Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.
Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. The good news about mental illness is that recovery is possible.
Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.
In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups, and other community services can also be components of a treatment plan and that assist with recovery. The availability of transportation, diet, exercise, sleep, friends, and meaningful paid or volunteer activities contribute to overall health and wellness, including mental illness recovery.
Here are some important facts about mental illness and recovery:
Call your insurance plan, or your company’s benefits administrator, and ask for a verbal and written description of what coverage is provided for behavioral health treatments. Many insurers offer coverage for mental health (MH) services and/or substance abuse (SA) treatments; some only cover substance abuse if it co-occurs with mental illness. If you plan to use MH or SA benefits through your insurance plan, you may be required to get a referral from your regular doctor before you can receive services.
Additionally, your employer may offer an employee assistance program, or EAP. An EAP is a resource provided either as part of, or separate from, employer-sponsored health plans. Usually EAP visits are free, but the number of visits may be limited. Preventive care measures such as health screenings, mental health or substance abuse screening, and/or wellness activities will be provided. An EAP may not include all services and programs, but many provide aid to employees and their families for substance abuse, stress, depression, and other mental health issues. EAP visits are confidential; information discussed in these visits will not be shared with your employer.
If you do not have access to an EAP or employer-sponsored health insurance, you may qualify for Medicare or Medicaid services. To determine your eligibility for these and other government programs, and to determine what kinds of coverage are provided, contact the Centers for Medicare and Medicaid Services (CMS), www.cms.gov, at 1-877-267-2323 (TDD: 1-866-226-1819) and your State’s department of insurance. On the web, you can find contact information for your State’s department of insurance onhttp://www.naic.org/state_web_map.htm. You can also find contact information for your state’s mental health program from the National Association of State Mental Health Program Directors at http://www.nasmhpd.org/members.cfm.
Your State mental health agency will be helpful in telling you how mental health services in your State are funded. In publicly funded mental health centers, such as those run by State, city or county governments, the cost of many services is calculated according to what you can afford to pay. So, if you have a lack of funds, services are still provided. This is called a sliding-scale, or sliding-fee, basis of payment. In addition, States, which often work with Federal programs, such as Medicaid, provide financial assistance to eligible individuals or families. Information about medical and health care assistance is available at your county/city social services departments, health and human services department, or Social Security office.
Insurance coverage for mental health (MH) and substance abuse (SA) benefits differs among plans, employers, and States. State laws may require insurers to provide a standard, minimal offering of MH and/or SA benefits although insurers are free to provide additional coverage. In general, mental health benefits are not as extensive as medical/surgical benefits and will require higher deductibles and co-payments in addition to any regular, fixed payments.
The following are common types of managed care health insurance plans:
a. PPOs, Preferred Provider Organizations, are sometimes referred to as fee-for-service plans. PPOs differ from FFS plans in that they use a network of providers and usually charge lower fees.
a. Under a HMO, a POS allows consumers to visit health care providers outside the HMO’s network as well as providers inside the network. Using a provider outside the network requires will result in higher copayments and deductibles, and you may have to file a claim for reimbursement.
b. Under a FFS plan, consumers can visit the provider of their choice. There may or may not be a network of providers – if there is a network, consumers are usually offered lower copayments and/or no deductible to see a provider within the network.
When you seek Mental Health and or Substance Abuse treatment, you will see a variety of health care professionals. You may also deal with a case manager from the insurance company or treatment facility. Depending on the type of your insurance, a case manager (CM) may, in conjunction with your health care provider, assess your health needs, refer you to a specialist, coordinate the services that you will receive, and/or follow up on your treatment. In some cases, you may only speak with the CM over the phone; in others, the CM may be a qualified practitioner that you will actually visit. A qualified practitioner is any practicing health care professional licensed by the State to treat patients and provide health services.
The qualified practitioners that you may see during the course of your treatment include the following:
Anyone of these qualified practitioners is referred to as a specialist if he or she has received advanced education in a particular area of health care such as mental illness or substance abuse. Your PCP should communicate with your specialist(s) to monitor your progress and to make sure that you are not receiving any treatments that may react with other medicines or disrupt any other health conditions.
You are eligible for a Medical Savings Account, or MSA, if you work for a business with 50 or less employees and have high-deductible employer-sponsored health insurance. Self-employed individuals are also eligible for MSAs if they have a high-deductible insurance plan. MSAs are accounts that can be used along with your health insurance plan only if your plan has a high deductible and is your only health insurance plan. “High” is defined as a $1,600 deductible or more annually per individual, and $3,200 or more annually per family. Before reaching this deductible, all medical costs, except for insurance premiums, can be paid from the consumer’s MSA (insurance premiums can be paid by the MSA if the consumer is between jobs and not collecting state or federal unemployment benefits). Contributions to the MSA are tax-exempt and the consumer gets to keep any account money that is not spent. Money in the MSA can be withdrawn for non-medical expenses, but those withdrawals are subject to a 15 percent tax.
A FSA, or Flexible Spending Account, is similar to an MSA, but FSAs do not have to be used with high-deductible insurance plans. These accounts are also open to anyone whose employer offers them. However, with a FSA, consumers do not get to keep their unspent account money and money can not be withdrawn for non-medical expenditures.
Mental health services are provided by several different professions, each of which has its own training and areas of expertise. When faced with serious mental illness, finding the right professional for yourself or a loved one is a critical ingredient in the process of diagnosis, treatment and recovery.
Mental Health Professionals: Who They Are
Mental health services are provided by several different professions, each of which has its own training and areas of expertise. Finding the right professional(s) for you or a loved one can be a critical ingredient in the process of diagnosis, treatment, and recovery when faced with serious mental illness.
Types of Mental Health Professionals:
If stress, or interpersonal or job-related tension, is interfering with your daily life or if a medical condition is causing you mental anguish, you may want to seek mental health care. If habitual use of legal or illegal substances is negatively affecting your health and/or your daily life, you should seek treatment for substance abuse. In either circumstance, you should seek care as soon as possible, before you feel that you can no longer cope with the situation. These problems are just as important, and treatable, as medical problems.
Two kinds of therapists warrant special note: psychiatrists and clinical social workers. Psychiatrists are medical doctors and can prescribe medication. Clinical social workers are trained in client-centered advocacy and can assist you with information, referral, and direct help in dealing with local, State, or Federal government agencies. As a result, they often serve as case managers to help people “navigate the system.” Clinical social workers and many other mental health professionals cannot write prescriptions. However, nurse practitioners that specialize in psychiatry and mental health can prescribe medication in most states.
Therapy is a collaborative process, so finding the right match-someone with whom you have a sense of rapport-is critical. After you find someone, keep in mind that therapy is work and sometimes can be painful. However, it also can be rewarding and life changing.
You can rest assured that all mental health professionals are ethically bound to keep what you say during therapy confidential. However, therapists also are bound by law to report information such as threats to blow up a building or to harm another person, for example.
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You can rest assured that all mental health professionals are ethically bound to keep what you say during therapy confidential. However, therapists also are bound by law to report information such as threats to blow up a building or to harm another person, for example
People generally have the right to consent to, or refuse, treatment. However, under certain conditions – such as when a person is considered a danger to self or others – he or she may be required to seek or receive treatment. This can include involuntary civil commitment, which can be for either outpatient or inpatient treatment, as well as forced medication. Laws about commitment vary by State.
The Department of Health and Human Services (HHS) considers suicide a significant public health problem and is involved in prevention activities. You may be interested in knowing about an innovative public/private collaboration, the National Strategy for Suicide Prevention, which directs necessary prevention services and programs. Federal collaborators include the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the National Institutes of Health, the Office of the Surgeon General, and the SAMHSA (all components of HHS). The private collaboration includes advocates, clinicians, researchers and suicide survivors. Information on this initiative is available at http://mentalhealth.samhsa.gov/suicideprevention.
Decisions regarding the admission, treatment, and care of people with emotional problems are made at the local and State levels, so the types of available services, and how those services are funded, vary by State. Your doctor or someone at your local mental health center can refer you to a licensed therapist who is registered and affiliated with his/her same professional association. This Mental Health Services Locator may also be of help:
The National Mental Health Information Center provides free publications on mental health topics. You can order publications by calling the Information Center at (800) 789-2647, sending an email with your mailing address to firstname.lastname@example.org, or placing an online order at http://nmhicstore.samhsa.gov/publications/ordering.aspx.
The National Mental Health Information Center does not have specific statistics, although our web site does provide access to Mental Health, United States, 2000 (CMHS publication number SMA01-3537, available free of charge from the Information Center). This publication provides mental health statistics about service utilization, financing, treatments, individuals with mental illness, and mental health practitioners.
Here are some reasons why…
Here is what we know…
Research has provided much information about what services and practices are effective in ending homelessness for people with serious mental illnesses. Key findings show:
The Americans with Disabilities Act (ADA) is a legal tool to fight discrimination. Any person who believes he or she has experienced employment discrimination based on a psychiatric disability has a right to file an administrative “charge” or “complaint” with theU.S. Equal Employment Opportunity Commission (EEOC) or with a State or local anti-discrimination agency. Such individuals also may file a lawsuit in court, but only after filing an administrative charge. For information on how to file a discrimination charge, the publication Filing an ADA Employment Discrimination Charge: Making It Work for Youmay be helpful.