Being healthy isn't just about eating nutritious foods, exercising, and not smoking. Sure, your physical health is important, but we can't forget about how our mental health affects our total health. Having the support of a therapist can be crucial for some mental health issues. However, spending money on a therapist isn't always feasible. Whether you don't have insurance, there aren't any in-network therapists in your area, or you can't afford the pricey fees, there are several barriers that may prevent you from accessing therapy. Fortunately, that doesn't mean you need to write off therapy entirely. Here are some ways to access low-cost or even free therapy or other mental health services.
Contact Your Insurance Company
Psychologist Amy Vigliotti, PhD, founder of SelfWorks [1], told POPSUGAR that insurance companies have to offer mental health benefits as part of the Mental Health Parity and Addiction Equity Act [2], which requires most insurance companies to offer equal coverage for both mental and physical health.
If you have health insurance, check to see what coverage you have for therapy; you may receive free sessions or have to pay a small copay. Contact your insurance company to find out how many sessions per month or per year are available to you and for a list of participating providers. It's probably best to call and talk to an actual representative instead of looking on the insurance company's website, so you can get the most up-to-date and accurate information.
Make sure to have your name and insurance ID number handy when you call. Dr. Vigliotti recommends getting a list of at least three to five participating therapists since some of them may not be taking on new patients at this time.
Sliding Scale
Sliding-scale pay may also be an option where a therapist or clinic and the patient determine an affordable session fee based on the financial need of the individual patient. "I know at some training institutes, it can be as low as $10 per session," Dr. Vigliotti said.
"Flexible payment models are definitely a thing most everywhere in the country," explained Thomas Kim, MD, a psychiatrist and adviser to Medici [3], a leading telemedicine platform. He added, "Finding those options will require persistence and patience as there is no central resource of who charges what and who accepts which insurance." You'll need to contact the therapist's office directly to discuss sliding-scale payment options.
Open Path Psychotherapy Collective [4] is another great resource that offers affordable, in-office and online psychotherapy sessions [5]. You can choose from this list of therapists [6], and each session ranges in price between $30 and $60. This service is a good option for those who don't have health insurance or whose health insurance doesn't provide adequate mental health benefits at an affordable rate.
Therapists in Training
But costs of deductibles and copays can still be cost prohibitive, Dr. Vigliotti said. So if finances are a barrier to your treatment, she said, you can seek professional help from training institutes, which offer low-fee sessions with psychologists or other mental health professionals in training. If you go to the American Psychological Association (APA) website [7], you can search for training institutes in your community that have been vetted by the APA as providing standard doctoral or postdoctoral training.
Each of these APA-accredited institutes should have a training outpatient mental health clinic where graduate or postgraduate students see patients for low fees (but not free). Graduate-level therapists are not licenced — they are gaining training hours toward licencure — but they are supervised by a licenced psychologist or therapist [8]. Some places could be as low as $5 to $10 per session. Postgraduate therapists are licenced, but they have returned to an institute for additional training and also offer low fees.
Dr. Kim also recommended finding therapists in training by calling the relevant departments in a school within your state of residence. "I imagine contacting any organisation by phone is currently difficult given our new reality," he said, and he recommended to keep calling. You can also email them through their website, and hopefully you can set up a teletherapy session [9] over the phone or video chat.
Hotlines
There are many hotlines available for free and confidential over-the-phone or over-text emotional support, 24 hours a day, seven days a week. In a previous interview, Adrienne Meier, PhD [10], explained that crisis hotlines can be beneficial to your mental health but are not the same thing as teletherapy [11]. Teletherapy refers to therapy sessions administered through HIPAA-compliant phone calls or video sessions from a licenced professional in your state. Regardless, hotlines can still be helpful, especially in a crisis. The below hotlines are free:
- NYC Well: [12] Text "Well" to 65173 or call 1-888-NYC-WELL
- National Suicide Prevention Lifeline [13] Call 1-800-273-TALK (8255)
- Substance Abuse and Mental Health Services: [14] 1-800-662-HELP (4357)
- Rape, Abuse, and Incest National Network [15]: 1-800-656-4673
- National Domestic Violence Hotline: [16] 1-800-799-7233
- Trans Lifeline: [17] 1-877-565-8860
- The Steve Fund [18] (for a young person of colour): Text STEVE to 741741
- National Eating Disorders Association: [19] 1-800-931-2237
Apps
If you want quick access on your phone, you can download an app to improve your mood and mental health, Dr. Vigliotti said. Helpful apps for relaxation, guided meditations, or ways to record and reflect on your feelings or mood include Headspace [20] (free two-week trial), Calm [21] (free seven-day trial), Buddhify [22] ($5), Daylio Journal [23] (free), Moodkit [24] ($5), Worry Watch [25] ($4), and Moodpath [26] (free).
Online therapy [27] is also an option where you receive text, audio, or video messageing from anywhere, at any time. You can use the Talkspace app [28] to find a licenced therapist by sharing some basic info and preferences. Or try the BetterHelp app [29], where you fill out a questionnaire and are then matched with a licenced therapist or counselor. Both cost $65 a week, and you get unlimited text, video, and audio messageing as well as weekly live sessions.
Support Groups
Support groups are a beneficial option, especially if you're nervous about working one on one with someone — being surrounded by people you relate to may make you feel more comfortable opening up. It's an effective way to make connections with other people going through the same issues such as depression, eating disorders, anxiety, or other mental illnesses. You'll share personal experiences, feelings, worries, concerns, information, and coping mechanisms. Here's how to find a support group near you:
- Find a meetup near you either by doing a Google search for "support group for _______ near me," looking on Facebook, or calling a local therapist's office for suggestions. Get specific about your search based on your needs, whether it's for anxiety, depression, or an eating disorder [31], for example. Here are some other resources for finding a local support group:
- National Association of Mental Illness [32]
- Anxiety and Depression Association of America [33]
- Mental Health America [34]
- Psychology Today [35]
- Depression and Bipolar Support Alliance [36]
- Lyf app: [37] Get support wherever you are with this virtual support group.
How to Manage Mental Health
In addition to professional help, self-care practices [38] can also offer benefits for improving mental health. Taking care of yourself by limiting stress, getting enough sleep, and eating a nutritious diet can all positively affect your mental health, Dr. Vigliotti said.
Moving your body regularly is another way to practice self-care. "Exercise releases the natural endorphins in your brain, which are mood boosters," Dr. Vigliotti said. She suggested trying to do 30 minutes of exercise daily, even if it's just a relaxing walk or some stretching.
"Low levels of vitamin D have also been linked to depression [39], so you can ask your doctor to test your levels and see if you would benefit from adding a vitamin D supplement to your daily regimen," she said. Cassie Majestic, MD [40], added, "If someone is deficient in vitamin D, of course that can contribute to depression [41] and supplementation may improve symptoms."
Journaling and talking to trusted, emotionally supportive friends or family can be so beneficial. In a previous interview, Sanam Hafeez [42], PsyD, a neuropsychologist and faculty member at Columbia University in New York City, said creating gratitude lists [43] can help with anxiety. Dr. Vigliotti agreed and said showing gratitude has been shown to improve mood [44] and optimism [45], lower anxiety and depression, and decrease negative thoughts that can lead to anxious feelings.
Focusing on personal development, like learning how to bake bread or play guitar, or making time for family relationships, like getting together for dinners, can also have a positive impact on your mental health and better equip you to resolve the challenge in front of you, said Dr. Kim. For some people, spirituality may also help, whether it's going to church, doing yoga, or being in nature.
"Anything that provides you enjoyment and interest is important for mental health. We need a balance of work, obligation, and leisure time," Dr. Vigliotti said. Make sure you leave yourself time to engage in your hobbies and interests, either alone or with loved ones.