psychological Association, says many of the practitioners he knows will help and accept a lower fee or can recommend low-cost options. He suggests going in for a consultation and, during that meeting, being honest about what you can afford.

"They're very patient driven," says Palmiter, who is also a professor and director of the Psychological Services Center at Marywood University. "They are very caring people and form an attachment to [patients]. I don't know a single psychologist who doesn't have a patient on reduced fee."

Support groups

Alcoholics Anonymous has been letting people help each other for decades. And since its founding, it has spawned support groups for everything from narcotics to gambling. If you prefer the anonymity of the Internet, there are online support groups like, which was started by Ablow.

"You fill out a profile and the site matches you with others who are similar in age, life circumstances and are confronting similar problems," he explains. "Since it's free, it's cost effective."

Do an Internet search and you'll find that most mental health disorders are represented by a nonprofit organization. On the National Eating Disorders Association (NEDA)'s Web site, for example, there is a list of where you can get help. If you don't have a computer, call the help line -- 800-931-2237 – and someone will assist you in finding options within your region and, if you have insurance, how to get them to pay for it.

"Eating disorders are not just a mental illness but also a physical illness," says NEDA CEO Lynn Grefe. "People with an eating disorder are destroying their organs. They are starving their bodies. It's important to work with someone who has experience. And usually it's a team. There has to be someone monitoring the physical health, so that's usually a MD, not just a shrink. Insurance rarely or barely pays for coverage. It's a terrible challenge."

Dial up help

Sometimes help is just a hotline call away. The most famous is the National Suicide Prevention Lifeline or 800-273-TALK. But there is also 800-SUICIDE and Covenant House's NINELINE (800-999-9999). Manned by crisis managers, they are free and open year round.

Hitting the books

Browse the library or bookstore. Chances are someone has written about your issue. Ablow recommends Self Creation by George Weinberg and Betrayal of the Self by Arno Gruen, Gaetano Benedetti and Ashley Montagu. Or check out CDs and DVDs that can help you relax and learn to mediate.

As Dr. Patricia Farrell points out, it's natural for people to feel stress during these tough economic times. As stress increases, so do feelings of "helplessness, often hopelessness, problems with sleep, eating and interpersonal relations. Self-esteem begins to suffer and the result is depression, anxiety and physical illness," says the clinical psychologist and WebMD Moderator for Anxiety/Panic.

Put yourself first.

Even though you may be getting help at below market prices, don't be afraid to go back to a clinic or organization if you don't think you and the expert are a good fit, says Berman. "People sometimes feel they have to accept whatever they get, but you really want to make sure that the expert is the right person for you."

Just as important, let whoever you're working with know how many sessions you can afford. Ablow says not everyone needs lifelong therapy. "Make it known from the very beginning that you intend to work on the problem for, say, 10 sessions, and at the end, you need a healing result. There are therapists who will take that challenge and can deliver a good outcome."

For those who have no insurance and are stuck going to a local hospital's ER or community mental health center, he urges you to be honest about the severity of your problems. "Never understate the problems in an attempt to keep a stiff mental upper lip," he says. ""Given our broken mental health system, they will show you the door. You have to be forthcoming about your problems."
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