Millennial Money: Getting therapy when cost is a barrier

FILE - A woman walks inside a hallway on Monday, Aug. 6, 2018, at Commonwealth Health Moses Taylor Hospital in Scranton, Pa. There are several things that can prevent you from getting therapy or other mental health treatment. A social stigma against needing that kind of help is a big one, as is the inability to take time out of the workday for appointments. But for many, the biggest blocker of all is the cost. You might not find a lot of therapists in your area that take your insurance, and even if you do, they may not be accepting new patients. Thankfully, you can access affordable mental health care through work or school, at teaching hospitals or through a therapist offering reduced pricing. (Butch Comegys/The Times-Tribune via AP, File)
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By SARA RATHNER of NerdWallet

The race to find mental health treatment can feel like a marathon when you may not have the energy or ability to even make it to the starting line. You may be faced with limited affordable options and a lack of available therapists.

“Prior to the pandemic, we had an inadequate workforce to meet the mental health demand of the country,” says Vaile Wright, who has a doctorate in counseling psychology and is the senior director of health care innovation at the American Psychological Association. “And that has only been exacerbated by the pandemic.”

According to the APA’s 2021 COVID-19 Practitioner Survey, 43% of psychologists reported an increase in overall number of patients compared with 2020. At the same time, 41% of psychologists said they couldn’t keep up with demand and 46% felt burned out.

Thankfully, there are multiple ways to access care at a variety of price points, including telehealth options.

USE RESOURCES THAT YOU MIGHT ALREADY HAVE

Your employer may offer an employee assistance program, or EAP, which can connect you, your spouse or partner and your children with various services including short-term counseling. Review your benefits to see what your EAP provides, if you have one.

If you have school-aged children, their guidance counselor can be a helpful resource not just for academic concerns, but also for more personal, social and behavioral issues. College students may also have access to free or low-cost counseling services on campus.

And don’t forget primary care physicians and OB-GYNs. Annual preventative care visits, which are free with insurance, are an opportunity to talk about your mental health. Your doctor might prescribe medication or refer you to other practitioners. Dr. Carlene MacMillan, co-chair of the American Academy of Child and Adolescent Psychiatry Consumer Issues Committee, recommends setting aside time during your routine appointment to talk about your mental health.

“If you’re healthy mentally, physically it’s easier to take care of whatever else is going on,” she says.

SEARCH FOR PROVIDERS WHO TAKE YOUR INSURANCE

You can search for in-network providers through your health insurance company, but MacMillan cautions that the information there might be out of date. Double-check with Psychology Today (yes, as in the magazine). Its website has a search tool you can use to find therapists, psychiatrists, treatment centers and support groups. According to MacMillan, the search results from this tool could be more up to date than some insurance databases.

Alma and Headway are two additional websites where you can search for providers who accept your health insurance.

ASK IF THERAPISTS OFFER REDUCED PRICING

Many therapists set aside appointment slots for patients who can’t afford the full hourly rate. Ask therapists in your area if they accept patients on a sliding scale, meaning they lower their rates based on your income. And if you’re open to group therapy, that can cost less than seeing a therapist one-on-one.

You can also look beyond private practices. “Most places, at least cities, have community mental health centers that offer a sliding scale,” says Nance Roy, chief clinical officer at The Jed Foundation, or JED, a nonprofit with the goal of supporting and protecting mental health for teens and young adults.

Open Path is a nonprofit that can help you find affordable care if your household income is less than $100,000 a year and you either lack health insurance or your insurance plan doesn’t offer mental health benefits . You can join their mental health collective by paying $59 for a lifetime membership. From there, you’ll be able to access therapy for a per-session fee of $30 to $60 for individual counseling, or $30 to $80 for couples or families.

TURN TO TEACHING HOSPITALS

Hospitals and universities in your area may have programs where you can see a clinician in training, who is supervised by a licensed practitioner, for a lower cost. Look for local teaching hospitals or colleges with psychology programs.

GET HELP VIRTUALLY

Use of telehealth expanded because of COVID-19, when privacy regulations adjusted to allow more ways for patients to communicate with medical professionals. Even now that in-person appointments are back, virtual appointments are still an option that’s especially convenient for anyone who previously had to take off work or pay for a babysitter to attend sessions.

“The possibilities of how you can consume mental health care is where the disruption really happened,” says Heela Gonen, vice president of strategic partnerships and communications at BetterHelp, an online therapy platform. “You see that people are not going back.”

Mental health platforms like BetterHelp and Brightside make it possible to communicate with a therapist on a video or phone call, or through text. For kids and teens, MacMillan recommends Little Otter and Brightline.

ADD ON SOME SELF-CARE

While you search for a therapist, or in between appointments, it can be helpful to incorporate mindfulness practices into your day, like meditation, breathing exercises or even just going for a walk and observing everything around you.

“The research is clear on the value of mindfulness in terms of promoting mental health,” Roy says. “It’s not about stopping your thoughts, it’s about letting them pass.”