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Wednesday, February 28, 2024

How to Navigate Online Mental Health Resources

After I stopped my anxiety medication too quickly, I needed expert assistance, and quickly. Though I wasn’t in full crisis mode, it wasn’t a good situation. It was a rookie mistake. Don’t do this on your own. I have good health insurance, so I felt confident I would find a doctor to taper off my meds safely. But finding an appropriate professional became a lengthy, frustrating process. The lack of current or reliable online information for mental health was a big problem, even for me—and I’ve worked in health care.

Like most people, I began my search via my insurance company’s website. Their portal had filters and drop-down boxes for criteria like condition, type of doctor needed, and zip codes. I decided to cast a wide net in hopes of getting a few options to choose from. Pages of providers appeared, but each listing offered limited information. Most had just a few educational credentials or major conditions the individual specialized in treating. The first two pages I scrolled through were counselors and social workers. This would not work for me: I needed medication management, and I had even included that as part of my requirements. Apparently, the filters did nothing.

After an hour, I found 10 possible candidates. But most of them weren’t taking new patients, or only saw children. My next attempt led me to seven physicians located in or outside my city. That was enough. I made a list of docs to call and contacted each one.

Not one of them was able to help me. In fact, three had left their practice, and the remaining four had moved somewhere into the black hole of mental health group facilities owned by a parent corporation. I came up empty. The hospital portals I visited were outdated, and missing information was the norm. My mental health was now being hindered by technology.

As a health care worker, I was disappointed. As a patient, I was furious. After my third hour, I gave up on websites and their 404 error pages. I turned to Google and wrote down names to investigate another day. It was exhausting.

In 2021, a research survey from the National Alliance on Mental Illness revealed growing dissatisfaction with online mental health information. The survey involved both individuals with mental health conditions and those seeking assistance for family members. Eighty percent of responders who used navigational tools to find treatment or services reported difficulties with data availability and accuracy.

These issues also involved patients who were in treatment and suddenly faced the possibility of losing their insurance coverage due to policy changes—as when a new company took over their insurance plan and implemented changes.

Aviva Gaskill is a clinical psychologist in Pennsylvania. She states that the system is almost as confusing for providers to navigate—if not more—when dealing with multiple insurance companies or large companies that all have different criteria for credentialing and/or reimbursement.

“Behavioral Health coverage, even for large insurance companies, is not the same state to state. Even when people leave hospitals and large practices, we will still show up on websites everywhere, even places we’ve never worked.”

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Gaskill noted that when she submits information online, it doesn’t seem to get picked up by the right department or web address. “I’m still on those lists. Magellan will tell patients I’m a provider, yet I was never credentialed for them in that state—ever.” She still gets calls from patients who tell her they were given her name from a list provided by their carriers or employee benefits representative at work.

Alan Morse is a clinical and consulting psychologist, as well as a board-certified coach. He says the traditional insurance model of credentialing certain providers to get paid is outdated and harmful. People are not getting the help they need, and doctors are leaving insurance plans to strike out on their own just to get paid.

“Mental health has not kept pace with other medical practices. People need to be more proactive and ask themselves what they really need. Work backward. What would a successful outcome look like for me? Could I see other trained professionals like counselors or coaches to help my situation?”

He suggested national associations like the American Psychiatric Association and National Register of Health Service Psychologists as a starting point but said not to overlook community outreach.

“Pastoral counseling, community mental health programs, synagogues, mosques, charity nonprofits, etc. are more helpful than people realize. They can put you in touch with resources or colleagues.”

Here are a few other things to keep in mind if you hit a cyber roadblock:

Do Your Homework

Think like a detective before you call anyone. Ask yourself what is important to you right now and what you think you’ll need to feel or function better. Then investigate who might be able to help you with that. It may take an assessment by a psychologist or psychiatrist, but it may not. An eating disorder specialist or substance counselor may start you in the right direction if you have bulimia or addiction issues. So be specific when you take stock of all that is contributing to your current dilemma.

Insurance Sites Are Not Gospel

Don’t believe everything you read. As noted earlier, insurers and large practice groups don’t update their information quickly enough to meet the demands of mental health patients and professionals. So the “Not taking New Patients” message you get may be outdated. You will need to make some calls and find out for yourself. Many providers have availability listed, but their schedules show no openings as part of a screening process. I know a few who didn’t want the public just calling and making appointments without providing some information first. When in doubt, call the provider and ask.

Verify Who Will Pay Your Bills

Other than finding someone, this may be the most important step unless you want invoices coming in for hundreds of dollars. If you are going through your insurance, make sure your particular plan will pay for it. Just because it says Blue Cross on your card doesn’t mean Blue Cross is the one paying for the service. Third-party companies are often involved, and reimbursement policies, including how much they pay, vary from state to state. Ask about your specific plan, not the general policy of your insurance company.

Be Honest About Your Immediate Needs

If you are in crisis, tell someone. If you have stopped taking your meds, or can’t stop crying, this is not the time to do extensive research. Call your primary doctor, who may call or recommend a colleague on your behalf or direct you to an agency. Don’t wait to “feel better” or put it off. Even if you have no plans to harm yourself or others, get help. If your only option is the emergency department, so be it. At the very least, hospitals can address your medications and direct you to counseling services until you find your way.

Understand That Private Health Care Is a Business

Most of us know this already, but it bears repeating. Smaller mental health practices are being bought and sold left and right. Many don’t take insurance at all. The reimbursement rates for mental health providers are far lower than for other types of providers. However, they may offer options like sliding scale payments (pay what you can afford) or give you a reduced rate. It all depends on the practice. Private companies make their own rules, so speak to someone in charge.

Above all else, know that it’s probably going to be a process of elimination. It takes real work to find good, affordable, and professional mental health assistance. There is no centralized database or catch-all. And the responsibility will be on the patient or guardian to figure out what to do as an individual or family.

But we are all worth the struggle. Please keep going.

If you or someone you know is in distress or needs mental health support, please contact the National Suicide Prevention Lifeline at 1-800-273-8255. Help is available 24 hours a day, 7 days a week, in English and Spanish.

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