Finding Mental Healthcare Treatment

Brag time:  Recently a private pay option offered by Solutions Counseling and Consulting was recognized in a local news story titled "Finding Mental Health Services For the Uninsured."

For me, offering this option to clients is a no-brainer.  In an email response to the reporter who wrote the report, I said, "When I don't have to bill insurance companies, I pass the savings on to clients."

As it turns out, offering treatment alternatives to clients pays off in a win/win scenario.  Over the past few months as I have seen the private pay portion of my practice grow, it is apparent that this alternative to traditional mental health treatment is catching on.  Surprisingly, many clients with insurance are also choosing this method of payment.  Here are some of the reasons this private pay plan is a good option for consumers of mental health services:

1. Consumers have limited or no mental health benefits.  Although mental health parody was included as part of an economic bailout in 2008, a large portion of our population remains without benefits.  Those who do have benefits are finding that employers are cutting both traditional health benefits and mental health benefits in response to the current economic crisis, making out of pocket costs higher across the board.
2. Diagnoses that can be billed to private insurance companies are limited.  In other words, having insurance coverage does not guarantee payment.  Here's a direct quote from a common provider of health insurance concerning things which aren't covered:  Treatment for conduct and impulse control disorders*, personality disorders, paraphilias and other Mental Illnesses that will not substantially improve beyond the current level of functioning, or that are not subject to favorable modification or management according to prevailing national standards of clinical practice, as reasonably determined by the Mental Health/Substance Abuse Designee.  And another:  Mental Health Services and Substance Abuse Services that extend beyond the period necessary for short-term evaluation, diagnosis, treatment or crisis intervention.  In spite of laws addressing mental health parody, we obviously still have a long way to go.  Can you imagine an insurance company saying that health insurance could not extend beyond short-term treatment, or that conditions that aren't subject to substantially improve won't be covered? Diabetes?  Cancer?  Heart conditions?  High blood pressure?  You'd be out of luck.  (*Conduct and impulse control disorders include, but are not limited to:  ADHD, Asperger's, and Autism, all common mental health disorders that are not covered by insurance.)  
3. Other treatments not commonly covered by insurance:  marriage/couples counseling, family counseling, and grief counseling (unless the consumer has a diagnosable condition).  At that point you have to ask:  Do I want myself or my child to be diagnosed with a mental illness in order to receive counseling?  Many times counseling can benefit individuals and families going through temporary life crises without needing to receive a mental health diagnosis.
4. Terms surrounding treatment of pre-existing conditions:  For many people, when benefits change due to changes in employment or coverage offered by employers, pre-existing conditions are questioned or not covered.  Another point about pre-existing conditions:  In order to bill insurance for treatment of diagnoses not covered by insurance (see above), providers often bill treatment under a co-morbid or duel diagnosis, with the secondary diagnosis being listed as the primary diagnosis.  (For example, a client with ADHD could receive counseling under a diagnosis of depression or anxiety, provided they meet minimal diagnostic criteria.)
5. Some problems don't require mental health treatment.  I have also recently updated consulting services offered on my website as a way to address parent and family needs for access to information and resources that often prevent the need for costly mental health treatment later on.  Families who access these services typically meet with me once or twice to discuss concerns and get ideas about handling problems that can lead to much greater concerns later on.  It is not uncommon for parents to struggle with questions and concerns about parenting, development, sleep, rules, and relationships and want sound information and ideas that would help them to help their families.  We live in a difficult world where children are often the target of environmental assaults such as internet addictions, gaming addictions, pornographic material, bullying, discrimination, etc.  These difficult circumstances make parenting difficult, and guidance through difficult behavioral and discipline issues can be helpful.  Why seek mental health treatment and diagnosis for common problems associated with keeping families safe and healthy?

The reasons for considering alternatives to traditional mental health treatment are many.  As a practitioner, I've enjoyed expanding services and offering treatment alternatives to clients which I feel puts them in the driver's seat of their own health care.  As a culture, we may be making strides in the treatment of mental health disorders, but meanwhile, it feels good to be addressing a few of the holes in our current system.

If you or someone you know is considering counseling, or alternatives to counseling, contact Mary for more information.