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According to the United States Census Bureau, in 2012, there were 48 million people in the U.S. (which accounts for 15.4% of the under-65 population) without health insurance. Then, four years later (thanks in large part to Obamacare), these numbers fell by a whopping 20 million to about 27 million. So while on the surface, a large portion of the U.S. population is in some form covered by health insurance (89.6% in 2014), the United States remains the sole industrialized nation without universal healthcare. (For perspective, there are 32 countries with universal healthcare, yet, interestingly, on a per capita basis, the U.S. spends more than double the $3453 average spent by all developed and developing countries in healthcare.) Even with Obamacare, those who remained uninsured cited high costs as their reason for not being covered—many do not receive it through work or are ineligible for assistance programs like Medicaid. And annual premiums and deductibles for families and single coverage are rising at an alarming rate, forcing a notable percentage into bankruptcy in large part due to the inability to pay medical bills. The system is flawed at best.
Mental health coverage and substance use disorder services have been recognized as a primary need through most individual and small group health insurance plans, including Medicare and Medicaid (though it varies by state and plan). However, coverage still isn't within arm's reach or is too expensive for many individuals, so many have never had the opportunity to see a therapist or receive treatment, despite the fact one in five adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year. So we thought we'd share some options for cost-effective therapy below, whether you have insurance or not. It's time to beat the stigma of seeking help for mental illness, and beat it affordably.
Find a Therapist Who Uses a Sliding Scale Payment System
Similar to how it sounds, a sliding scale payment system means the patient's fee can slide either up or down based on their ability to pay, generally based on household income. This site will help you search for a therapist in your area who uses this system.
Try an App
Talkspace is a great app for people who can't see a therapist in-office or can't afford it. Once you download the app, you'll take an assessment, choose a payment plan (they start at $49/week), and then you'll be matched with a therapist who you'll chat with on a consistent basis. Most of the communication will be written, but you can also schedule a video chat.
BetterHelp is also an excellent way to access therapy at your fingertips without spending an arm and a leg. Trained and licensed psychologists, counselors, and social workers will be matched to you within 24 hours of signing up. Then, you'll be set up with a chatroom where you can message your counselor at any time, or do a video chat or a phone call. Your messages will always be saved in the chatroom so you can go back and reference them whenever you need. Costs range from $35 to $80 per week.
If You're a Student, Take Advantage of Your School's Clinic
I personally visited my school's counseling clinic when I wanted to speak with a therapist, and it was an amazing (and free) experience.
Visit Your Community's Mental Health Center
"Community mental health centers provide free or low-cost therapy options and services covered by Medicaid insurance," says Julie Hanks, LCSW, a therapist and blogger at Psych Central. Visit your state's Department of Human (or Social) Services website to find a center near you.
Consider Military OneSource
Confidential counselors are available for service members and their families at any time through Military OneSource at 1-800-342-9647. Active-duty soldiers may also have access to Embedded Behavioral Health, or a team of trained, licensed clinicians within walking distance of base.
Contact a Local Church
Even if you aren't religious, many churches offer counseling services through an in-house team of counselors or, if you're comfortable, through the priest or pastor, oftentimes at no cost.
Try Group Counseling
While there's a lack of privacy and anonymity with group counseling, studies show that meeting in a group setting is successful because of the shared sense of purpose and the support from peers who may be facing similar circumstances as you are. It's also generally more affordable than individual therapy, usually ranging between $40 and $90.
Reach Out to NAMI
If you're still unsure where to even begin and need help finding the right source for you, NAMI, or National Alliance on Mental Illness, vows to "monitor and advocate regularly to help ensure access to an array of treatments and services" for all people in need. You can reach them by phone at 800-950-NAMI or via email at firstname.lastname@example.org. It also offers classes, support groups, and presentations—check out the NAMI website to find a meeting group near you.
If you or someone you know is currently facing a mental health emergency, please dial 911 or contact the National Suicide Prevention Lifeline at 1‑800‑273‑TALK.