The ABCs of Mental Health Treatment

[Note: This is the last in a three-part series of articles written several years ago for a local publication. The purpose was to do some education about mental health, especially for a church audience. I thought it might be good to revisit.]

LMFT.  LPC.  LCSW.  PsyD.  MD.  M.Div.  Ph.D.  CAC.  RN.  CSB.  Medicaid.  Medicare.  MHP.  When you dive into the bowl of alphabet soup that is our mental health system, it is confusing mix of letters, providers, payment types, and places to go for services.

How do I access the mental health system?

The first item to know is how to access the system in situations of dire need.  In other words if you or a loved one are unable to leave the house because of debilitating depression or anxiety or if you or a loved one is suicidal or homicidal, then you need to call emergency services at 911.

If the need is not an emergency, but is urgent, then it is a good idea to call your regular doctor or pediatrician and discuss the symptoms you are noticing and ask for a referral.  Many times the doctor may ask for a blood test to evaluate for other conditions that may look like depression or anxiety.  Thyroid problems or diabetes are common conditions that have symptoms that may look like mental health concerns.

Another important consideration in our health care system is how you are going to pay for services.  If you are insured, it is best to look at your insurance card for words such as “behavioral health” or “mental health” or “substance abuse” and to call the number on the card to discuss a referral.  Many insurances have separate plans for mental health coverage; it is important to understand these rules so that you do not go to a provider that is not “in-network” and then face a large bill.

If you are not insured, or are insured by Medicaid, another avenue for mental health services is your local community service board.  These are the state-funded mental health providers such as Oconee Center, Phoenix Center or River Edge Behavioral Health Center.  They typically have a variety of services ranging from all-day services for adults, treatment for addiction, counselors and psychiatrists.

Lastly, there is inpatient treatment.  While there was a time when inpatient treatment last for weeks and perhaps months, being hospitalized in a psychiatric unit typically lasts for three days to one week.  Treatment in this setting is to manage a temporary crisis until a patient can be stabilized and released to outpatient treatment.

What happens at a psychiatric hospital?

Inpatient units are typically in a large hospital or in a separate psychiatric facility.  Inpatient treatment is NOT what many of us saw in the film One Flew Over the Cuckoo’s Nest.  Typically, there are counselors, nurses, and psychiatrists on staff there who will monitor whether medications are working.  There are also groups and classes that patients attend to work on the life circumstances that may have created or may be maintaining some of the problems in their life.

There are also in-between sorts of options for people who need the intensity of everyday treatment, but are not needing to stay in a locked unit.  These programs are usually called “intensive outpatient” or “partial hospitalization” programs.  These can be wonderful options!

But who are the people who provide these services?

The type of provider you need to see is largely based on what type of need you have.  Just as doctors are regulated by a medical board, there are also boards that license and regulate counseling.  These boards ensure that providers who hold that license have fulfilled the requirements, both in terms of education and experience, which enable them to competently provide mental health counseling and psychology.

If you are looking for psychological testing, then a psychologist is who you need to call.  These tests (which are both paper/pencil and computer-based) can test for everything from mental illnesses, learning disabilities, intelligence, and can also be helpful in assessing career paths and in helping groups of people learn more about each other to help them work better together.

Some psychologists also provide therapy to help with behavioral health issues.  These are generally folks with a Psy.D., but may also be people who have a Ph.D.

Other providers typically have a Master’s degree in professional counseling, marriage and family therapy, or social work.  Master’s level providers are the bulk of people providing therapy to address behavioral health.  The type of license is either a LPC, LMFT or LCSW.  Sometimes you will see someone with a LAPC, LAMFT, or LMSW; this means that this person does not yet have their full license, but is working towards the ability to practice independently.

What happens in therapy?

Typical sessions with a therapist or counselor are 50 minutes and cover some of the patterns of behavior, family structures, and ways of thinking that may exacerbate the problem or have led to the problem.  The MOST important item in finding this type of provider is that you feel you have a good “fit” with this person.  Research has shown that beyond the style/type of counselor, whether you have a good fit with them is one of the strongest predictors that you will get better.

Meds?

Master’s level providers and psychologists do NOT prescribe medications.  Psychiatrists are the providers who do treat mental illness with medication and other interventions that require a license to practice medicine.

Another group of providers are certified addiction counselors.  These are people that have been through training and supervision in order to specialize in providing services for people struggling with addictions.  While this is not regulated by the state of Georgia, there is a state organization that certifies them.

In finding a provider, insurance is definitely a factor, but you should also ask your clergy, your friends, and your family about their experiences with a provider.  The “fit” is important, so make sure that you trust and are comfortable with the person.

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