What should you do if you're under a lot of stress or dealing with a mental health issue and you don't have the money for treatment?

You're not alone if you're concerned about paying for mental health care. Lots of people need help and worry that they can't afford it. Even if you have insurance, it can be challenging. Some insurance companies don't cover mental health services very much, if at all, and they often have expensive copays and deductibles.

Still, it is possible to find affordable — sometimes even free — mental health care or support.

Free or Low-Cost Counseling

When it comes to finding a counselor, start at school. School counselors and school psychologists can provide a good listening ear — for free! They can help you size up the situation you're dealing with and, if needed, refer you to more support in your county or community.

If your school counselor can't help, you'll need to do a little more research to figure out how to get help. Some of the free or low-cost mental health care possibilities to explore include:

• Local mental health centers and clinics. These groups are funded by federal and state governments so they charge less than you might pay a private therapist. Search online for "mental health services" and the name of the county or city where you live. Or, go to the website for the National Association of Free Clinics. The U.S. Department of Health and Human Services' Health Resources and Services Administration also provides a list of federally funded clinics by state.
  (Note: By clicking either of these links, you will be leaving the TeensHealth site.)
  
  One thing to keep in mind: Not every mental health clinic will fit your needs. Some might not work with people your age. For example, a clinic might specialize in veterans or kids with developmental disabilities. It's still worth a call, though. Even if a clinic can't help you, the people who work there might recommend someone who can.
• Hospitals. Call your local hospitals and ask what kinds of mental health services they offer — and at what price. Teaching hospitals, where doctors are trained, often provide low- or no-cost services.
• Colleges and universities. If a college in your area offers graduate degrees in psychology or social work, the students might run free or low-cost clinics as part of their training.
• On-campus health services. If you're in college or about to start, find out what kind of counseling and therapy your school offers and at what cost. Ask if they offer financial assistance for students.
• Employee Assistance Programs (EAPs). These free programs provide professional therapists to evaluate people for mental health conditions and offer short-term counseling. Not everyone has access to this benefit: EAPs are run through workplaces, so you (or your parents) need to work for an employer that offers this type of program.
• Private therapists. Ask trusted friends and adults who they'd recommend, then call to see if they offer a "sliding fee scale" (this means they charge based on how much you can afford to pay). Some psychologists even offer certain services for free, if necessary. You can find a therapist in your area by going to the website for your state's psychological association or to the site for the American Psychological Association (APA). To qualify for low-cost services, you may need to prove financial need. If you still live at home, that could mean getting parents or guardians involved in filling out paperwork. But your therapist will keep everything confidential.

If you're in college, you may be covered under a parent's health insurance policy. (Depending on the rules in your state, you may even be covered if you are not in college.) It's worth a call to your parent's insurance company to find out.

Financial Help

Programs like Medicaid or the State Children's Health Insurance Program (SCHIP) offer free or reduced-fee medical insurance to teens who are not covered. To find out if you qualify for mental health assistance through these programs, call your doctor's office or hospital and ask to speak to a financial counselor. Your school counselor also might be able to help you figure out what kind of public medical assistance you could qualify for and guide you through the process of applying.

People under age 18 who live at home will need a parent or guardian to sign off on the paperwork for these programs. After that, though, your care will be confidential. A therapist won't tell parents what you've talked about — unless he or she thinks you may harm yourself or another person.

Getting Help in a Crisis

If you're feeling suicidal, very hopeless or depressed, or like you might harm yourself or others in any way, call a suicide or crisis hotline. These offer free help right away.

• Suicide hotlines. Toll-free confidential lines like 1-800-SUICIDE or 1-800-999-9999 are staffed 24 hours a day, 7 days a week by trained professionals who can help you without ever knowing your name or seeing your face. They can often give you a referral to a mental health professional you can follow up with in your area.
• Crisis hotlines. These help survivors of rape, violence, and other traumas, Some may also provide short-term counseling. To find one, do an online search for your state and "crisis hotline."

Other cost-effective ways to help you work through crisis situations are:

• Emergency rooms. Emergency rooms are required to evaluate and care for people who have emotional emergencies as well as physical ones. If you think you might hurt yourself or someone else, you can also call 911.
• Local crisis centers. Some states have walk-in crisis centers for people coping with mental health problems, abuse, or sexual assault. They're a bit like ERs for people who are having an emotional crisis.
  
  Each county and state does things differently. A few might not have crisis centers. Others may have mobile units that come to you in an emergency. Some crisis centers operate in hospitals, others are run by non-profits or county mental health services. To see if there's a crisis center near you, search online for your city, county, or state and terms like "crisis center," "crisis counseling center," "psychiatric emergency services," or "crisis intervention."

If you need help finding any kind of services, contact your state's mental health association or psychological association to find out where you can get therapy and treatment near you.
(Note: By clicking either of these links, you will be leaving the TeensHealth site.)

Prescriptions

Paying for prescriptions can really drain your wallet. Here are some ways to be smart about the money you spend on medicines:

• Find out if you can take generic or non-brand medicines. Ask your doctor or pharmacist if there are over-the-counter versions of the same kinds of prescription medications.
• Find out about prescription assistance programs (also called "patient assistance programs"). The Partnership for Prescription Association gives free or low-cost prescriptions to people who qualify based on income. Visit their website to learn more.
• Compare prices at local pharmacies. Call each to ask what they're charging for your prescriptions.
• Contact the pharmaceutical company that makes the medication. All the big pharmaceutical companies have prescription assistance numbers you can call for help.
• Beware of free prescription samples (or coupons and rebates). They sound appealing, but they are often for expensive, name-brand medications. That's fine while the samples last. But since doctors don't like to change a medication if it's working, you could get stuck paying full price after the samples run out.
  
  Before accepting a free sample, talk to your doctor about whether you can afford that medication in the long term. If it's something you'll only need for as long as the samples last, take advantage of the freebie!

If you're already taking medication, there are two things to know:

1. Never stop taking a prescribed medication or reduce your dosage because you can't afford to fill the prescription. Some medications can cause side effects if they're adjusted or stopped without a doctor's advice.
2. Never use someone else's medicine. Even if the person has the same health condition you do, medications work differently for different people.

If you can't afford to refill a prescription, call the prescribing doctor. Say you're having a hard time affording your meds and need some advice. It's not unusual these days for people to ask for this kind of help, and doctor's offices often know how to get it or put you in touch with someone who can.

Parents and Other Adults

Navigating your way through the health care system can be confusing (even for adults). That's why it's a good idea to have a parent, relative, doctor, school counselor, or social worker help you connect with a mental health professional.

But what if you want to get counseling without a parent (or guardian) knowing? In many states, teens can be given mental health treatment without parental consent. When you call a clinic, hospital, or therapist, ask about your state's rules on parental consent for mental health services. And, when you see a counselor, find out about the rules when it comes to filling a prescription. Even if you can get confidential care, your parents may need to give the OK to fill prescriptions.

Whatever happens, don't let money hold you back from getting help. Affordable mental health care options are out there — it may just take some time and effort to find them. But don't give up. Stress and mental health problems don't usually get better on their own.

Reviewed by: Michelle New, PhD
Date reviewed: September 2010