By Jessica Roy
Therapy can be great. It also can be expensive.
The Affordable Care Act included a mandate for insurers to cover mental healthcare as an essential service. But consumers may discover a wide gulf between what’s technically covered by their plan and what they can afford. If your plan has a high deductible, you might be stuck paying hundreds of dollars out of pocket before coverage kicks in. Or you might not be able to find therapists in your area who accept your insurance. And depending on your cultural background, there might be a stigma around seeking traditional talk therapy.
“In a lot of circles and communities, especially communities of color and immigrants, you just don’t share that you’re getting help outside of home,” said Curley Bonds, a physician and psychiatrist and the chief medical officer for the Los Angeles County Department of Mental Health.
“A lot of people think of therapy as this indulgence as opposed to an effective treatment,” said Katrina DeBonis, a psychiatrist and associate clinical professor at UCLA. “They might think therapy is only for rich people. One part of it is realizing that’s not true.”
She said a number of plans contract with platforms for telehealth or other virtual therapies. If that’s not available, or if you’d rather pursue a different avenue of treatment, there are still lots of free and low-cost alternatives.
IF YOU NEED
HELP RIGHT NOW
If you are currently experiencing a mental health crisis, there are free phone- and text-based ways to get help. The National Suicide Prevention Hotline is available at (800) 273-8255; it’s also available for Spanish speakers at (888) 628-9454 and for those who are deaf or hard of hearing at suicide preventionlifeline.org.
If you can’t or don’t want to talk on the phone, the Crisis Text Line has crisis counselors available via text (send “HOME” to 741741), WhatsApp and Facebook Messenger.
Your workplace, school or place of worship: Check with your employer to find out if your job offers an Employee Assistance Program. These programs often cover several free sessions with a counselor.
If you’re a student, inquire about a school counselor. In both cases, the person you talk to won’t go to your employer or family and tell them what you talked about. Many churches, temples and other places of worship offer confidential support and counseling for free.
Warmlines: If you’re not at crisis level but just need someone to talk to, L.A. and Orange counties offer “warmlines” where you can chat or vent about whatever is on your mind, including anxiety, substance abuse or loneliness. Beyond immediate assistance, the person you speak to can offer advice and referrals. The Los Angeles County warmline is available from 9 a.m. to 9 p.m. at (800) 854-7771 (option 2). The Orange County warmline is available 24 hours a day, seven days a week, at (714) 991-6412.
Local resources through 211: Calling 211 from anywhere in the United States will connect you to someone knowledgeable about your local resources for all sorts of things, including mental health, rent and mortgage assistance, transportation, child and elder care, and job training. The 211 service is available 24/7 in California.
Support groups: Most places that offered in-person support groups pre-pandemic are still going the virtual route. The National Alliance on Mental Illness of Urban Los Angeles and associated chapters throughout L.A. offer weekly peer support groups over Zoom, led by trained facilitators, for people living with mental illness or their family members. Self-Help and Recovery Exchange has a regularly updated calendar of volunteer-run support groups, including ones that meet on Zoom or in person in Culver City and downtown L.A. Group topics include substance abuse, addiction, grief and loss, anger management and a variety of mental health conditions.
Online peer support: L.A. County offers 24/7 peer support through the iPrevail platform for free. You must be physically in L.A. County to register for the free account. Other cities and counties also offer free or subsidized iPrevail support; if your area doesn’t, it’s $9.99 a month. 7 Cups offers free peer support 24/7 with an option to upgrade to a licensed therapist for $150 a month.
Pandemic-specific resources: The L.A. County Department of Mental Health has published information and resources geared toward people experiencing anxiety, panic, grief, stress, frustration, depression or other mental health issues as a result of the pandemic. The department also partnered with the UCLA Public Partnership for Wellbeing to offer a guide to resources specifically for front-line workers, county employees and education and care workers.
Meditation: “Have you tried meditating?” might come off as trite but, really, experts say you should try meditating. “Practicing mindfulness can be helpful,” DeBonis said. “It’s free and evidence-based for a lot of mental health conditions. Not everyone takes to it right away, but it’s worth trying.”
Guided meditations and developing mindfulness practices can be powerful tools to support mental health. Apps like Calm and Headspace offer free trials and then paid versions afterward. If you’re in L.A. County, Headspace is still free.
LOW-COST ALTERNATIVES TO THERAPY
Sliding-scale clinics: There might be therapists or clinics in your area that offer services at lower rates based on your ability to pay. Google “sliding scale therapy near me” to see what’s available.
Graduate schools and teaching hospitals: If there’s a college or teaching hospital in your area, it may offer therapy sessions at reduced rates with clinicians in training. Contact them and ask what they offer.
Therapy apps: Apps such as Talkspace and BetterHelp offer therapy over text, phone or video, usually for less than the average sticker price of in-person sessions. They charge a per-session, monthly or annual fee, often with upsells for additional sessions or services.
Other mental health apps: If you’re looking for apps suited to a particular condition, issue or treatment type, you can browse more than 200 in One Mind PsyberGuide’s database. You can specify that you’re looking for apps geared toward things like “chronic pain,” “dialectical behavior therapy,” “PTSD,” “borderline personality disorder,” “productivity” and more.
Books and workbooks: Bibliotherapy is its own sub-discipline of therapy. But you don’t necessarily need a licensed bibliotherapist to find value from books or workbooks.
“You can make a lot of progress on your own if you’re motivated and can access a book from the library or from Amazon,” DeBonis said.