Ken Duckworth, MD
Ken Duckworth, MD, chief medical officer of the nonprofit National Alliance on Mental Illness, Arlington, Virginia, and author of You Are Not Alone: The NAMI Guide to Navigating Mental Health.
NAMI.org
It is a sad fact—people struggling with mental health concerns often end up struggling to find a therapist to help them. In fact, it’s not uncommon these days to call every in-network therapist in a geographical area and not be able to find a single one who is accepting new patients. Many therapists were stretched thin even before depression and anxiety rates shot up during the COVID pandemic.
But don’t give up. Ken Duckworth, MD, chief medical officer of the National Alliance on Mental Illness, says there are ways to find the help that you need…
Be persistent with your insurance provider. The first step is obvious—call therapists in your area who are in your insurance or Medicare Advantage plan network. Don’t just call one or two—work your way down the list of local mental health providers on the insurer’s website, calling every one who seems appropriate for your needs. If you have Original Medicare, use Medicare.gov to search for therapists who accept Medicare-approved payments.
If you can’t get in the door with any of these therapists: Contact your insurance provider or Medicare Advantage plan and ask for help finding an appropriate mental health professional who can take you as a new patient. Insurers have a responsibility to provide their policyholders with access to necessary health care.
If this fails: Reach out to local providers who are not in-network, and ask if they are willing to take you as a new patient. Then file a formal appeal with your insurer requesting that it cover your treatment from this out-of-network provider as if he/she were in network. This written appeal should explain why you require care and detail your unsuccessful attempts to obtain it from the insurer’s in-network providers, including your failed attempt to have the insurer locate a provider for you.
If this request is rejected: Ask how you can appeal the rejection, then try again. Appeals are not always successful, but considering the high cost of paying for therapy out of pocket, it is always worth trying.
Ask your primary care physician for help. Your doctor’s practice might have a social worker on staff to deal with patients’ mental health needs and/or have contacts among local mental health providers. He/she also might be able to provide some basic mental health services, such as prescribing antidepressant medications, if appropriate.
The following can provide useful support, though they might not fully replace a therapist…
Call volunteer support “warmlines.” These free services let callers chat with trained volunteers, not therapists.
The National Alliance on Mental Illness (NAMI) HelpLine is available across the US (800-950-NAMI)…or ask your local NAMI chapter if there are additional warmlines or other resources available in your area. To find your local chapter’s contact information, visit NAMI.org/findsupport. Your local NAMI chapter also might recommend therapists in your area who are taking new patients. Warning: Warmlines are not crisis hotlines. If you are having a mental health crisis, dial 988, the suicide and crisis lifeline…or go to an emergency room.
Speak to a pastoral counselor. Many religious organizations offer counseling, but the quality varies—not all pastoral counselors have extensive training. Ask your faith leader what his/her experience is with counseling people who have had similar experiences and symptoms. They often can work in concert with traditional mental health providers.
Join a peer support group. Mental health organizations including NAMI (NAMI.org), Mental Health America (MHA.org) and the Depression and Bipolar Support Alliance (DBSAlliance.org) offer in-person or Zoom-based peer support groups that are similar to the well-known Alcoholics Anonymous meetings.
Contact psychology clinics at local universities. Academic centers that train psychologists and psychiatrists often offer therapy from therapists in training. These trainees lack extensive experience, but they typically are overseen by experienced instructors. Before signing up, ask how closely the trainees are supervised and who provides that supervision.
Consider online therapy services—but be aware of their issues. Services such as Talkspace (Talkspace.com) and BetterHelp (BetterHelp.com) connect patients with licensed therapists over the Internet. But the effectiveness of these services has not yet been well-established…and they’ve had some troubling privacy lapses. Example: BetterHelp recently paid a $7.8 million fine for sharing its customers’ data for advertising purposes.
