Deciding on a mental health professional is confusing and challenging. For most, by the time they contact someone they have exhausted all their other options for symptom relief and emotional support. People do not make major purchases without first doing their research and the same should be true when looking for mental health treatment. Here are some tips to help you make the best decision for you.

Always follow your instincts. If you Doctor/Therapist makes you uncomfortable, acknowledge this. It is important to find someone you can trust and feel comfortable sharing your thoughts and feelings with. A therapist should never pass judgement on you for what you are confiding. They should always treat you with compassion, respect, and acceptance. Your provider should never belittle or make fun of you. The two of you can laugh together about something, but you should never feel as though you are being laughed at.  This will create an enviroment where you will be able to be open and confront issues you might not be comfortable discussing with anyone else.

Most importantly, your provider should never touch you in a sexual manner. Any contact that makes you uneasy should be pointed out immediately. This is not to say that a provider should never have any physical contact with a patient; a reassuring sqeeze of your shoulder, holding your hand during a hard session, or hugging you as you leave are acceptable as long as it does not make you feel uncomfortable. The provider should understand and respect boundries, both yours personally and those implied by the nature of the provider/patient relationship. Fondling, sitting on the Therapist’s lap, kissing, or sex of any type is always completely inappropriate.

There are certain rights that all patients have. You have the right to ask any questions related to your treatment. This includes knowing what diagnosis the Therapist is assigning you and what is being filed through your insurance claims. You also have the right to look at the records being kept by your provider regarding your treatment. You may request a copy of these records, but be aware that there may be a fee for copying them. This important to keep track of as insurance companies are famous for using a “preexisting condition” as a reason for denial. You may also refuse to answer any questions. The therapy is to help you but this has to happen at a rate that you are comfortable with. You should never feel pressured into answering questions on subjects that you are not ready to discuss. Do understand, however, that you will have to be willing to face some hard truths about yourself and your life and to do this you will at some point probably have to talk about things that are very difficult for you. This is why the trust issue is so very important with any Doctor or Therapist.

The provider should be able to give you the estimated length of time you will need treatment.This will not be an ironclad timeframe; no Therapist should ever give a guaranteed recovery date. Treatment is different for everyone and how you respond is not something the provider will be able to predict. There is no set formula, this is not a two week course of antibiotics that will erase all symptoms. Some people will begin to notice changes within a few sessions and others will take months or even years. Be prepared to commit to the process and do whatever is neccessary to feel better and you will get the most out of your treatment. If you go in half-hearted and refuse to embrace the process you will be wasting both your time and that of the provider.

You wouldn’t go to a doctor who was not licensed and the same should be true of your mental health provider. Licenses can include a psychologist (PhD), psychiatrist (MD), licensed professional counselor (LPC), licensed social worker (LCSW), or licensed mental health counselor (LMHC). These professionals are required to take a test and are supervised for a specific number of hours providing therapy before they can even take these tests. Seeking help from someone who does not know what they are doing will only create more problems for you.

Often when you feel you don’t want to go to therapy is when you need to go the most. This tends to happen when you are avoiding confronting or dealing with a painful issue. Therapy is hard work and sometimes can be a emotionally painful and draining process. During the first sessions, it is not uncommon to feel worse before you begin feel better. You are dealing with issues and emotions that you might not have ever discussed before or maybe are not even conciously aware that you have. This is why people give up before the process has a chance to work. Think of it like pulling out a splinter; the splinter hurts and can become infected if not treated. Pulling it out can be a painful process in itsself but once it is out you feel so much better. Therapy works the same way. It takes a great deal of strength and courage to share your thoughts, feelings, and issues with a stranger, even a professional. The more open you are with yourself and your provider, the more effective the treatment will be.

The provider is bound under confidentiality laws to never share anything you say in therapy with another person. (Exceptions to this include if the provider feels you are suicidal, a threat to a child or elderly person, or if you might pose a threat to someone else’s life.) The provider should not be on the phone while you are in session or talk to friends or family, yours or theirs, about you without expressed consent from you to do so.

Always remember that no matter who you decide to talk with or what form of therapy you decide to try, that there is always hope. Healing can be a long and difficult process but in the end you will come out of it happier, healthier, and stronger.

Popularity: 73% [?]

From the department of labor…

“Fact Sheet: The Mental Health Parity Act

U.S. Department of Labor
Employee Benefits Security Administration
October 2008

The Mental Health Parity Act (MHPA), signed into law on September 26, 1996, requires that annual or lifetime dollar limits on mental health benefits be no lower than any such dollar limits for medical and surgical benefits offered by a group health plan or health insurance issuer offering coverage in connection with a group health plan.

MHPA applies to group health plans for plan years beginning on or after January 1, 1998.  The original sunset provision (providing that the parity requirements would not apply to benefits for services furnished on or after September 30, 2001) has been extended several times. If you have questions about the sunset provision, contact the EBSA office nearest you.

The law:

• Generally requires parity of mental health benefits with medical/surgical benefits with respect to the application of aggregate lifetime and annual dollar limits under a group health plan

• Provides that employers retain discretion regarding the extent and scope of mental health benefits offered to workers and their families (including cost sharing, limits on numbers of visits or days of coverage, and requirements relating to medical necessity)

The law, however, does not apply to benefits for substance abuse or chemical dependency.

The law also contains the following two exemptions:

• Small employer exemption. MHPA does not apply to any group health plan or coverage of any employer who employed an average of between 2 and 50 employees on business days during the preceding calendar year, and who employs at least 2 employees on the first day of the plan year

• Increased cost exemption. MHPA does not apply to a group health plan or group health insurance coverage if the application of the parity provisions results in an increase in the cost under the plan or coverage of at least one percent”

Basically this means that mental illness and physical illness treatment must have the same annual limits but could have special rules such as different co-pays and deductibles or limits on visits. But this only applies if you work for a company of more than 50, it won’t raise the cost of the plan more than 1%, and you are not seeking help for substance abuse. Not a great deal of help but it was a step in the right direction and allowed for the next step, The Wellstone Act.

The new Wellstone Act changes MHPA in the following ways…

While MHPA imposes restrictions on annual and lifetime limits, it does not stop a health plan from imposing special rules for mental health benefits such as deductibles, co-pays, coinsurance and number of visits allowed. The Wellstone Act prohibits any of these types of restrictions and includes substance abuse treatment under the mental health category.

The exception under MHPA for employers with no more than 50 employees continues under the Wellstone Act.  However, the increased cost exemption changes from a 1% increase in cost to 2% in the first year and then goes back down to 1% in subsequent years. And, the plan must be in effect for more than 6 months before they can even apply for this exemption.

MHPA and the Wellstone Act do not require employers to provide mental health or substance abuse benefits.  However, if an employer chooses to do so in its group health plan, these requirements must be satisfied.  The Wellstone Act begins to apply as of the first day of the first plan year beginning after October 3, 2009 (January 1, 2010 for calendar year plans).

Popularity: 44% [?]

House Approves Bill on Mental Health Parity

“WASHINGTON — After more than a decade of struggle, the House on Wednesday passed a bill requiring most group health plans to provide more generous coverage for treatment of mental illnesses, comparable to what they provide for physical illnesses.

The vote was 268 to 148, with 47 Republicans joining 221 Democrats in support of the measure.

The Senate has passed a similar bill requiring equivalence, or parity, in coverage of mental and physical ailments. Federal law now allows insurers to discriminate, and most do so, by setting higher co-payments or stricter limits on mental health benefits.

“Illness of the brain must be treated just like illness anywhere else in the body,” said Speaker Nancy Pelosi, Democrat of California. Supporters of the House bill, including consumer groups and the American Psychiatric Association, said it would be a boon to many of the 35 million Americans who experience disabling symptoms of mental disorders each year.

Insurers and employers supported the Senate bill. Many opposed the House version, saying it would drive up costs.

President Bush endorsed the principle of mental health parity in 2002. But on Wednesday, the White House opposed the House bill, saying it “would effectively mandate coverage of a broad range of diseases.”

Both bills would outlaw health insurance practices that set lower limits on treatment or higher co-payments for mental health services than for other medical care.

Typical annual limits include 30 visits to a doctor or 30 days of hospital care for treatment of a mental disorder. Such limits would no longer be allowed if the insurer had no limits on treatment of conditions like cancer, heart disease and diabetes.

The Congressional Budget Office estimated that an earlier version of the House bill would increase premiums for group health insurance by an average of four-tenths of 1 percent. Some of the cost could be passed on to workers.

The House bill does not apply to health plans sponsored by an employer with 50 or fewer employees. Nor does it apply to coverage in the individual insurance market.

Three factors contributed to support for the legislation. First, researchers have found biological causes and effective treatments for numerous mental illnesses. Second, a number of companies now specialize in managing mental health benefits, making the costs to insurers and employers more affordable.

Finally, some doctors say that the stigma of mental illness has faded as people see members of the armed forces returning from Iraq and Afghanistan with mental disorders.

Supporters of mental health parity see it as a civil rights issue, and the debate Wednesday was filled with poignant moments.

“I have a mental illness, and I am fortunately getting the best care this country has to offer because I am a member of Congress,” said Representative Patrick J. Kennedy, Democrat of Rhode Island and chief sponsor of the House bill. Mr. Kennedy has been treated for depression and drug dependence.

The main Republican sponsor, Representative Jim Ramstad of Minnesota, a recovering alcoholic, said, “I am living proof that treatment works and recovery is real.”

The House bill is named for Senator Paul Wellstone, the Minnesota Democrat killed in a plane crash in 2002. He had a brother with severe mental illness. The main sponsor of the Senate bill, Pete V. Domenici, Republican of New Mexico, has a daughter with schizophrenia.

Under a 1996 law, health plans are forbidden to set annual or lifetime dollar limits on mental health care that are lower than the limits for other services. But insurers have gotten around the law by setting different limits on the number of outpatient visits or hospital days, and by charging different co-payments.

The protections of the House bill apply to people who need treatment for alcohol and drug abuse, as well as mental illness.

Under the bill, if an insurer chooses to provide mental health coverage, it must “include benefits” for any mental health condition listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

E. Neil Trautwein, a vice president of the National Retail Federation, a trade group, said: “Businesses will be faced with the choice of covering every single mental or substance abuse disorder listed in the diagnostic manual, or nothing at all. Neither choice is appealing.”

Among the conditions listed in the manual, critics noted, are caffeine intoxication and sleep disorders resulting from jet lag.

Nicholas M. Meyers, director of government relations at the American Psychiatric Association, said: “This is nonsense. Simply because a diagnosis is made does not obligate insurers to pay for treatment.”

Insurers could still deny coverage if they found that a service was not medically necessary.”

Popularity: 40% [?]