When You Can't Afford Mental Health Treatment

Though insurers are technically required to provide parity in coverage for physical and mental health conditions, the realities of coverage are much more nuanced and complex. Here’s what you need to know about coverage—and how to find help if you can’t afford it out of pocket.

Mental Health Coverage: Why Is It Still So Expensive?

Legislators and providers have been trying to fix mental health coverage for years. Providers need to be paid for their work, but that doesn't mean consumers need to go bankrupt footing the bill. The problem is that insurers often force consumers to jump through many hoops to get coverage—even when the letter of the law requires equal coverage.

Some of the coverage barriers people regularly encounter include:

• High copays and deductibles
• Coverage for only a small number of providers, who may not be accessible or who may not treat the issues for which you need care
• Needing a referral to a mental health care provider
• Being limited to a small number of visits, or to visits at relatively long intervals, such as monthly
• Spotty coverage for prescription drugs
• Coverage that requires a diagnosis before you can pursue mental health treatment. Not all mental health issues are diseases: For example, a couple can desperately need marriage counseling without either member of the couple having a mental health issue.

Mental Health Coverage Options Through Medicaid and Private Insurance

If you have Medicaid or private insurance, you have a right to appeal coverage decisions. You may also be able to seek an exception to coverage rules if the treatment you need isn’t covered, or if you can otherwise prove a medical need. Work with a therapist who is skilled at insurance issues, and who can submit claims to your insurer—or give you receipts so that you can submit the claims yourself.

Of course, not everyone has insurance. And even with insurance, coverage is a costly option for many people. Some other options for covering mental health care include:

Mental Health Care for Students and College Employees

Almost all colleges and universities offer some form of counseling. Students and current employees can often take advantage of this counseling for free, or at a substantial discount. If the counseling center at your school is unable to meet your needs, they may refer you to another center, and may cover all or a portion of the costs.

Other Options for Affordable Care

Mental Health Practitioners in Training

Mental health practitioners must accumulate a specific number of hours before they can become licensed to practice in the state in which they practice. Many schools that train mental health practitioners help them get their hours by offering discount mental health clinics. Try contacting a school near you for more information.

Sliding-Scale Clinics

Some mental health professionals offer treatment based on a sliding-scale fee system that’s adjusted according to need. A number of clinics also serve clients on a sliding-scale basis, often with fees as low as $10 or $20. Particularly if you live in a large city, a sliding-scale clinic may be your best option.

State and Local Health Departments

If you have a serious mental health condition, you may be able to seek counseling at a state or local community health department. Treatment is often based on need and financial situation, so call before you go. The CDC maintains a comprehensive list of public health departments.

Alternative Remedies

Alternative medicine is not a substitute for evidence-based psychiatric treatment. Some people, however, have good luck with acupuncture, massage, and dietary changes. There’s also mounting evidence that some nutritional supplements may help. For example, one recent study suggests that magnesium supplements could improve symptoms of depression. This makes it a lower-cost alternative to traditional treatment options.

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Lifestyle Remedies

Mental illnesses are real medical conditions. Like other medical conditions, lifestyle remedies can keep symptoms from getting worse. In some cases, they may even reduce symptoms. Every person with depression or another mental illness is different, and what works for one person might not work for another. In general, however, strategies such as exercise, eating a balanced diet, getting more sleep, initiating a regular routine, engaging in fulfilling hobbies, and spending time with loved ones can alleviate some mental health symptoms, but again, lifestyle remedies do not replace medical treatment.

Treatment Through a Primary Care Provider

Primary care providers are equipped to treat many mild to moderate mental health symptoms, including anxiety and depression. If you’re concerned about the costs of specialized care, ask your primary care provider about helping you to manage symptoms with medications and regular check-ups. You may be able to feel better with a little support and a few lifestyle changes.