Rebecca Resnik, PsyD  
Bethesda, MD

Specialties: ADHD, dyslexia, developmental delays

Interests: Developmental Disabilities
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Affordable Mental Health Care: How to find free or reduced-fee treatment in your area

Jan 14, 2009 - 22 comments

Affordable Mental Health Care: How to find free or reduced-fee treatment in your area

The following is a guide to finding affordable psychological and psychiatric services in your area. Many people call or write me asking how they can find treatment if they do not have insurance or can not pay their deductibles. It is extremely frustrating to need help and not be able to afford it, even if you have insurance. It is sad that many insurance companies do not cover psychological and psychiatric services to the extent that all of their subscribers can access care. Unfortunately, many psychologists can no longer afford to participate with insurance companies or Medicaid/Medicare. The reasons for this include low reimbursement rates, frequency of denied payment for services, and the burden of insurance related paperwork. While the situation is problematic, there is no reason to assume that you can not get the care you need.

On the bright side, if you can take the time and energy to search, you have a good chance of finding someone who can help. First, here are some terms to be familiar with:

Sliding Fee Scale—this means that the clinician will adjust the price of services in accordance with your ability to pay
Community Mental Health Center—a public, non-profit agency that provides mental health treatment
Pro Bono Services—Free services offered to those in need. The ethical code of the American Psychological Association encourages psychologists to do pro-bono work, and most do some form of uncompensated service.

Do not be shy about asking clinicians if they can accommodate your financial situation. If they can not, they should be able to refer you to someone who can provide you less expensive treatment that would meet your needs. You may also find that a psychologist will agree to conduct a short-term, focused treatment on a specific problem. Ask if you can come every other week or monthly. Ask if there is a payment plan. Some psychologists are willing to provide therapy over the phone or through the computer if your work schedule makes it difficult to attend sessions.

Here are some ideas for where you can find free and affordable mental health care:

1. Call your general practitioner. Your physician should have a list of places he or she is comfortable sending you.
2. Contact an advocacy group’s local chapter. Organizations such as the National Alliance on Mental Illness (http://www.nami.org/Template.cfm?section=your_local_NAMI, Alcoholics Anonymous (http://www.aa.org/lang/en/meeting_finder.cfm?origpage=29), or the Association of Retarded Citizens (ARC) in your area will be able to help find treatment for specific needs. Advocacy groups typically maintain lists of local community therapists and respite care providers.
3. Contact your local hospital. Hospitals take insurance, including medical assistance. Call the Behavioral Health or Outpatient Psychology/Psychiatry department. Teaching hospitals (those that train student psychologists and psychiatrists) may be particularly good sources of less expensive care.
4. For urgent matters, try a crisis hotline. Even if you are not in immediate danger of harming yourself, they can still help. The people who answer the phone will have lists of places you can go where you can be seen as quickly as possible, even if you can not pay.
5. Ask your child’s school guidance counselor or school psychologist. Part of that person’s job is to refer students and families to local mental health care services.
6. Contact your local division of social services. You can often find this through your county’s website, or through private social service organizations such as Jewish Social Services (jssa.org).
7. Private ‘find a therapist’ websites such as www.therapists.psychologytoday.com/ will let you search for providers who are willing to offer sliding scale or pro bono care.
8. Local colleges and universities often maintain clinics that provide care to the general public. These clinics can be contacted through the departments of Psychology, Counseling, or Social Work. For example, if you went to the George Washington University Center for Professional Psychology website, you would find a link to the Center Clinic (http://www.gwu.edu/~cclinic/PsydCenterClinicContactUs.html). The Center Clinic is an example of a training clinic staffed by doctoral students who are supervised by licensed psychologists.
9. If you are a member of a religious community, clergy members can often refer you to pastoral counseling or other mental health care providers who have a spiritual orientation to treatment.

Good luck!

Post a Comment
Avatar universal
by schway01, Jan 14, 2009
Thank you for this post. I have found that the sliding scale is a Godsend for medical treatment, at least for immediate and most general needs. I found out that the local hospital has one as well. You just need to ask. I only wish more private practice could offer a scale. Maybe this is something on the horizon.
What caught my eye about your post is, finding mental health centers that offer a sliding scale. I had honestly never even thought of it, because when I had insurance I could barely afford it. I was diagnosed with depression and bi-polar disorder over 5 years ago, and have not had any follow up since losing my insurance in 2005, and no real care since the fall of 2003. I think I have done fairly well, as I am also dealing with neuropathy and spinal issues which make life miserable. I feel sorry for my family in all of this, because of some pretty wild mood swings. (like a rollercoaster)

Again, thank you, for making me think outside of the box.

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by ILADVOCATE, Jan 15, 2009
Yes I think those are some very helpful guidelines but one thing I've noticed for myself is that with Medicare and Medicaid (especially Medicare Part D) that although denials for coverage and prescriptions are constant and it really overwhelms professionals (including psychologists and psychiatrists) to have to write up the appeal letters, denials for coverage once appealed can be exempted (and this applies to other forms of insurance as well) and independent living centers (there is one in every county of every state
can provide help with appeals for coverage as well as agencies such as the Medicare Rights Center. Denials for coverage including for prescriptions and direct representation can be handled by a variety of agencies so that psychiatrists and psychologists won't have to deal with these difficulties. With many people that have a low income, Medicare and Medicaid are their only feasible options and there are agencies that will help with the bureaucracy that often prevents them from being feasible coverage options for some providers.

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by Sondra1952, Jan 28, 2009
Thanks for the information.  I've suffered with a panic disorder, agorophobia, PTSD, and the last 3 years, horrible depression, which I've now been on disability for since 2/07, and have not worked since 6/06.  When I finally became eligible for Medicare this January, I almost cried when I saw that they only pay 50/50 for mental health professionals.  So frustrating.  With an income of under $15,000/yr., how the heck can a person afford to get healthy?  And I seem to be running into the "we don't take new medicare patients", too.  I'm actually so tired, and feel so all around crappy, that I'm finding it hard to even muster up the energy to keep looking.  I'm also trying to wean myself off of a 25 yr. addiction to klonopin, which obviously no longer is working, and am down from 3 mg/daily to .75 mg/daily.  Haven't seen an increase in my panic disorder, just my depression and dizziness (I am doing the taper very slowly).  Anyway, I wish I could find a Dr. that could work on the problem without just prescribing these drugs, as I'm beginning to wonder if the long-term cause of the drugs is causing the depression.  Sorry, didn't mean to digress there.  Thanks for the info.  I wish I had the energy to lobby for better mental health care, but I don't.  Boy, wasn't this an uplifting post!

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by Sondra1952, Jan 28, 2009
P.S.  I've had the panic disorder/agorophobia for 31 yrs., but it's been under control for a good share of that time, up until 2/06 when I was in a car accident which seemed to really kick it into high gear, also bringing along this mind-blowing depression, which was something new.  Wierd, huh?

Avatar universal
by junglejim46, Jan 28, 2009
You just don't know how long I've waited to somehow find possible ways around this.  The information has been so long waited for.  I was really beginning to think there was no where to turn to for help.  It has given me so much to look into.  I, personally can't thank you enought for the information and help.

Avatar universal
by jpeek345, Jan 28, 2009
This is much needed. I could write a book on navigating the mental health entity in this country with roots inherited from Wilhelm Reichs posit on "all mental illness".
There are many paths to "help". It is the greatest irony of civilized man that the government allow a pharmaceutical market to judge the temperature of mental illness in it's own country (over 100 million persons using psycho-pharmaceuticals) while it does nothing to recognize the bane mental illness is to its people. Not to mention the lost work hours and vaccuumed-out economy.

Avatar universal
by bearcubs, Jan 28, 2009
Thank you so much for getting this information out.  I have received many types of counseling over the years, most of it paid for by insurance or was provided through my work.  But I must say that the very best treatment I received was at a cost of only $10.00 per visit (to cover the paperwork costs only) and was through one of those programs where Psychology students were working on their degrees and were being supervised by a licensed clinical psychologist.  The bulk of my treatment consisted of EMDR and TIR for PTSD.  I had been through many different types of medications and whatnot but no one had suggested or attempted anything like EMDR until I got a student who was WONDERFUL.  It was a win-win situation.  He was learning from me and I was finally receiving the right kind of treatment for me.  I had to sign some forms, of course, acknowledging that he was learning and that my case would be seen and reviewed by a clinical psychologist, etc, etc, etc.  I was no longer on any antidepressants and during treatment, I was able to discontinue taking the anti-anxiety meds because we had dealt with the root causes.  I can now recognize the signs before a situation arises and am now able to work it out myself without having to resort to meds.  There have been the occasional times that I have had to take something for a day or two (deaths in the family, etc.) but they have been normal situations that anyone would find stressful and need help dealing with.  

I was given the student's name through a psychologist who was the leader of my prayer group.  I had told her that I found the psychiatrists and psychologists in my area to be very secular and some even anti-catholic.  The student was a christian but not catholic but he was very understanding of how my catholic faith permeates every aspect of my life, most especially with moral issues and family issues.   He moved from my area but our work together had come to a close anyway.  I tell everyone I know about the student teaching program offered at our local university extension.  I believe you can find out through any college or university in your area that offers psychology programs. Just like any other service, you have to find the right person for the job.  If one student doesn't work out for you, keep trying until you get one you are comfortable with.  

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by paloma88, Jan 28, 2009

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by Rebecca Resnik, PsyDBlank, Jan 28, 2009
Thanks for all of your kind words, I very much appreciate your taking the time to write. Please feel free to share any more tips from your experiences so others may benefit.


Avatar universal
by BigWally48, Jan 28, 2009
Where I live, HHS is trying to get mental health patients of the help.  I lost Medicaid so have to work with Medicare - including the monthly premium and $40 co-pays on a $800 a month Disability check.  Yes, I need the help I had the help, but then it is slowly getting taken away!

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by DrKay, Feb 01, 2009
Dr. Resnick, what do you do if you have a complaint about a psychologist?  he was nothing like what you described above.

Avatar universal
by secretmtnlion, Feb 14, 2009
What hole have you been in? Obviously you don't suffer from a severe form of any psychological disease!!!!  I do and as I also have a degree and a job in mental health, I tried all of your suggestions, many times- from sliding scale, medicaid, student doctors and psychologists, call in centers, homeless shelters, drop in free clinics-everything.  All of them told me to try different suggestions you mentioned which I had already tried.  NAMI IS A JOKE.  Once again, NAMI IS A JOKE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  A new group for mental health is needed and I will start it if I have to.  I knew enough about my mental illness that in my search for help I knew I was sliding downwards but no one would help me!!  I couldn't afford healthcare coverage at my work, and they had a 6 month waiting period to even get mental help.  I'm healthy besides my mental illness and I couldn't afford the insurance premiums even if I tried.  Everyone at my job knew what was going on with me- thanks to a horrible boss who told everyone yet I couldn't get help and was fired.  By then I was in such a mess I couldn't even take care of myself day to day let alone think about a civil liberties case against my old job!  Eventually I wound up in the hospital for a month!!!  It pisses me off to hear people like you tell the same **** over and over again to people with severe cases of mental disorders, because these people are usually so far on the bottom, they can't get help.  It's not just me, everyone in the hospital had the same story as me!!  I am a mental health professional and I still couldn't get help just because of money- I had none and the only reason I had a roof over my head was a kind landlord who looked the other way when I couldn't pay rent and brought me food.  Do you want to know the real caveat to me and a lot of those people in the hospital?  The hospital stays all costed tens of thousands of dollars and the hospital winds up eating the cost due to the destitute nature of the patients.  But the hospital stays could have been prevented for over half of even the severely mentally disabled if they could have just found help!

Avatar universal
by jules0864, Aug 19, 2009
I have had lots of similiar struggles, as i have read with other on here. The mental heath issues and trying to get the help I needed. It took years to find my way. I am better now in many ways but still struggle with my mental heath issues at times and I feel like therepists I have seen are trying to ease me out. saying I am doing better and that the agency wants to discontinue services. Why is this happening exactly?? I have medicare and now medicaid too. I have a condition that doesn't just go away and things get hard at times-and i need a trained professional to talk to. Does anyone understand the reasons behind them trying to end my therepy.

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by Rebecca Resnik, PsyDBlank, Aug 20, 2009
Hello Jules,
   my guess would be that it has more to do with your insurance than your wish to continue improving your mental health. Reimbursement is very low for both medicare and medicaid, thus many clinics can not afford to accept it and stay in business. Usually only hospitals or agencies who receive public funding can provide these services. In order to get any reimbursement at all, agencies must get approval to provide treatment to people with medical assistance insurance. If your condition improves, then your clinicians are likely to be denied approval to continue your care. I am hoping that our country finds a way to improve this dreadful situation.

Best wishes

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by aprilolthoff, Nov 02, 2009
hello :)
ive been having anxiety problems,do you know where i can get help?
i take prozac 10 mg

Avatar universal
by marcyd, Dec 05, 2009
Affordable health care is a matter of doing your homework and shopping around.  Unfortunately, these days many consumers are suffering from a lack of income which also reduces the resources that are available to shop and research health care.  Wellness center directory style sites such as http://wellnesscenters.com are a great starting point to search for local health care.  Consumers can view doctor profiles, read consumer reviews and find contact information to make an informed decision when it comes to health care.

Avatar universal
by stella113, Aug 03, 2010
My daughter desperately needs inpatient care, but has no insurance and is disabled and unemployed. Are there any teaching hospitals or non profit in patient institutions she could go to in the US?

Avatar universal
by freetravelr123, Nov 08, 2010
i don't have health insurance and i lost my job with almost no saving, can someone please point me a direction where i can get profefssional help.

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by lurella41, Jan 11, 2012
Thank you for all of your wonderful ideas and resources for finding help.

Avatar universal
by romaakter002, Nov 20, 2012
great tips. Its amazing how many parents do not take their children outside at all. Walks are so healthy and so fun for the kids (and the workers!)

please follow this link:-
find child care

Avatar universal
by jimbolatta, Oct 01, 2017
Dealing with depression, anxiety and insomnia now for 17 years has given some perspective. I've been in and out of the hospitals too. One was for 2 1/2 months. Which, by the way, was the best one due to the patient timing of care. I'm on medicaid and medicare and fortunately work part time as a peer recovery coach helping others with the same illnesses.
My vision is to create a non profit center for treating and healing mental illness that has a beautiful environment, excellent nutrition, wonderful and compassionate health professionals, peer support and a spiritual element. It might be in Syracuse, NY. All the seasons will be enjoyed and a part of the healing process. If you're in support of such a vision. Let me know. jim.***@****

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by rosealvina, Feb 22, 2022
Thanks for sharing such an amazing and informative guide. This is good and helpful for those who are suffering from mental health issues and are not in the condition to afford therapy this helps them a lot in getting free services and to overcome their issues. Keep up sharing such kind of helpful things which is good for others.

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