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Finding mental health services for your child can often seem like an immense challenge. Beyond the obstacles of stigma and shame, there are multiple barriers to obtaining help, including locating an available specialist who is licensed and trained amid a national shortage, navigating the complexities of the mental health system — public and private — engaging the school system for support and finding the right match for your child.
However, overcoming these challenges is possible with the right resources, support and determination.
Here are a few tips on how to help your child get the care they need.
In the absence of a national health care system, the mental health system is incredibly complex and confusing, even for doctors. It looks different in each state and often in communities within the same state. It’s important not to get discouraged — here are some tips to help you get started.
Health insurance can be complicated, and insurance policies vary, even those within the same company. Coverage of mental health services is typically different from coverage of other medical care. Call your insurer and ask what your policy covers (including outpatient, inpatient, partial or day programs) and ask what the copayments and/or deductibles are. Ask if your policy is an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) and request a list of providers who take your insurance.
One advantage of a PPO is that if your policy does not work with a provider you want (out of network), you could be eligible for partial reimbursement for paying out of pocket. Ask how much the insurance company would pay for a provider’s services — “the allowable fee.”
Be sure to see what the provider charges and compare that with the insurance rate. The reimbursement is usually a percentage of their allowable fee, not the provider’s fee. So, 70% reimbursement may be far less than you think, depending on what the provider charges. Sadly, many providers do not take insurance, but you should be able to get some reimbursement if you have a PPO.
If you have a Medicaid or an Affordable Care Act plan, you may not be able to see a clinician in private practice depending on your plan, and, unfortunately, it can be more challenging to get reimbursement from these plans. In this case, call hospital clinics or large group practices, as they frequently take all types of insurance.
Additionally, some hospitals have psychiatric walk-in clinics for urgent care, and this avoids the hassle of emergency rooms. However, you should choose this option only if you are confident that the situation is not an emergency but serious enough that your child is showing symptoms of a mental health condition.
Federal legislation mandates that public schools provide evaluation for children who have difficulties that interfere with their ability to learn. These difficulties include things like vision, hearing and also emotional or behavioral problems that interfere with academic or social functioning. Every parent or guardian has the right to request a complete evaluation of their child. This may include a clinical evaluation (in school or as an outpatient elsewhere) and psychological testing (in school or outside school). Once approved by the school, they are obligated to pay for the evaluation.
After you obtain the evaluation, you and your child will attend a team meeting, including teachers and usually the school psychologist. You can also bring in your own psychiatrist or psychologist if you like (or even a letter stating their concerns and treatment plans). In that meeting, you discuss challenges and develop an Individual Educational Plans (IEPs) to help your child. If it’s determined that your child isn’t eligible for an IEP, then another option is working with the school to develop a plan for less intensive services through a Section 504 Plans. 504 Plans do not require that a child have a disability.
Check out our “Getting Your Child Mental Health Support and Accommodations in School” page for more information on this topic.
You may not find a lot of options for therapists for your child. Yet, like all relationships, you need to be sure that your child and therapist “click,” that their relationship is trustworthy and that you also are confident with the match. How well they fit may have little to do with credentials. Sometimes, the most famous therapist in your community, who attended the best training programs, isn’t right for your child.
There are two primary factors you should pay attention to:
Most behavioral treatments take time, so don’t worry if progress is not immediate. The therapist may not be a poor match; rather, the work may take more time. Be sure to ask your clinician for the diagnosis and the treatment plan, including the types of treatment being provided, and keep asking any questions you have until you fully understand what types of interventions your child’s clinician is providing.
If things don’t appear to be going well with the diagnosis and treatment plan, you might want to ask your child’s clinician for a consultation with another provider. This can ensure there is agreement on what the core problems are and that the best evidence-based treatment is in place. Every good clinician should welcome a fresh set of eyes on the situation.