by Dwain Hebda
The first step in taking control of mental health issues – resolving to take action – is the hardest one. But what happens once you or a loved one is ready to get help?
“The therapy relationship is very personal, it’s really a ‘right fit’ thing,” says Ken Clark, practice director with Chenal Family Therapy. “It’s like buying shoes; don’t buy a pair you’re not going to be comfortable walking in.”
Clark recommends Psychology Today listings as a go-to first step. Most therapists within a given zip code have individual bios there, describing areas of expertise, practice information and other details. (See psychologytoday.com/us/therapists.)
Working through your physician is another good option. Most doctors keep one or two therapists in mind for such referrals and they can help the mental health professional understand your medical history and medications as appropriate. And don’t overlook asking friends or family members for recommendations.
“Some people feel uncomfortable with that, yet there’s few things that will direct you as quickly as somebody who’s had a good personal experience or a bad personal experience,” Clark says. “You can always do the ‘asking for a friend’ thing.”
Contacting a practice takes a simple call or email, but keep in mind therapists are like any other professional and the ones most in demand may not be taking new patients or have immediate openings. Also, be prepared to provide specific details about your situation.
“Be really clear with whoever you talk to, whether it’s the therapist or the scheduling team, what the problem is,” Clark says. “Tell them why you’re coming in and what ‘better’ feels like. Ethical therapists will tell you if something sounds like you need to go see a different person if your issue isn’t their specialty.”
Most insurance plans cover mental health services, but the scope varies widely. Therefore, it’s vital to thoroughly understand what your insurance policy covers before starting any kind of treatment. Larger practices generally have insurance verification personnel who can provide some direction, but the patient needs to take the lead here.
“Check with your provider, especially if you’re working with a smaller practice,” Clark says. “The insurance company itself is going to be the best expert on what your plan covers and how it applies to you.
“Also, watch for changeovers in plan years, resetting deductibles and things like that,” he adds. We always get clients who are painfully surprised; maybe they started therapy in October when it was mostly covered and then their deductible reset in January.”
Finally, Clark says, treat the first few sessions as a test drive. Therapists each have their own style and that style won’t click with every patient. If you don’t feel compatibility, keep looking.
“You need at least two to four sessions to decide if it’s a right fit personality-wise, regardless of expertise,” Clark says. “There is absolutely no shame, and any therapist should be OK with somebody saying, ‘Hey, you’re smart, but not exactly my style. We’re going to keep shopping.’
WHAT TO DO IN AN EMERGENCY
There are times when quick action is required, namely when a person is a danger to themselves or others. Clark offers the following steps for making the right call in these situations.
To understand the level of crisis, assess the person’s intent to act (wants to hurt themselves or others) means to act (has a way to do it) and plan to act (knows when they’ll do it). When in doubt, always call 911 or head for a hospital emergency room.
“Once we start answering ‘Yes’ to those questions – one of them, much less three of them – then it goes from, ‘We’re going to call somebody Monday morning,’ to ‘We need to get somebody somewhere now,’” Clark says.
“Safety is always the first priority. If a hospital doesn’t have an in-patient unit for mental health, they can make a referral and will help transport.”
Situations below crisis mode can be harder to gauge. Clark recommends calling a mobile assessment team available through local hospitals and mental health facilities. As the name suggests, these teams come to you to help assess the situation and recommend the next step.
“This doesn’t just apply to people who are maybe suicidal,” Clark says. “This could apply to situations where people are delusional or showing signs of psychosis or schizophrenia where you can’t afford to wait eight weeks to get in to see someone.”