How to Access Behavioral Health or Mental Health SErvices

It can be hard to find someone to treat problems involving emotions, thoughts, or behaviors.  These tips are to help you (or someone you care about) get an appointment with the right kind of mental health care provider.

Step 1:  Decide how urgent the need for treatment is.
If you or the person you are helping is thinking of suicide or killing someone else, or if there is concern for their safety, do one of the following:
-See your doctor, if you can get an appointment soon.
-Call the crisis line in your county (you can find the number through the operator, or on-line at http://www.dshs.wa.gov/dbhr/mhcrisis.shtml)
-Call the national suicide help line 1-800-273-8255, TTY Users 1-800-799-4TTY (4889)
-Go to the emergency room

Step 2:  Talk to your medical Primary Care Provider (PCP), if possible.
Even if you are getting treatment now for a mental health condition, ask your PCP about what options may be available to you for additional services.  PCPs typically can recommend mental health providers or treatment settings, or may have access to special programs within your health care system.

Step 3:  Determine the type of health insurance benefit you have.
The insurance you have is very important.  Figure out if you have (1) private insurance; (2) public insurance like Medicare or Medicaid, or Medical Coupons; (3) no insurance.

PRIVATE INSURANCE:  contact your insurer to learn the following:
-How many visits are allowed?
-What is the co-pay for each visit?
-What providers accept the insurance as “preferred” providers, and how can you contact them?

PUBLIC INSURANCE:  determine what services are available to you, by calling the insurance office.
    -MEDICARE call 1-800-562-3022
    -MEDICAID call 1-800-772-1213

NO INSURANCE:  If you do not have health insurance, you will need to contact a community behavioral health agency to see about eligibility.  You can do this by:
-Calling a behavioral health agency directly 1-866-4CRISIS
    
-Calling the county mental health line (see the information above, on Step 1)

Step 4:  Figure out what kind of provider would work best for you.
Different types of mental health provider see different types of patients.  It is sometimes hard to know which would be able to help you most.  Often people can be helped by any or all of them.  Roughly the differences are the following:

Psychiatrists are medical doctors.  They attend four years of medical school and then at least four years more of training (“residency”) to learn about mental health.  They specialize in the diagnosis and treatment of mental health conditions.  They can prescribe medications to treat mental health problems, but may also offer psychotherapy or group therapy.

Clinical Psychologists are specialists in mental health problems and in their assessment and treatment.  They study psychology for four to six years, and then complete at least one more year of clinical and/or research training (“internship”).  They offer different types of treatments, including psychotherapy, group therapy, or family therapy.  They do not prescribe medications.

Licensed Mental Health Counselors are trained professionals, who take classes and complete clinical training in mental health problems.  They often focus on educational and strength-based rather than medical approaches to dealing with problems.  They offer psychotherapy, and individual, family, and group approaches.  They do not prescribe medications.

Licensed Independent Clinical Social Workers (LICSW) have a Master’s degree in social work.  They are trained through supervised clinical work experience, and have passed national- or state-certified licensing exams. They offer psychotherapy, and individual, family, and group approaches.  They do not prescribe medications.

Psychiatric Advanced Registered Nurse Practitions (ARNP) have education and training in nursing, and have completed an approved Master’s or Doctoral advanced nursing education program, which includes clinical training.  They can prescribe medications to treat mental health problems, and may offer other types of treatment.

If you are unsure which type of provider would be most useful to you, you can discuss this with your primary care doctor, or contact different providers and briefly tell them the types of problems you are having.
 
Step 5:   Ask for a referral, and get an appointment.
If possible, ask your PCP for a referral to a mental health provider.  This may be an important step for your insurance.
Identify providers whom you may be able to see, and call them.  It can take a number of calls before you can find someone who is available with new appointments.  Please do not give up.
If you are having trouble finding any providers who can see you, call your insurer (or the crisis line), and give them details about your difficulties, such as a list of all the providers you called, and what they told you.

Step 6:  Go to your appointments.
Please try to make your appointments if at all possible.  Not showing up will often mean that the provider will not be able to see you again in the future.

Step 7:  Don’t give up.
Even though it may be hard to find the right person, in the long run you can find someone to help you work through your difficulties.  The following ideas can make it more likely that you get the most from treatment:
-Agree to a “trial period” of a certain number of sessions with a provider, after which you will decide if you want to stay with them.
-Ask your provider for a specific treatment plan.  How long should the treatment take?  How will it work?  What is expected of you?  Will this involve more costs than your insurance company will pay?
-If you feel like your provider is not giving you the type of help you want, tell this to the provider.  If they argue with you, or cannot accept what you say, find someone else.