How to Obtain Mental Health Services
North Star Psychiatry
Where to Seek Mental Health Services
Most people seek mental health treatment in the outpatient setting. Such treatment can be provided by primary care physicians, psychiatrists, and therapists. Primary care physicians can prescribe psychiatric medications, but not all doctors are comfortable doing so, especially when the patient has more complex treatment needs. But if the patient cannot find a psychiatrist or is waiting to see one, the primary care physician is usually a good place to start.
Finding a Psychiatrist
Psychiatrists are medical doctors who specialize in treating patients with mental illnesses. They prescribe medications and sometimes provide psychotherapy. They can also refer patients for specialized services, called “wraparound services,” to provide additional treatment and support. There are also nurse practitioners and physician assistants who specialize in psychiatry and can provide outpatient treatment. It is important to know that psychiatrists – especially child and adolescent psychiatrists, can be difficult to find, and many do not take insurance. It is often helpful to ask your insurance company for a list of local providers who accept your insurance. For children and adolescents, mental health treatment is frequently covered by Medicaid, although not all providers participate with Medicaid. If you intend to use insurance, depending on the plan, you may or may not need a referral from your primary care physician to see a psychiatrist.
Finding a Therapist
Many patients seek therapy before they try medication. Usually, therapy is provided by psychologists and other mental health clinicians. Most therapists are at the Masters or Doctoral level. Therapists are diverse in their training and treatment approaches. Some therapists offer specialized treatment for clients with specific conditions (i.e., trauma therapy, grief counseling, anger management, sex therapy, etc.), while others are generalists. Like psychiatrists, some therapists take insurance, and some do not. With such a varied mix of therapists, it can be bewildering to know which provider to choose. A psychiatrist will often refer patients for therapy and provide names of specific providers whom they recommend. However, without such guidance, it is important to learn about the therapist’s education, training, and treatment philosophy. And if all else fails, the conventional wisdom is to find someone you like and with whom you are comfortable sharing your feelings. In the end, the quality of the relationship between client and therapist is a major factor in determining the therapeutic outcome.
Seeking Emergency Help
When an individual is in crisis, he or she should seek emergency help right away. Examples of emergency safety concerns include recent suicide attempts, severe self-injury, suicidal ideation, homicidal ideation, severe aggression, acute agitation, a pattern of reckless or otherwise dangerous behaviors, and the inability to care for oneself. When such an emergency occurs, it is important to call 911 or a crisis line or go to the nearest emergency room or crisis center immediately.
Once at the hospital or crisis center, the individual will be evaluated by a professional, and a decision will be made as to whether inpatient hospitalization is medically necessary. A patient may be hospitalized voluntarily (called a “201”) or involuntarily (called a “302”). Usually, the emergency facility will perform a “bed search” to find space at a nearby psychiatric inpatient facility. In the meantime, the patient will stay at the ER or crisis center until a spot has been found for them at a hospital. It is not uncommon for this process to take time, sometimes even multiple days, because of the scarcity of available resources. Once a bed is found, the patient will be transported to the hospital, and inpatient treatment will begin.
Most people will receive inpatient treatment for about a week, although the length of stay can vary considerably. Upon discharge, the patient will receive referrals for aftercare services that the treatment team recommends. Services that are commonly recommended are outpatient psychotherapy, medication management with a psychiatrist, partial hospitalization, and intensive outpatient treatment. It is important to understand that the purpose of inpatient treatment is to achieve safety and stabilization in the very short term; most therapeutic progress occurs outside the hospital setting.