Currently, insurance in the US is required to have mental health and drug and alcohol services covered as part of its services. If the Affordable Care Act is revoked, it is unclear if these services will continue to be covered in the same way. Here’s some questions to ask yourself, and some resources to help with decision-making.
Do I have a written document to share with people about my mental health support and services?
Under Trump, we are quite likely to see the approval of HR 2646 or the Murphy Bill as it is popularly called. Under this bill, people with mental health diagnoses are likely to see rights to privacy and rights to choices in their treatment significantly eroded. One action that mental health consumers can take now before February is to write or update Wellness Recovery Action Plans(WRAP) and/or to write up a Psychiatric Advance Directive. Both of these models allow for mental health consumers to specify what we want and don’t want from hospitalization and to designate a person who we trust to implement these provisions that we specified in advance regarding treatments, medications, people we want to see, people we don’t want to see, etc.
This crisis toolkit, a collection of resources from The Icarus Project (TIP) can be very useful in navigating emotional health crisis. TIP also offers an online support group, and has coordinated this “Find A Buddy” resource for folks to offer peer support across distance in these hard times.
Do I have insurance that will continue covering the care that I need, including therapy and/or medications?
If not, here are some options.
Federally Qualified Health Centers These health centers are able to see people regardless of health insurance status. Many of them have behavioral health services. This site allows you to search for one nearby using zip code.
BetterHelp – online counseling, financial assistance available
Rad Remedy – RAD Remedy’s mission is to connect trans, gender non-conforming, intersex, and queer folks to accurate, safe, respectful, and comprehensive care in order to improve individual and community health.
Look at clinical and counseling programs at colleges. They often have cheap clinics if you are okay with seeing a counselor-in-training. Multifaith chaplains at colleges, in hospitals, and in prisons. By training, most chaplains, even those from a particular faith community, are expected to support people of all faith backgrounds and no faith background–including in providing space for organizing.
Psychoanalytic training institutes – Google “psychoanalytic institute” in major cities to find out if there is a clinic. Some clinics will take people paying as little as $5 per session.
There are also some resources listed on our Where Can I Go For Care? page.
If you lose previous insurance coverage and cannot afford the cost of prescriptions you’ve taken for your mental health diagnosis, the NeedyMeds Patient Assistance Program might be able to help you get a discount on your meds.
If there’s no way for me to get the care that I need, can I use stopgap measures like hotlines and self-care?
Note: Many of the numbers below are crisis routing services, meaning they direct calls to the nearest crisis center, and they determine that based on the area code. (e.g. If your number is a 212 number but you’re somewhere else, Lifeline will connect your call to a 212 crisis center.) Call a local line directly to reach counselors who understand what referrals are available. If you no longer live in the area code of your phone number: Google and call the direct number for your LOCAL crisis line if you need emergency services, location specific referrals for mental health care, etc.
- The Trevor Project
- For LGBT+ youth ages 13-24
- Open 12-6pm PST 7 days a week
- National Suicide Prevention Lifeline
- Lifeline Crisis Chat (text based)
- For anyone in crisis
- Multiple languages available
- Veterans Crisis Line: 1-800-273-8255
- Rape, Abuse, and Incest National Network (RAINN) Hotline
- 1-800-656-HOPE (4673) or go to http://online.rainn.org for confidential help 24/7
- If you’ve been affected by sexual assault
- Crisis Text Line
- Text NAMI to 741-741
- Connect with a trained crisis counselor to receive free counseling
- For anyone in crisis
- 24/7 crisis support via text message
- Domestic Violence Hotline
- Available for anyone in need of assistance related to domestic violence, in 170 languages
- Trans Lifeline
- National Alliance on Mental Health HelpLine
- Prepared to answer questions pertaining to symptoms, treatment options, local support groups, legal issues, education & employment issues, and helping family members
- M-F 10am-6pm EST
- State by state directory of warmlines
- Manage Election-Related Stress (a resource from the University of Michigan’s CAPS center)
- emergencykitten.com – New kitten pictures when you refresh
- Gifs to help breathe and relax
- Tools for self care and community care
- Tools for navigating mental health crisis
- Exercises for practicing compassion for oneself
- Grounding exercises
- Critical Self-Care Syllabus
- Everything is Awful and I’m not okay: Questions to Ask Before Giving up (a self-care/crisis management handout)
- Mood boosters (based on mindfulness and reflection)
- Guided Mindfulness Meditations (resource from UCLA Mindful Awareness Research Center)
- Women of Color self-care tips
- Mad Maps guide designed to help you understand power structures and the effect they have had on you
- You Feel Like Shit, a guide to help you through self-care when you’re not sure what you need, or what to do. (great for those with executive dysfunction)
- Meditative Tools
- The Quiet Place is an online space designed to create a place of quiet where you can relax and take a step back
- Pixel Thoughts put your stressful thought in a star and watch it float away
- Just a Thought A Steven Universe Song about meditation/letting go
- PTSD Coach App – designed by the VA with veterans in mind, but includes information about trauma, tracking tools, and support services. Free.
- Moodnotes Journaling App, allows you to record an experience/moment, name feelings associated with that experience, and then the app asks you questions to help deescalate negative feelings, think positively, and avoid traps that can lead a pattern of negative thinking. There is also security features to ensure privacy.
- There are a variety of free yoga classes available on YouTube – with different approaches and modifications possible for different bodies.
Now might be a good time to think about picking up new emotional wellness skills and practices. Maybe it might help to learn to eat for health or learn new chill out skills like meditation or yoga. Take up new hobbies that affirm your existence. Join with others in these activities and have accountability buddies. Seriously, lifestyle changes are really fucking hard and there’s going to be a lot of bullshit happening to make this difficult, but we need to not just survive the next few years we need to fucking thrive.
General tips on finding a counselor/therapist anywhere
Find a list of behavioral health providers in your area that either accept your insurance, or have sliding scale services available. Send them an email with questions, or ask to interview them on the phone. Let them know what you are looking for, a bit of your background, and ask if they are experienced in the issues you need help with. If they don’t initially feel like a trusting, genuinely helpful person, you may end up wasting your time seeing them to find that they are not the “right fit”. Ask to meet with them for a “trial session” if you are unsure. Most counselors are 100% okay with that and won’t charge you.
Always ask what insurance companies they accept and if your insurance will cover your appointments. Many therapists are listed online through Psychology Today. You can narrow your search by insurance coverage, therapeutic specialty, and credentials. Be sure to verify the insurance coverage with the provider as this information is the most likely to be out of date.
If you’ve experienced trauma, some people prefer a counselor who has advanced training in EMDR (eye movement desensitization and reprocessing) therapy. It is one of the only therapies recognized as a legitimate, effective treatment for PTSD by the World Health Organization (WHO).
If you have depression or anxiety, some types of therapy that might help are MBCT (Mindfulness-Based Cognitive Therapy), ACT (Acceptance and Commitment Therapy) and CBT (Cognitive Behavioral Therapy) because these have good evidence and have programs that can be run all the way through in a limited number of focused visits.
If you are living with a personality disorder or an eating disorder, DBT (Dialectical Behavior Therapy), might be a good option.