Can affordable therapy really be within everyone’s reach? Join us as Dr. Tami and Harold tackle the critical issue of making mental health care accessible for individuals with low income. We start by demystifying the process of checking eligibility for insurance, highlighting how many might already qualify without knowing it. Dr. Tami shares her clinic's approach to sliding fee scales, ensuring that therapy costs are adjusted based on income and dependents. We also discuss state programs and human service centers that provide behavioral health services using similar sliding fee scales. Indigenous communities are not left out, as we shine a light on the invaluable resources offered by IHS facilities.
We don't stop there. We delve into the broader issue of mental health care accessibility, emphasizing the glaring disparities faced by many. The conversation underscores the importance of making quality mental health services, including evidence-based treatments, available to everyone regardless of their financial situation or insurance status. We call on clinicians to innovate and find ways to make essential services accessible. And, we invite our listeners to engage with us, share their questions, and suggest topics for future discussions. Prioritizing mental health is crucial, and this episode is jam-packed with insights on how to seek the best possible support on a budget.
Your support matters to us! Please give us a follow on each of our platforms to stay updated on what we're doing at PsychologistSay.
Can affordable therapy really be within everyone’s reach? Join us as Dr. Tami and Harold tackle the critical issue of making mental health care accessible for individuals with low income. We start by demystifying the process of checking eligibility for insurance, highlighting how many might already qualify without knowing it. Dr. Tami shares her clinic's approach to sliding fee scales, ensuring that therapy costs are adjusted based on income and dependents. We also discuss state programs and human service centers that provide behavioral health services using similar sliding fee scales. Indigenous communities are not left out, as we shine a light on the invaluable resources offered by IHS facilities.
We don't stop there. We delve into the broader issue of mental health care accessibility, emphasizing the glaring disparities faced by many. The conversation underscores the importance of making quality mental health services, including evidence-based treatments, available to everyone regardless of their financial situation or insurance status. We call on clinicians to innovate and find ways to make essential services accessible. And, we invite our listeners to engage with us, share their questions, and suggest topics for future discussions. Prioritizing mental health is crucial, and this episode is jam-packed with insights on how to seek the best possible support on a budget.
Your support matters to us! Please give us a follow on each of our platforms to stay updated on what we're doing at PsychologistSay.
The following is a series of candid conversations. The content is intended for informational purposes only and is not a substitute for seeking help from a mental health care professional. To learn more info regarding additional disclaimers, privacy policies and terms and conditions, please visit HelloDrTammycom.
Speaker 2:
Bonjour, welcome to Psychologist Say, a podcast where I talk about the psychology of everyday living. I'm your host, Dr Tammy, and I'm joined today by my co-host, Harold. How are you doing today, Harold?
Speaker 1:
I'm doing great. I'm doing great.
Speaker 2:
Wonderful. So, harold, let us know that one of our listeners had a question that was sent to us. So what was the question, harold?
Speaker 1:
He was wondering about how somebody who's low income or you know, has difficulty paying for any kind of therapy. Like what are their avenues, what can they do to pay for therapy?
Speaker 2:
Right, great question. So there are several different options to think about and really one thing is if they're an individual has low income, it's always good to check to see if you do qualify for any type of insurance. Sometimes people assume that maybe because they're low income that they can afford insurance, and so I always do say at least do your homework in that area to see if there are some options and if there's not, another good thing to do is look for clinics that have a sliding scale fee scale fee. So even, for example, my clinic, we offer this.
Speaker 1:
And so this is something that will go based off of your income. Okay, so like what is it?
Speaker 2:
So it's just based off of your annual income and the number of dependents that you have in your home, and so, whatever that is, then you're charged a percentage versus the full fee of attending a session.
Speaker 1:
Okay, so if a potential patient comes in with documents of their income, their dependents, you'll adjust your own fee based on that, right Okay?
Speaker 2:
And one thing is not every clinic will do this, so you want to find a clinic that offers a sliding scale fee.
Speaker 1:
Okay, so this is nothing mandated. You have to find a clinic that's willing to work with you in that way.
Speaker 2:
Yeah, if you want to go to a private practice which I'm a private practice, so many private practices may not offer this. This is something that my clinic offers, and it's a way this was the whole mission of my clinic was to make sure that we're inclusive and that we can provide therapy to everybody who is in need of therapy. And I mean, the reality is, when you are running a business, you do have to be able to charge. So it is important you know that if there is insurance out there that people can, that's always a good route to go to try to find that and then finding a clinic that offers that they're able to work with you if you do not qualify for insurance but you still want these services, and so usually that's what clinics will require is to bring in some proof of income, and then we're able to work through that, and if your income is at a certain percentage and you kind of pick that percentage, then you can qualify for discounted services.
Speaker 1:
So if you want to go to a private practice, you will have to pay something.
Speaker 2:
I imagine that most people will have some kind of fee for yes, because it's a business.
Speaker 1:
The purpose is to make money.
Speaker 2:
Well, the purpose is to be able to provide services, and that's the whole way the clinic runs. It's a job, it's what they're doing for income. So there's other things to think about. There are state programs that offer human service centers. There are state programs that offer human service centers. So that's another area where you can look in your state and find out what other human services at the Department of Human Services and each area will have a behavioral health clinic where you're able to access services and they may do the same thing.
Speaker 1:
The sliding fee scale Okay, so even with public options, there's going to be some kind of payment involved.
Speaker 2:
Right, but they'll have that sliding fee. Yeah, so nobody's paying insane amounts of money, Right no, it's more based off of what you can afford, based off of your income.
Speaker 1:
Okay, so what if somebody came in and they have no income?
Speaker 2:
Oh, that's a good question. Well, I think through the state programs they still that's part of the program they get state funds to be able to provide these services. So it would be the same thing be able to provide these services. So it would be the same thing like if you're an Indian country and you're going to an IHS. That would be another option for our Indigenous people who are enrolled and they live in an area near a behavioral health facility. That's another great option to think about. If you do not have the income and you will not get that bill, so IHS will still bill insurance but yet you're not stuck with that co-pay. But also, if you do not have insurance, you're still able to get those behavioral health services. So that's another great option for Indigenous people who are listening to the podcast. And we can still look for those state programs that are run. There may be some nonprofit programs that offer certain discounts or they may have certain grant funds that cover therapy. I think it depends on how many resources you have in your area.
Speaker 1:
Yeah.
Speaker 2:
So here in our smaller rural community I'm not aware of a nonprofit that offers something like that, but I could imagine, yes, in larger communities you may be able to get services if you do not have money. If it was through a nonprofit and they have it set up that way. If it was through a nonprofit and they have it set up that way. I'm glad you brought that up because it's really making me think of there's probably even more ways than I was originally thinking about.
Speaker 1:
Mm-hmm.
Speaker 2:
And the other one is looking online. This has been an option where you can look at getting so many sessions for like a flat rate, so that you know what you're getting into. The prices may vary, but there are a lot of individuals who do not have insurance who are going that route. They're able to get like a package deal for so many sessions and they know exactly how much money they're going to pay for these sessions, and so that's another great option to look and do your homework and to start seeing what's out there. I think people are going to find there's a lot more than they knew existed, especially with being able to do therapy online.
Speaker 1:
So are there any options? In particular, you know about.
Speaker 2:
I'm not sure of the name, but I think they're advertised quite often on BetterHelpcom, maybe one, I think. Yeah, that is exactly what one is called BetterHelp, and I'm not trying to advertise. But those are some of the areas where you're able to go in and look for online therapy. Look for affordable. You know, in your internet search, look for affordable therapy options. Your internet search, look for affordable therapy options. I think there are support groups that you may be even able to access, where that's not individual therapy, it's not therapy, but maybe somebody is wanting to seek support, you know, looking for family support, looking. Maybe they have a diagnosis and they're looking for an online support group for anxiety disorders.
Speaker 1:
Where people can get together and kind of talk about Chat virtual meetings.
Speaker 2:
Those are the other options I think of. How do we enhance and connect with other people and get the support we need?
Speaker 1:
Yeah, At least they're not like if someone is going through a difficult time, at least with those options they're not alone.
Speaker 2:
They don't feel alone. Yeah, Right, and you know there's always crisis lines where you're able to call in. You know every state has them. I believe ours in North Dakota, I think it's 988, a crisis line. Yes, 988, help is available. Those are really good things, Like even if it's, it doesn't mean you're starting therapy, but it means if I'm in a, in a tough spot, I can dial this number and and talk to somebody.
Speaker 1:
Yeah, If things get really tough.
Speaker 2:
If things get really tough. Every state has these resources. So those are good ways to say how do I maybe develop my own mental health kind of toolkit? Maybe you don't need it now, but maybe it's something that in the moment you won't want to create, or maybe somebody in your home or maybe a friend would need some of these resources. So I think this I'm really glad our listener asked us this question because it's a great question and locally, like, what I've done is I try to write grants.
Speaker 2:
We try to do contracts with programs, schools, communities with programs, schools communities where we can try to help offer these services through contract as well. So whenever you're providing contract services, then you're not billing insurance, you don't have to deal with co-pays. So there are a lot of things like that I think that I do as an Indigenous clinic to try to help individuals get their needs met. Also, I have a grant right now where we're able to provide some therapy while I'm credentialing providers for insurance. So sometimes there may be options like that where clinics are working and trying to provide and get creative on ways that they can give services.
Speaker 1:
That sounds great. So I guess I have a question with that pay scale. Do you have an idea of what's the low end on that scale? The sliding scale fee, the sliding scale fee, yes.
Speaker 2:
So it's looking at different percentages, right, and the family size, what your current income is. So you have to be able to qualify. If that's what they're using, they'll qualify for a certain number of sometimes they do even do a number of sessions at a certain rate. It can take what could be a session that could cost $100 or $200, and it could take it down to like $45, various.
Speaker 1:
I mean this really Everyone's situation will be a little different.
Speaker 2:
Everyone and depending on what service, because every service has its own fee. Yeah, so that's one thing that you know as a private practice. This is good to know for our listeners that if you are self-paying and that's where you don't have insurance and you want to self-pay, that you go through, your provider gives you a good faith estimate. So that's another way to try to say well, how expensive is this going to be if I self-pay? It's an estimate of here is what our sessions cost and here's how many sessions I'm proposing that you have. This is my treatment plan and here's a good estimate of what it will cost you before they fully engage and start to get those bills.
Speaker 1:
So they'll lay out like an individual session cost and maybe a total cost. Yes, yep.
Speaker 2:
Where it's like. Well, this would be the cost of our first visit. If I don't do testing, I'm planning on seeing you for six sessions at this price per session. So it's a good faith estimate. So they know after you know. In total, this is likely what you'll be paying out of pocket if you self-pay.
Speaker 1:
Right, but that's an estimate.
Speaker 2:
That's an estimate, so that means like we didn't anticipate that you may have had a crisis session.
Speaker 2:
And maybe you need more sessions or well even if you needed more, we would have to then again, you know, review that with them. We wouldn't just say like, see you next week and it wasn't on, you know. So that's part of that treatment planning where you want to say, okay, uh, we're, we're rounding, you know, we're at the almost, you know, in two sessions we're at the end of our six and I think I would like to see you four more times and then again at this rate, you know, you kind of just keep them aware because that's where out of pocket, and I and that's something I do, you know, right away when individuals say, well, I'll just pay out of pocket, and I, even on the telephone, I said, okay, well, let me like, let me go through what this could cost you, just even over the phone, and sometimes people are surprised and they're backing off with, oh OK, wait, hold on.
Speaker 1:
Yeah, this could be expensive.
Speaker 2:
Yes, so they may, and that's one you know that's a downfall of all health care. It is, it's pricey, it is expensive. Yep, so it's something. These are. This is really good questions, because we do. You know, we want people to be able to engage in therapy and it's really looking at being creative and finding what resources can work with you. Even talking to your provider about it or your clinic, like what we're doing now, it could be a really good way for me to talk to somebody who wants to come in and see me that I would go through all these options with them, and even you may even refer them to somewhere else if you know that it meets their needs better.
Speaker 1:
Yeah, I think this is a good one, because this is a topic I don't think I ever heard in psychology before is how do I pay for this Right? And there's so many people, especially in our community, that they just can't afford it and many can't. They just don't have insurance, they just can't afford it, and that's all over the nation.
Speaker 2:
This is something that and it's one of the highest need areas. You know it's an area that is in such need and you know it shouldn't be a privilege to have good mental health care and have quality providers and be getting the best, most evidence-based treatment. You know everything that we're trying to do here at the clinic, so I think this is really just bringing up a bigger conversation, you know, for down the road and looking at just health care in general and being able to take care of our needs and that's for everybody. You know that inclusivity of everybody should have access to this, and that's where I'm hoping that more and more clinicians get really creative on how they can do that. So, miigwech, thank you. Great conversation, harold. Thank you to our listener for bringing this question our way. If you have any more questions or topics for us, please don't hesitate to go to our website and go to our link. Send us a message and we'll be happy to try to do our best to create a conversation about it.
Speaker 1:
You can also send us a text message through Spotify. There should be an option within our episode menu screens.
Speaker 2:
Beautiful Anything you want to leave with Harold. Any thoughts for the listeners?
Speaker 1:
Ask us more questions. We'd love to hear them.
Speaker 2:
Miigwech. Ps Therapy can be very expensive, yet your mental health is definitely something that we believe is a priority. Let's look at all the ways that we can help you find the right setup for you. You.
