January 4th, 2011
10:29 AM ET

How can I get mental health services?

Question asked by Daniel Peterson of Pueblo, Colorado

How can I get acceptable mental health services? I am 31, living off of Supplemental Security Income and have Medicaid. I cannot get assistance to have all basic essentials met. I am limited to what can be done alone without money or being able to walk or go too many places at once. I just need to know what to do.

Expert answer

I have been thinking for a number of weeks about your question. I wish I could tell you what to do in a practical way that would meet your needs. Because of my line of work, I know a lot of folks in your situation, and it's really rough. I think I've been avoiding answering your question because it made me feel so bad that so little is available to so many people in our country who need help the most.

Be that as it may, let me make some general suggestions. You included the city where you live in your e-mailed question. You are fortunate compared with many people in that you have fairly extensive psychiatric facilities in your area. Having said that, I don't know enough about your city to suggest exactly what you should do.

So let me make some general suggestions. One can often get better treatment at county-based mental health clinics than with private doctors who accept Medicaid. There are several reasons for this. First, the clinics don't have the same need to turn a profit as doctors in private practice do, so they are often willing to spend more time helping. Second, they often have a range of programs that one can use as needed. I spent a fair amount of time looking through the county mental health clinic for your city, and it looks pretty good to me.

Sometimes a change in perspective can also help a person deal with all the hassles and frustrations of trying to get mental health care with minimal financial resources.

I often tell patients that they should treat getting the best care they can like a job. Think about it. Most folks work 40 hours a week to put bread on the table. If you devoted 40 hours a week to working on how to optimize your mental health treatment, as well as social services, you might find many doors opening to you. Persistence is everything - persistence and patience.

If you take my advice to heart, try not to get frustrated or angry with people in the health care system. Patient-but-persistent friendliness on your part is the best way to get them to want to help you.

soundoff (50 Responses)
  1. Trish McFadyen

    Dear Dr.,
    There is very little help for mental health patients. My husband and I are the parents of a 10 year old adopted daughter who has mental health issues. If I were to win tonight's mega millions the first thing I would do is put together a foundation that were assist those who need mental health services and cannot afford the services and the prescriptions. My husband and I are both employed and have insurance, but our insurance falls short for mental health benefits and where we can go for help. We need more mental health services. If you could help me find funding for a foundation to grant funds for mental health I would be appreciative. I am going to research a way to fund those who provide quality mental health services for those who cannot afford it. Thank you for your time. Trish McFadyen, Port Royal, SC

    January 4, 2011 at 10:52 | Report abuse | Reply
    • Daina

      You can't get mental health services (not a big enough cash cow for hospitals to bother with) send a thank you note to Ronnie Reagan, the republican party and our lovely for-profit 'healthcare system' sarcasm intended.

      January 4, 2011 at 14:02 | Report abuse |
    • LS

      Try appealing to your insurance company. Under the mental heath parity act, you should be able to get decent mental health coverage. Also, contact NAMI, they can help you navigate services. This is your local chapter: http://www.nami.org/MSTemplate.cfm?MicrositeID=121
      They also have a link to the mental health services in your area. Have you tried these clinics:
      Coastal Empire Community Mental Health Center (CEMHC) – local mental health agency
      After hours crisis line: 800-922-7844 Hilton Head Clinic:
      o 151 Dillon Rd., Hilton Head Island 29925; 681-4865
      o Area coordinator: Omega Smalls-Francis Beaufort Clinic:
      o 1050 Ribaut Rd., Beaufort, SC 29902
       524-3378 (Adult Services)
       524-2610 (Child and adolescent services)
      o Clinic Director: Jerry Stewart
      Worst comes to worst, try taking her to an emergency room or local crisis center. Good luck! I hope you are able to get her help.

      January 5, 2011 at 18:21 | Report abuse |
  2. V West

    The person you are referring to must live in a major city or large county. This local help could not be further from the truth. I was nice at first and resorted to begging for help and got no where for my son who is now 24. This was four years ago. He was unable to complete college. I had to announce our problems to the world newspaper and tv in order for help to come, before that all I got was I am sorry there is nothing we can do! If he had been treated immediately for first episode (without warning) schizophrenia maybe his recovery would have been possible or at least helped so he and the rest of the family would not have had to suffer so. It is ashamed that no one cares if it is not happening to their loved ones. Sorry trying hard not to be bitter. My son now has full disability, Medicare and Medicaid why did it have to take so long?

    January 4, 2011 at 11:30 | Report abuse | Reply
    • LS

      When your son was in college, did you try sending him to his school's counseling center? Or health services? That would've been my first course of action.

      Also, Schizophrenia doesn't strike without warning. But the signs can be hard to spot.

      January 5, 2011 at 18:15 | Report abuse |
  3. Bipolar in North Texas

    I use a Dallas County Mental Health Mental Retardation clinic. MHMRs function differently depending on the county in which you live. The one where I am functions fairly well. If I miss an appointment it is not the end of the world, because I can show up early in the morning another day as a "walk-in" and eventually see the doctor. I usually bring a book to read, or something to do while I am waiting. After the visit with the doctor, she will prescribe meds and I go back out to the lobby to wait 45 mins to pick them up from the pharmacy which is located within the clinic. Depending on your coverage, you may or may not have to pay anything for your meds and you may or may not have to go to a separate pharmacy to get them. Right now my psychiatrist is trying to figure out whether I also have ADHD, or if those symptoms are actually related to bipolar mania. I am taking a lot of depakote at increasingly high levels. I'm interested to know what others' experiences have been regarding their mental health treatment. Here is a helpful website with some resources: http://www.theicarusproject.net

    My experience while living in Austin, TX was horrible. Travis County MHMR is very poorly organized, is understaffed and overburdened. They do not have sufficient funding. The doctors there prescribed me Seroquel and Zyprexa without warning me of the risks for weight gain due to changes in metabolism and diabetes. But to be fair, I was not very responsible and missed a lot of appointments, after which I was placed at the end of a very long waiting list. My choices were to either wait anywhere between 3 months to a year to be contacted by MHMR, check myself into a hospital in order to be placed directly into MHMR services upon release, or get a Travis County Medical Assistance Program insurance card and go to a Travis County indigent health care clinic to see a doctor who could refer me back into MHMR services. I did the latter and ended up billed over $200. I refuse to pay the bill.

    January 4, 2011 at 11:43 | Report abuse | Reply
  4. Mary

    I used to work in the mental health services and would run into a lot of clients with these problems. I am not familiar with Colorado, but County Mental Health is a good place to start. My sister has Tourette's and as an adult, we had a lot of difficulty. She received basic services for her multiple conditions at CMH. The first thing that has been suggested to me for my sister was to go to the Emergency Room if things get really bad. They cannot turn you away and can refer you for treatment. Secondly, there are County Clinics that take sliding scales and one can be seen for very little. Those Clinics can do a lot and can work with you on getting medication for free through the drug company itself. If the depression is based on being a victim of a crime, and a police report can be found, you can get help through the Victim's of Crime Program for counseling. If you are disabled through a disease, contact that disease website: i.e. "Lupus" or "Diabetes" and their foundations can give much information on getting the help you need. Lastly, finding a support group can do wonders for depression AND can be a wealth of information as you will come in contact with others just like you who may have already done the leg work. A support group in your area would be the first thing I would look into as these people are dealing with the same issues, and talking about how you feel, and not feeling so isolated and alone will help immensely, let alone that a support group can be a lifeline to help that you might not be able to find on your own. Hope this helps!

    January 4, 2011 at 12:25 | Report abuse | Reply
    • LS

      See my link below. It takes you to the website with the lists of mental health centers in your area.

      January 5, 2011 at 18:10 | Report abuse |
  5. Mary

    P.S. If you go to the ED, as the person above did, make sure you ask for County assistance before you check in and express that you are indigent. No need to have further trauma getting a bill you can't pay. I don't know about Colorado, but here in California this is what you can do. Of course, no one will tell you this at the front desk, and you have to fill out the paperwork before you are seen.

    January 4, 2011 at 12:27 | Report abuse | Reply
  6. VLH

    As a psychologist in private practice, I understand that there a lot of providers who provide sloppy work simply because managed care has made it difficult to stay in business without taking shortcuts or writing incomplete reports. However, please do no lump all of us in that barrel of rotten apples – some of us take a hit every time we bill Medicaid, Medicare, or private insurance, but if I ever have to resort to poor service to make a buck, I'll get out of the business

    January 4, 2011 at 12:37 | Report abuse | Reply
    • LS

      I interpreted the doctors comment about providers in private practice is that if they take Medicaid they are likely not very good or inexperienced and thus can be sloppy and cut corners.

      It's great that you take medicaid patients! Its hard enough to find decent psychotherapists or psychiatrist that'll take private insurance, the situation for medicaid is even worse.

      January 5, 2011 at 18:09 | Report abuse |
  7. Margaret

    This is a serious problem that effects all citizens whether they realize it or not. It upsets me so when a tragedy happens and the media and talk shows repeated tell people to get help if they are experienceing problems. Is there immediate help in this country anywhere? At one time there was a year waiting list in my area and I think they are good. It is just getting to be a patient that is the problem. Often the wait is too long. With the mood of the couontry now i can't see it getting any better. i think the advice to join a support group was probable the best in the short term.

    January 4, 2011 at 13:15 | Report abuse | Reply
  8. Kate Klingensmith

    Another alternative is to check out the National Alliance for Mental Illness. They have a lot of great programs. There support groups, called Connections, is a great place to find others who have traveled the road you are on. Also, if people don't have prescription coverage throught insurance, they can get free medications by contacting the pharmaceutical companies directly. Look for Patience Assistance Programs at the manufacturer.

    January 4, 2011 at 13:29 | Report abuse | Reply
  9. Laura

    I work in mental health nursing. When asked to identify her "goals for treatment" a recent new admit stated "I need you to get me an apartment, a car, an allowance to live on, and all my meds paid for." then cursed the casemanager who told her that was unrealistic. Those clients make it harder for everyone else. I love the article's suggestion that people consider it their "job" to spend time and effort getting services...now if only the rest of us can make enough (reasonable) assistance available.

    January 4, 2011 at 15:12 | Report abuse | Reply
    • V West

      Did it occur to you that that person was probably manic when he/she said those things?

      January 4, 2011 at 15:46 | Report abuse |
    • LS

      ummm. this person was probably psychotic or manic and/or joking with you.

      January 5, 2011 at 18:07 | Report abuse |
  10. Lisa Wysocky

    I live in Nashville, Tennessee. My bright, funny, talented son had schizophrenia, depression, panic disorder and anxiety. When he maxed out his mental health benefits at age 19 there was nowhere to turn. For various reasons he did not qualify for state or county services until he became homeless (by choice), but by then he had deteriorated so much I could not get him to go. He passed away July 25, 2009 at age 23 of a heroin overdose. I have started a nonprofit called Colby's Army to bring attention to this issue, but while we are doing a lot of good, it will not bring my only child back.

    January 4, 2011 at 15:47 | Report abuse | Reply
    • Teresa

      Lisa – your post is heartbreaking. So sorry for your loss, I can't even imagine. Its difficult to understand how our country can do so much for certain groups but little or nothing else for others. Mental health impacts every other aspect of one's life and should be taken as seriously as other illnesses and must be managed. My son (17) also suffers from depression, anxiety and possibly ADHD. Our insurance doesn't cover mental health services but we try to afford what we can. I understand the frustration of wanting to help your child and hitting obstacles at every turn. It's just not right.

      January 21, 2011 at 12:18 | Report abuse |
  11. Rodney

    I was treated at Spanish Peaks Mental Health for 7 years. As to the following, I know exactly what I'm talking about. Go to thier main office at 1304 Chinook (If you use buses, the university or belmont bus will get you there.) or call them at 545-2746. Tell them you want an intake for services. Make sure to tell them you are on SSI and that you have medicaid – this will help you get services sooner. If they put you on a waiting list, make sure to call every week to see what number you are. If you've had your name on a list for a month, ask to see an emergency services worker to try to push your name higher on the list.

    Don't bother trying to get meds or services from Pueblo Community Health center. Last I knew, they don't have a psychiatrist on staff and won't write scripts for psychotropic meds. State hospital won't take you unless you are referred by another agency/hospital.

    January 4, 2011 at 16:49 | Report abuse | Reply
  12. LS

    You are in luck! I did some research for you and there appears to abundant mental health services available in Pueblo and surrounding areas through the Colorado department of human services. They accept Medicaid as well as sliding scale. Here is the link: http://www.cdhs.state.co.us/cmhip/mentalhealthcenters.htm I would start calling the centers nearby and ask to see someone there.

    For others in your situation, look for mental health centers in your area as well as universities in the area that may have clinical psychology or clinical social work training programs or med schools, usually if they have such a program, you can see supervises advanced doctoral students or psychiatrists in training (sometimes they are already doctors) for free or low costs. Often times the care you get by the supervises trainees is top notch. Also, you maybe able to get in a clinical trial and get free psychotherapy that way!

    January 5, 2011 at 18:05 | Report abuse | Reply
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