The New York Times has run two articles recently, “How to Find Mental Health Care When Money Is Tight” and “In Anxious Times, Medical Help for the Mind as Well as the Body” which ran 2 weeks ago. While I found many important and useful links and points of information, I was left wanting to clarify the points of cost and access.
Mental health practitioners are concerned first in helping people who want it. Yes, we are in this business to make a living, but part of the calling is also seeing that nobody goes without care when it’s needed. At MFT3 we have what is called a sliding scale fee structure. What that means is that we will reduce the rate to make sessions more accessible to a potential client. This policy is based on creating a relationship that is mutually satisfying; I don’t want a client coming in less frequently than therapeutically sustainable due to cost, I would rather take a smaller fee and create a better healing environment.
Of course, argument goes to the notion if someone is already in a depressed or anxious state, that discussing costs may not be a first thought or come naturally. I always discuss cost first over the phone but also check-in with the client as we move forward and adjust as necessary as situations change.
I have also developed a large and diverse network of collaborative professionals who are in every type of agency, and can refer to a no-cost practitioner if that best suits a client’s needs. I personally have never found the size of a fee having any impact – pro or con – on someone’s ability to be seen by a therapist. This notion flies in the face of the ethics of the field.
As we have been learning, not all insurance plans are created equally and the mere fact that someone has insurance does not ensure that they have good mental health coverage. Also, as jobs are lost so goes insurance in many instances. By having created a personal financial relationship separate from insurance via sliding scale, I find that clients are more apt to continue with sessions in the midst of job loss as a support through the depression associated with the loss, the work of finding a new job, supporting all family members through potential lifestyle changes, and so on.
My point is to always ask about cost, especially if it may be an extra stressor during an already tough time. As professionals, we are well aware and prepared to work with you in this matter. Yes, therapy will cost you money, but let us not underestimate the costs associated with not treating mental illness in a timely manner, too.
Please note that depression, particularly, is an isolating condition, and that getting out and finding a therapist is a very important step in breaking the solitary hold it can have on someone. If prescription medication is indicated, note too that some may take as long as 3 months to stabilize in your system, not a quick fix.
And always, if the need is critical, call 9-1-1 first.