When You Can’t Afford Help

The cost of mental health care can seem daunting. Whether it is a lack of insurance coverage, high deductibles, job loss or other money woes, finances often lead many people to suffer rather than seek treatment. With a little creativity, however, there are often ways to get help.

First, let’s look at some low-cost options for professional treatment:

Public and private mental health agencies. Most agencies offer an income-based sliding scale, and accept public assistance such as Medicaid. Many have caring and competent therapists, along with the resources to handle issues like medication, crisis intervention and serious or persistent mental illness.

Colleges and universities. Graduate students in psychology are one of my favorite resources for therapy. First, their fees are extremely reasonable: in my area, local university mental health clinics charge as little as $15 per session. Second, graduate interns are often up on the very latest clinical skills and supervised by top experts in the field.

Pre-licensure candidates. Most states require thousands of supervised hours to become a psychotherapist, and clinicians working toward licensure are often eager to see clients at little or no cost. State associations of fields such as social work, mental health counseling or marriage and family therapy may be able to help you locate clinicians in training, as well as larger mental health practices.

Pro-bono therapy. Many private therapists honor an unspoken professional obligation to treat a certain number of people at little or no charge. Don’t be afraid to disclose your financial situation to therapists and see what is possible. Also, your local mental health association (a consumer advocacy group distinct from mental health agencies) may be able to arrange treatment options you can afford.

Finally, here are some resources that can help or support you in addition to formal professional help:

Crisislines. Crisis counselors are available 24 hours a day from anywhere in the United States at 800-273-TALK (8255). You do not need to be suicidal or desperate to call: their job is to listen empathetically, direct you to resources, and help you take next steps in any situation. Crisis counseling is NOT psychotherapy, and not designed for the treatment of ongoing mental health issues. But trained volunteers are always there to talk with you.

Support groups. Live or online support groups can be a source of both information and fellowship. Support groups are also not meant to take the place of therapy, and are not for everyone – specific groups can vary widely depending on their participants or leadership.

Community-based programs. Many areas offer low cost therapist-led training programs for mental health skills such as managing your anxiety or controlling your emotions – check your local community activity listings. My own Anxiety Camp program, for example, teaches people in upstate New York how to deal with fears and phobias in an intensive weekend program costing less than $100.

The common thread through all of these ideas is: don’t give up when the cost of care seems overwhelming. Ask questions, explore resources, and keep trying. Your good mental health is worth it.