Mental Health

Getting Help

Finding a Healthcare Professional

Healthcare-Professional

Before beginning to look for a mental health professional, check your insurance. Find out what services it covers and if your are limited to certain doctors. After you know that, you can:

Ask friends

– People often find this to be the best method especially asking people who understand who you are and what you are looking for.
Seek the advice of your doctor or other health professional.
Contact local mental health centers, clinics, or hospitals.
Talk with your insurance company- This is especially important because many insurance company only cover certain types of professionals, certain individual professionals, and limited amounts of time.
If you or your spouse works for a large corporation or are a student, contact the health services department- Large corporation sometimes and colleges often have free counseling or counseling referrals.
Look in the yellow pages or in the blue pages – Sometimes there are also local referral centers. Try looking under “Guide to Health and Human Services.”

It is important to keep phone numbers, insurance coverage and other important information on hand as you begin to find a therapist. Use the Getting Help Worksheet to keep information organized.

Financial Concerns

For many of us what we can afford financially guides many of our medical and health decisions. If you have insurance, your first step to finding a clinician might be to find out what services and which mental health professionals your insurance company will cover. For example, some private practices will not accept Medicare and Medicaid.

Some clinicians will allow you to pay on a sliding scale. This means that you pay according to what you can afford. If you have access to any of the following resources, you might want to explore how they can work for you:

Employee assistance programs

– Sometimes large corporations will have programs that provide or help find mental health treatment for their employees.

Universities and colleges

– Universities and colleges often have health centers, counseling centers, or counseling referrals centers. If you are a student, employee or family relation of a student or employee at a university or college, you might want to find out what resources it has.
Elementary, junior high, and high schools-Local schools sometimes provide mental health help or counseling for their students and their families.

Religious affiliations

– Sometimes your religious organizations (including YMCA and other religious community centers) have networks that provide or help find and pay for mental health care.

Local community mental health center

– These centers are often supported by local government and treat people with limited health care coverage such as Medicare and Medicaid.

Training programs

– Clinical training programs such as ones at universities and hospitals sometimes provide free or less expensive services with clinicians in training. Often there are certain limitations on who can volunteer for these types of programs.

Research projects

– Often mental health researchers need people to participate in treatment studies. Participants in these studies often receive free treatment. Your local college, university, health center, or hospital may be a good place to look for this option.

Working With Your Doctor

Working-With-Your-Doctor

Even after finding a doctor that they feel comfortable with, some people are intimidated by the thought of talking to their doctor. Office visits are short and some people feel they do not want to “bother” the doctor with their questions. However, a person’s recovery to health is a joint effort between patient and doctor. Doctors rely on information from patients to monitor and adjust treatment. Here are some suggestions to help you get the most out of working with your doctor.

Open and honest communication between you and your doctor is critical to getting better. You should be comfortable being honest with your doctor and be able to expect a genuine and open approach from your doctor.
Make a top five problem list of things that give you the most trouble. Developing your priorities in treatment helps the doctor focus your treatment and guides your recovery. You might make different lists for symptoms that give you the most problems or side effects you might have to medication. Keep track of your progress with the things you choose for your lists.
Write down any questions you have for your doctor. Sometimes people remember important questions after they have left the doctor’s office. Keep a running list of issues and questions that might occur to you in-between visits. Feel free to check your notes while you are talking to your doctor.
Let your doctor know about your symptoms. A doctor will not be able to modify your treatment unless he or she knows what you are experiencing. Sometimes symptoms can be much improved, but still annoy you. Discussing them with your doctor does not mean “treatment has failed,” but is an important way to deal with an illness. Decreasing the severity of some symptoms, but not totally getting rid them can still be a very positive goal.
Let your doctor know about any medication side effects. Not everyone experiences side effects, and many side effects may disappear once your body adjusts to the medication. But if any side effect is troubling you, your doctor may be able to give you another medication to counteract it. He or she may also have some practical advice on how to manage the side effect with diet or daily activity changes. If for any reason you feel that you cannot continue to take your medication, talk to your doctor immediately, but don’t stop taking them until he or she has directed you otherwise.

Questions to Ask a Therapist

Once you find a therapist that you are interested in, you might want to come prepared with some questions about how your treatment will work. Which questions you will want to ask depend on who you are, what your needs are, and what kind of therapist you are interested in.

About Them

What are your areas of expertise or interest?
How often do you treat people with my diagnosis/problems?
What kind of training do you have?

About Your Needs

What sort of treatment do you use to help people with my diagnosis/problems?
What sort of approach will we use?
What will be my role in treatment?
What would be the role of my family in treatment?

About Finances

What are your fees?
What kind of insurance do you accept?
How often will we meet and about how long might I be in therapy?
How does payment work here (e.g., do you pay first and then get reimbursed by the insurance company or do they bill your insurance company directly?)

Reference

Mental Health–General
Caring for the Mind

by Dianne Hales and Robert Hales (New York, Bantam Books, 1995)
An excellent overview of mental illness, its diagnosis and treatment.

Diagnostic and Statistical Manual, Fourth Edition (DSM-IV)

by the American Psychiatric Association (Washington DC, APA, 1994)
The American Psychiatric Association’s manual for classifying mental illnesses.

Bipolar Disorder
Manic-depressive Illness

by Frederick Goodwin and Kay Redfield Jamison (New York, Oxford University Press, 1990)
Still considered the definitive textbook on bipolar disorder.

An Unquiet Mind

by Kay Redfield Jamison (New York, Knopf, 1995)
Written by an influential researcher on the bipolar disorder about her personal experience with having the illness.

We Heard the Angels of Madness: One Family’s Struggle With Manic Depression

by Diane and Lisa Berger (New York, Morrow, 1991)
This book is written by a woman whose son was diagnosed with bipolar disorder. The book alternates chapters describing her experience with chapters describing bipolar disorder in general.

Depression

Depression: The Mood Disease

by F M Mondimore (Baltimore, John Hopkins University Press, 1993)
Clearly explains depression and its causes, symptoms, and treatment.

Depression: What Families Should Know

by E F Shimberg (New York, Ballantine, 1992)
A helpful guide for families on how to cope with the experience of having a loved ones with depression.

How to Heal Depression

by H H Bloomfield and P McWilliams (New York, McGraw-Hill Press, 1989)
A concise and comprehensive to what depression is and suggestions and resources for recovery.

Understanding Depression: A Complete Guide to Its Diagnosis and Treatment

by Donald F. Klein: (New York, Oxford University Press, 1993)
A good introduction to depression which explains the biological foundation and the emotional aspect of the illness.

Drug References

Drug-References

Pocket Handbook of Psychiatric Drug Treatment

by Harold Kaplan and Benjamin Sadock (Baltimore, Williams and Wilkens, 1996)
This book is intended as a simple reference for psychiatric residents. The reading level can be a bit difficult, but the drug descriptions are much more succinct and to the point than most references.

The Essential Guide to Psychiatric Drugs

by Jack Gorman (New York, St. Martin’s Press, 1990)
Includes descriptions of commonly used psychiatric drugs, including information about generic and brand names, dosage, uses, side effects, and medical conditions that can be worsened by each drug.

Stimulants and Hyperactive Children: A Guide
by Hugh Johnson (Madison WI, Child Psychopharmacology Center, Univ. of Wisconsin, 1990)
This book includes a good question-and-answer format discussion of stimulant treatment for attention deficit hyperactivity disorder.

Psychotherapy

Schizophrenia

Surviving Schizophrenia: A Family Manual
by E. Fuller Torrey (New York, Perennial Library, 1988)

This is a good basic discussion of the symptoms, diagnosis, prognosis, and treatment of schizophrenia. Includes sections on home care and legal issues.

Antipsychotic Medications and Schizophrenia: A Guide
by Jonathan Temte, James Jefferson, and John Griest (Madison,Information Centers, Univ. of Wisconsin, 1992)

A good general guide to medications used to treat schizophrenia, including a detailed explanation of side effects. Note that it is beginning to get outdated.

The Family Face of Schizophrenia

by Patricia Backlar (New York, Putnam’s, 1994)

This book reviews several examples of families with a member diagnosed as schizophrenic. Includes good discussions of legal issues and family resources. The reading level may be a bit difficult for the average reader.

Understanding Schizophrenia

by Richard Keefe and Philip Harvey (New York, Free Press, 1994)
Written by leading experts in the field of schizophrenia, it includes good sections on genetic and chemical factors in schizophrenia and the parts of the brain that may be responsible for schizophrenia. The reading level is fairly sophisticated.

Organizations

Mental Health—General
American Psychiatric Association
1400 K St. NW
Washington, DC 20005
(202) 682-6220     National Alliance for the Mentally Ill
200 North Glebe Road, Suite 1015
Arlingtom, VA 22203
(800) 950-6264
American Psychological Association
750 1st Street NE
Washington DC 20002-4242
(202) 336-5500     National Association of Social Workers
750 1st Street, NE, Suite 700
Washington, DC 20002
(800) 638-8799
Center for Cognitive Therapy
3600 Market Street, 7th Floor
Philadelphia, PA 19104-2648
(215) 898-4100     National Mental Health Association
1021 Prince Street
Alexandria, VA, 22314-7722
(800) 969-6642
Attention Deficit Hyperactivity Disorder
Children and Adolescents with Attention Deficit Disorder (CH.A.D.D.)
499 Northwest 10th Avenue, Suite 101
Plantation, FL 33317
(800) 233-4050     The National Attention Deficit Disorder Association
(ADDA)
PO Box 972
Mentor, OH 44061
(800) 487-2282
Bipolar Disorder
National Depressive and Manic Depressive Association (NDMDA)
730 Franklin Street, Suite 501
Chicago, IL 60610
(312) 642-0049     Stanley Center for the Innovative Treatment of Bipolar Disorder
3811 O’Hara Street, Suite 279
Pittsburgh, PA 15213
(412) 624-2476

Depression
Depression and Related Affective Disorders Association
Meyer 3-181, 550 Bldg.
600 North Wolfe Street
Baltimore, MD 21287
(410) 955-4647     National Foundation for Depressive Illness
PO Box 2257
New York. NY 10116
(800) 248-4344
Schizophrenia

The National Alliance for Research on Schizophrenia and Depression (NARSAD)
60 Cutter Mill Road, Suite 404
Great Neck, New York 11021
(516) 829-0091, (516)487-6930 FAX

Treatments

Hospital Stay

A lot of myths exist about things associated with mental health. Nothing is more misrepresented or overly dramatized than a hospital stay for mental illness. Being treated in a hospital can be very important in certain situations.

It is necessary when an illness becomes so severe that:

A person has lost the ability to function in their daily lives
A person has lost hope and has persistent thoughts of suicide, or harming themselves.
A person has lost touch with reality and has thoughts of harming other people.

It is also helpful:

When a person’s situation and symptoms are very complicated.
When a person is suffering a lot from his symptoms.

Personal Safety

Personal-Safety

A hospital stay can help keep a person safe and provide valuable time for treatment to start reducing their symptoms. Once symptoms improve, the ability to function and think more clearly returns. Hospitals can provide a person with a lot of support. A team of health care professionals works with a single patient and there are usually therapeutic groups throughout the day.

Diagnosis

A hospital stay can provide a doctor the chance to learn a lot about a patient and his symptoms in a small amount of time. Properly identifying the problem is essential to finding the right treatment for a person. Getting input from a person, 24 hours a day is the fastest way to diagnose a condition and start helping a person feel better.

Adjustments in Medication

A hospital stay can provide a doctor the opportunity to adjust medications faster and bring quicker relief to patients. Medications can be adjusted to a helpful level much faster in the hospital than during a series of out-patient visits. The hospital staff can closely monitor any improvement or side effect that might occur with changes in medication.

Length of stay

People no longer stay in hospitals for months on end until they are completely better. Today, hospital stays try to reduce the severity of symptoms so that a person might safely and more effectively continue to deal with the illness outside of the hospital. Hospital stays generally last from a few days to about one or two weeks. Considering the months or years of productive living that can be lost to mental illness, a few days in a hospital is a valuable investment of time and effort.

Hospital Environment

Again mental health units or hospitals are nothing like what is seen on television. Patients wear their own clothes and are not running around in strait jackets. Patients receive treatment from a number of health care professionals (nurses, psychologists, social workers, and doctors) that all work together to help a person recover. Therapeutic groups are usually provided throughout the day. In these groups, the other patients that have also sought help in the hospital often become additional sources of support.

Lab tests

Although stays are in a medical or psychiatric hospital, this does not mean a lot of tests will be ordered everyday. A thorough medical history and physical will provide most of the information needed for treatment. At the start of the hospital stay some blood tests may be done like checking a person’s thyroid functions, liver tests, or anemia. Generally, these tests can all be done in only one or two blood draws.

Sometimes a person can become so impaired by a mental illness that he or she does not recognize the need for help and refuses treatment. For example when a person has become hopeless and suicidal, delusional and a danger to others, or lost the ability to function in everyday life, someone else may have to help that person get into treatment.

The decision to seek treatment for an unwilling person is often a difficult one for families. Sometimes there is a sense of guilt or fear that the patient will be angry with them. However, it is important to focus on the benefits and reduction in suffering that a person can receive from proper treatment. Once their illness has improved, most patients understand the need for a hospital stay and may agree on their own to stay in the hospital.

Families do not have the power or responsibility to “put people” into a hospital. In most cases, the family acts only as “petitioners” or “people asking for help.” Legally, the family is only making a request that a person be medically evaluated for the need for treatment. It is the medical and legal system that then decides how to best treat a patient and will admit people on an involuntary basis if necessary.

Different states have different laws and requirements for getting a person in treatment on an involuntary basis. The local community mental health center usually can provide information on the commitment procedure.