Navigating the Healthcare System for Your Psychiatric Needs

A Guide to Navigating Mental HealthcareYou’ve made the courageous decision to seek help for your mental health. That is the most important first step. But what comes next? The healthcare system can feel like a complex and confusing maze, and it can be hard to know where to even begin. Knowing the basic path and the key players involved can make the process of finding and receiving care feel much less intimidating.

At Televero Health, we want to help demystify this process. Think of this as a simple roadmap to help you navigate your way to the right care for you.

Step 1: The Starting Point – Your PCP

For many people, the best place to start is with their Primary Care Physician (PCP). Your PCP knows your overall health history and can be a great first point of contact. They can:

  • Do an initial screening for common conditions like depression and anxiety.
  • Rule out any physical health problems that could be causing your symptoms.
  • Sometimes, they may even be comfortable prescribing a first-line antidepressant medication.
  • Most importantly, they can provide you with a referral to a mental health specialist.

Step 2: Finding the Right Mental Health Provider

Your PCP will likely refer you to a specialist. There are two main types of mental health providers you might see:

  • A Therapist: This is a professional trained in providing psychotherapy, or “talk therapy.” Their title might be psychologist (PhD or PsyD), licensed clinical social worker (LCSW), or licensed professional counselor (LPC), among others. They help you to understand your feelings, change your thought patterns, and develop coping skills.
  • A Prescriber: This is a medical professional who is licensed to prescribe psychiatric medication. The two main types are:
    • A Psychiatrist: A medical doctor (MD or DO) who specializes in mental health.
    • A Psychiatric-Mental Health Nurse Practitioner (PMHNP): An advanced practice nurse who specializes in mental health.

For many conditions, the most effective treatment involves seeing both a therapist and a prescriber.

Step 3: Understanding Your Insurance

Navigating insurance can be one of the most frustrating parts of the process. Before you make any appointments, it’s a good idea to call the member services number on the back of your insurance card. This can save you a lot of time and money. Here are a few key questions to ask:

  • “What are my mental health (or behavioral health) benefits?”
  • “Do I need a referral from my PCP to see a specialist?”
  • “Can you give me a list of in-network psychiatrists and therapists in my area?” (“In-network” means the provider has a contract with your insurance company, which makes your care much cheaper.)
  • “What is my copay (the fixed amount you pay for each visit)?”
  • “What is my deductible (the amount you have to pay out-of-pocket before your insurance starts to pay)?”

Step 4: Making the Appointment

Once you have a list of in-network providers, you can start making calls. Don’t be discouraged if the first few providers you call are not accepting new patients or have a long waitlist. This is common. Be persistent. When you schedule your first appointment, they will likely ask for your insurance information.

Step 5: The First Visit and Beyond

Your first appointment will be an “intake” or evaluation, where your new provider will ask you a lot of questions to get a complete picture of your history and your current symptoms. This is the beginning of your partnership.

As you move forward, remember the importance of “coordination of care.” This means allowing your different providers (your PCP, your therapist, and your psychiatrist) to communicate with each other. You will need to sign a release of information form for each one. This ensures that everyone on your team is on the same page and that you are getting safe, integrated care.

Navigating the system takes some effort, but it is manageable. By taking it one step at a time, you can successfully find your way through the maze and connect with the care you need and deserve.

Key Takeaways

  • A great starting point for seeking mental healthcare is your Primary Care Physician (PCP), who can provide an initial screening and a referral.
  • It’s important to understand the difference between a therapist (who provides talk therapy) and a prescriber (like a psychiatrist, who manages medication).
  • Before making appointments, call your insurance company to understand your mental health benefits and get a list of in-network providers.
  • Be persistent when looking for a provider, and be sure to sign releases of information so that all the members of your healthcare team can communicate.

Ready to take the first step? We can help. Get started with Televero Health today.