It’s a scary time for a lot of people—and if that’s taking a toll on your mental health, you’re not alone.
Nearly half of adults in the U.S. reported their mental health has been negatively impacted due to worry and stress over the coronavirus, according to an April Kaiser Family Foundation poll. On top of the pandemic, recent high-profile police killings of Black people have called for anti-racism protests to erupt globally. All of this leads to a need for accessibility to mental health services.
The good news is, there are a lot of options out there for people who can’t afford expensive treatment.
Here’s how to start your search.
Do you have insurance?
Thanks to the Affordable Care Act, most people with health insurance now have mental health benefits, says Joel Young, a psychiatrist and the medical director of the Rochester Center for Behavioral Medicine. And even if you don't have insurance now, you likely qualify. Medicaid, funded by the federal government and individual states, provides millions of low-income Americans with coverage. You can file today; the process varies by state.
We know: figuring out the ins and outs of what your insurance covers can be tricky. Call the number on the back of your insurance card—many will have a contact number specifically for mental health services—and ask for the details. (They can also help you find a provider once you get to that step).
“Many times the insurance companies will do the hard work for you but people don’t really know that,” says Kimberly Morrow, a licensed clinical social worker in Erie, Pennsylvania.
If you're insured through your employer, you likely have another option at your disposal. Over 97% of companies with more than 5,000 employees and 80% of companies with 1,001 to 5,000 employees have "Employee Assistance Programs," according to the International Employee Assistance Professionals Association. These vary in structure—some include legal and financial counseling, or health-risk assessments—and many will foot the bill for up to eight therapy sessions for their employees.
“It’s worth it for everybody to ask their employer,” Morrow says.
If you have insurance but high deductibles or copayments are keeping you from therapy, check in with your insurance company. Many are currently waiving these so-called "cost shares" due to the pandemic. Aetna and Empire Blue Cross Blue Shield, for example, are waiving cost shares for telehealth mental health services through September 30, 2020.
If that proves unsuccessful, know that many doctors are open to decreasing their copayment, or are willing to go on a sliding scale if you explain your situation, Young says. If you tell them you lost your job and are currently searching for a new one, they might lower the copayment until you’ve landed a new gig.
Some mental health care providers offer sliding scale fees based on your specific situation right off the bat. These usually depend on income; the lower yours is, the less you have to pay. The payment varies, though: Some therapists charge people who make between $30,000 and $40,000 a year $40 per session and those who make between $120,000 and $150,000 a year $150 per session, while others use a formula to determine their fees (like 0.001 multiplied by your annual income), according to OpenCounseling.
The website for the Open Path Psychotherapy Collective has a network of therapists that offer a fee on the sliding scale of $30 to $60 for individual counseling. You can connect with their therapists around the country in person or online.
Reach out to local health centers
In addition to the sliding scale options listed above, there are other options for low-income and uninsured Americans.
For starters, the federal government helps fund community-based health care providers, which aim to care for people in underserved communities, in almost every county, Young says.
You can find these centers through the U.S. Health Resources and Services Administration website. OpeningCounseling, a website that connects people to free and low-cost counseling, also has a guide to these services in each state, with details on eligibility, how to find local programs and mental health clinics and access numbers. All of these clinics take Medicaid, and some take private insurance.
Finding a therapist in training is another way to access mental health care at a lower cost. Training clinics, especially those associated with universities, will often offer reduced fees for you to meet with someone still getting trained up. These are usually students interns and residents working towards their PhDs in psychology. You’ll want to find places with those PhD programs, Morrow says, and ask if they have reduced rates through a training center. You can find many of these centers via the American Psychoanalytic Association.
Even if you see a student therapist or young therapist who is not exhaustively experienced, they’re being supervised by someone who is more experienced, Young adds.
See if outside funding is available
With a little research, it’s possible to find an outside source to help pay for therapy, or a nonprofit offering sessions for free or at low cost.
Some therapists are creating programs specifically for the Black community—a group that is struggling tremendously with the news of recent police killings.
“They’re realizing how much it hits close to home,” says JaNaè Taylor, a licensed psychotherapist and founder of Minding My Black Business, a platform dedicated to supporting the mental health needs of Black entrepreneurs and business people. “That really makes the day-to-day struggle even harder.”
Saleemah McNeil, a reproductive psychotherapist and founder of the Oshun Family Center in Jenkintown, Pennsylvania is offering free therapy to Black residents in and around Philadelphia with donor funds. While her original goal was to raise $5,000 and conduct all the therapy sessions herself, she recently raised over $81,000, which is footing the bill for 46 people in treatment with eight different therapists. You can join the waiting list for therapy (or donate to the cause!) via the Oshun Family Center.
The Loveland Foundation—an organization that provides financial assistance to Black women and girls seeking therapy across the country—is another option. And Ourrelationship.com offers online programs to eligible couples for free as an alternative to in-person couples therapy via a grant from the Administration for Children and Families.
Try a virtual solution
Although online apps can never take the place of a traditional therapeutic relationship, they are a low stakes way of learning some of the same skills that you'd get at an in-person session—like recognizing and challenging thoughts, identifying emotions, and meditation.
“You have access to them 24/7,” Morrow says, adding that if you’re in the middle of a panic attack, you can reach right for your phone, write down the symptoms and some apps will be able to talk you through methods a therapist might tell you.
Her clients have liked Calm and Headspace for meditation, NOCD for treating obsessive-compulsive disorder, Thought Challenger for recognizing the changing unhelpful thinking and Woebot to reduce anxiety and depression.
There are new apps popping up everyday. If you're overwhelmed by all the options, the Anxiety and Depression Association of America have reviewed many of the mental health apps on their effectiveness, ease of use and more.
These days, many centers and private therapists are also offering telehealth options.
"It's a game changer," says Taylor, adding that now people can squeeze therapy in from the laundry room or the car when they might not have been able to make it to an in-person session.
Taylor works with BetterHelp.com, an online counseling platform that recruits licensed counselors to meet with people via exchanging messages, chatting live online, speaking over the phone or video conferencing. You can find counselors on a sliding scale of $40 to $70 per week for unlimited access to your counselor.
“It is exhausting to go through all of those channels to find the one that is financially feasible and a good fit for therapy,” McNeil admits. “But just hang in there because someone is there for everybody.”