*If you’re currently experiencing a mental health crisis or if you’re considering harming yourself or others, please get help immediately. You can call the free and confidential National Suicide Prevention Lifeline at 1-800-273-TALK or visit your closest emergency room for immediate intervention
Free & Affordable Treatment Options
It’s a stunning statistic: 56% of American adults with mental illness don’t get the help they need. Often, this is because of the cost of mental health care, the employment struggles many with mental health issues face, or both.
The good news is that there are programs and options for both getting affordable care and offsetting other financial hardships that may accompany mental health issues.
When it comes to the cost of help, the healthcare system in the U.S. is built on the assumption that the person needing a service will be covered by insurance. Getting insurance coverage if you don’t already have it will increase your treatment options.
Health insurance plans are offered from several sources and are generally required to provide mental health coverage. If you’re employed, your employer may offer insurance, and some employers also pay toward the monthly premium as part of the benefits package to make it more affordable. Many of these plans do not exclude coverage for pre-existing conditions, but it’s important to check your employer-offered plan to be sure. Young people who need coverage can be included in a parent’s employer-provided insurance plan (until age 26), and college students may be able to get low-cost insurance through the state their school is located in.
If insurance coverage through family, work, or school isn’t available, government insurance through Medicare or Medicaid or an insurance plan offered through the Affordable Care Act Marketplace (also known as “ObamaCare”) are other options. Government insurance and ACA healthcare plans are expressly prohibited from denying coverage or charging more to cover a pre-existing condition, including mental health issues or substance abuse, which means getting coverage is possible regardless of your medical history.
Medicare and Medicaid for Mental Health
Medicaid and Medicare are federally funded insurance programs and qualifying is based on income, age, and disability status. To apply for either of these programs or for help starting the Social Security Disability application, contact your local Social Services agency.
Free Clinics and Health Services
While it’s imperative that you work toward getting health insurance coverage for ongoing treatment and to protect your health and financial well-being, there are some free and low-cost options you can explore.
Federally Qualified Health Centers (FQHC) offer services through local Community Health Centers, and they must meet strict requirements to be eligible for government funding. Many of these centers provide mental health services on a sliding-fee scale based on ability to pay.
Sometimes private therapists will also make income-based arrangements with patients. Call therapists in your area to ask if they provide this option. Reaching out to local nonprofits can be helpful as well. Not only can they provide information about local resources that might be open to you, some have even recruited groups of professionals like therapists, psychologists, and psychiatrists who donate time to see patients as a pro-bono service.
Other options include VA Medical Centers if you’re active or former military. Campus Student Health or Student Counseling Centers can provide support if you’re a college student. Even if you aren’t a student, a nearby university or a training hospital may provide help at a low cost. Psychology (Ph.D.) and Psychiatry (M.D.) candidates are required to perform a certain number of direct patient service hours during their final internships and residencies. These near-professionals are supervised by a clinically licensed teaching professional, and you can expect a high quality of care.
Assistance for Working Individuals
Aside from finding adequate and affordable care, many people with a mental illness also struggle with employment.
If you’re currently looking for work, some employers offer guaranteed interviews for people with a disability who meet the minimum role requirements.
Your state may also provide ways to help people with disabilities find employment through vocational rehabilitation services or supported employment. The supported employment program partners with employers to help people with serious mental illness get jobs and be successful in them. Check with the mental health agency where you receive support services and/or your local employment office for information and support for seeking employment with a disability.
Whether you’re interviewing or already employed there are systems in place to ensure that you’re not subjected to unfair treatment once you tell your employer about your disability. The Equality Act is legislation that governs what employers or potential employers can and can’t do for people with disabilities including mental illnesses. It’s aimed at both preventing discrimination in the hiring process and ensuring that reasonable accommodations are made for applicants and employees with a disability.
Except in very rare cases (like applying for a teaching position), potential employers are not allowed to ask whether you have a medical or mental health issue. Once you’ve been hired, employers are responsible for removing any barriers that prevent you from being able to perform your work successfully because of your disability. Being familiar with what the law requires from employers will help protect you in the workplace.
Something else to keep in mind is that having a job doesn’t necessarily impact your benefit amounts or eligibility. You can receive federal support like SNAP, Medicaid, or Disability benefits as a supplement to other income as long as you’re not earning above the income limit. Your local Social Services office can provide eligibility information, income limits, and instructions for reporting income changes as they occur for each kind of assistance you receive.
Difficulty Maintaining Consistent Employment
Sometimes finding and keeping a job with a mental illness can be a challenge. Almost 60% of people receiving mental health services in the U.S. say they want to work, but the national unemployment rate for the same group is 80%.
Applying for disability benefits can be a good option even if you’re able to work, but it’s probably a necessity if mental illness is preventing or severely limiting you from finding or keeping a job.
Applying for Disability
Mental illness is the third most common Social Security Disability category. Mental health issues can also exist along with other primary disabilities, and 58.8% of adults receiving Supplemental Security Income (SSI) and 34.7% of Social Security Disability Insurance (SSDI) in 2016 had a psychiatric condition either as a primary disability or along with one.
The most common mental illnesses that qualify as disabilities are grouped into categories like anxiety disorders, affective disorders (like chronic depression), autism, personality disorders, psychotic disorders (like paranoia and schizophrenia), mood disorders, bipolar disorder, and more. If you have questions about whether your illness is covered and whether you could be entitled to Social Security Disability benefits, you can visit the Social Security Administration (SSA) website or contact your local Social Services agency for more information and to begin the application process.
The SSA has its own definition of what a disability is and diagnostic criteria to determine whether an individual qualifies. You’ll need to provide medical records and documentation from your doctors, and you’ll interview with a caseworker to answer questions about how your disability affects your day-to-day life. You’ll also be required to provide information about your income and assets. It’s possible that requests for documentation and interviews with caseworkers could be repeated through several stages of the SSA review.
Qualifying for disability benefits can be a frustrating and time-consuming process. For people with mental illnesses with symptoms that make it hard to follow up and stay on top of the complicated process, having a support system is crucial to success. Enlist family and friends to help you stay on top of where you are in the process and to help you gather documentation you’ll need to submit. Also, make your local Social Services agency aware that the disability you’re applying for makes the application process difficult for you. They can provide additional support through the process.
Social Security and Social Security Disability for Mental Health
The outcome of the application process isn’t just to determine whether you qualify for disability benefits, but also to determine what type of disability benefits you qualify for.
SSDI is paid when a contribution threshold through past work is met. It’s the Social Security withholding you may have seen on your paychecks. The SSDI benefits are paid from the Social Security Trust Fund on a monthly basis, and the amount you receive is determined by your total previous contributions.
SSI, however, is strictly need-based, and eligibility is determined by proof of financial hardship. SSI is for individuals who have never worked or who do not meet the minimum work contributions. This benefit, also paid monthly, is a flat rate and amount.
SSDI and SSI are both disability benefits paid directly to the person with a disability to help cover living costs. Qualifying for disability benefits also qualifies you for government health insurance. Those who qualify for SSDI qualify for Medicare, and those who qualify for SSI qualify for Medicaid.
It is possible that you could qualify for both SSDI and SSI and to receive benefits from both. If that applies to you, a case manager will explain what exactly that will entail based on your specific situation.
If you’ve recently lost your job or changed employment, COBRA allows you to keep your former employer’s health insurance for up to 18 months as long as the premium continues to be paid. If you or a dependent have a disability, COBRA coverage can be extended for 36 total months of coverage. Because employer group policies are often more expansive that private policies the cost maintaining coverage through COBRA can be prohibitive. Still, it provides a way to prevent coverage lapses if/when your employment situation changes.
Mental Illness Housing Options
If you’re experiencing financial hardship because of (or along with) your mental illness, it’s possible that finding affordable housing or paying for the housing you have is difficult. Certain types of mental illness can also make living alone difficult, which means a different kind of housing could be necessary.
If you’re experiencing a housing emergency, The U.S. Department of Housing and Urban Development website has resources and information about homelessness prevention, temporary housing, and where you can get help in your state. Your local United Way and other similar charity organizations may also be able to help. You can look online or call 211 anywhere in the U.S. to get a list of resources near you.
If your mental illness prevents you from being able to live independently, there are several options that may be covered or partially covered by health insurance. Supervised group housing is an option that is best for people whose illness significantly impacts their ability to perform day-to-day living tasks. This kind of housing is similar to assisted living facilities. Residents have their own rooms, but common spaces are shared and support staff provides 24-hour assistance with things like medication, transportation, and treatment management.
Partially supervised group housing is for residents who can live semi-independently and be left alone for several hours at a time. Residents in partially supervised housing still getting help with cooking, cleaning, medication, and other needs. Staff members are always available on-call, but they are present 24 hours a day. Supportive housing provides limited assistance akin to in-home nursing for medical issues. Staff only visit occasionally, unless called for, and residents are mostly independent. Consult your policy or contact your policyholder to learn more about your managed care coverage including possible residential support.
For those who can remain independent, renting a home and working with a caseworker to ensure that your ongoing care is maintained can be a good solution, if it’s affordable to do so. If it’s not affordable because of financial hardship, you may qualify for federal programs like Section 8, which helps pay a portion of rent in any place that meets the federal requirements, or Section 811, which does the same but is specifically for people with disabilities. Public housing is another federal program offering government-owned accommodations to very low-income households and to people with disabilities. These programs have income limits, disability status requirements, or both. More information, including how to apply, can be found at the U.S. Housing and Urban Development website.
Regardless of which housing path you need to take, it’s important for you to be aware of your budget. If you don’t already have a monthly budget, now is the time to make one, especially if you’re also navigating the disability benefits application or if maintaining employment is (or may become) difficult.
When considering your budget, housing should be a maximum of 35% of your income. If you’re paying more than that, you may need to consider other options. Your budget should also include insurance coverage if you’re not eligible for Medicare or Medicaid.
It’s understandable if living with mental illness, managing costs of living and care, navigating employment, and going through the process of applying for Social Security Disability feels overwhelming. Gather a support system to help as you go through the steps to secure ongoing treatment with the coverage and financial assistance you need, and remember to take immediate steps if you find yourself in crisis.