There are a number of low cost options for mental health care. From using your health insurance or employee assistance program, to sliding scale options and community mental health clinics, finding affordable therapy is possible. If you need mental health care but cost is a deterrent, read on to learn about affordable options and how to access them.
1. Know What Your Insurance Covers
A great place to start when looking for affordable mental health care is with your insurance. In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) was passed, requiring that most insurance plans offer coverage for mental health and addiction treatments similar to the coverage offered for other health conditions.1 As a result, many insurance companies now provide coverage for mental health treatment such as therapy.
If you have insurance, using your coverage can make mental health care significantly more affordable. It’s important to first understand what your insurance plan covers as coverage can vary widely from company to company and plan to plan. Depending on your coverage, you may pay as little as your co-pay. In some cases you may even pay nothing.
To understand your coverage, look at the summary plan description and/or the summary of benefits and coverage documents provided by your insurance company. These documents, which are provided at the time of enrollment and can be requested at any time, lay out your coverage in plain language.
If you have questions about your coverage, check with your HR representative (if your insurance is provided through your employer) or your insurance company’s website or call center.
2. Sliding Scale Therapy
If the cost of therapy is a barrier, consider looking for therapists who offer sliding scale therapy. Sliding scale therapy is a fee structure where the therapist or agency provides services at varying rates depending on the person’s financial situation. Therapists in private practice, group practice, and agency settings may all offer sliding scale fees. However, not every therapist or organization will, due either to ethical or practical considerations.
How a sliding scale fee is determined depends on the therapist/organization offering it. Some therapists reserve spots in their schedule for specific fees while others will use a formula to calculate a client’s fee. A therapist may request financial documents to help them determine the fee you will be charged while others use an honor system. Organizations that provide sliding scale services will likely request financial documents.
When looking for a therapist who offers sliding scale fees, check out their online directory profiles and website as it will often be noted in the section about their fees. Many organizations that offer sliding scale fees will also note that on their website or provide that information when you call to inquire about services.
The nonprofit Open Path Collective offers a directory of therapists who provide therapy for $30-$60 a session to individuals without insurance or inadequate insurance coverage. After registering with Open Path Collective and paying a one time membership fee of $59, you are able to schedule an appointment with a therapist in their directory. This is an excellent option for finding therapists who offer sliding scale fees in your area.
How Do I Ask a Therapist About Their Sliding Scale Options?
Asking about a sliding scale option may feel uncomfortable or difficult. It can be helpful to know that many therapists reserve spots for clients who need to utilize a sliding scale fee and are happy to work with you to find a fee that works for both of you.
Here are some tips for discussing sliding scale options with a therapist:
Know What You Are Able to Pay Before You Call
Look at your weekly budget and figure out what you can afford for weekly therapy sessions. This is important because sliding scale options differ from therapist to therapist- one therapist’s lowest sliding scale fee may be $20 while others may be $75. Knowing what you can afford before you call can help you find the right fit more quickly.
Be Prepared to Discuss Your Financial Situation
Some therapists use specific formulas to calculate the sliding scale fee they offer based on each person’s situation. Some basic information you may need to provide is your annual and/or monthly income, current employment status, and number of dependents. The therapist may request documentation of your income and/or employment status.
Figure Out When You Would be Able to Attend Sessions
Many therapists who offer sliding scale options will do so during non-peak hours. While the standard of care you receive will not be any different, the scheduling availability may be less flexible. Know your schedule so you can quickly figure out if the therapist’s availability will work for you.
Email Template for Reaching Out to a Therapist
When reaching out to a therapist by email, be clear that you are interested in their services and need to understand what their sliding scale options are. You may mention that you saw they offer sliding scale fees and wanted to learn more about those options, or ask if they have any sliding scale spots if you didn’t see that information listed. The goal for an email inquiry about sliding scale fees is to understand what, if any, options are available to you.
Dear (therapist’s name),
I am writing because I am interested in potentially utilizing your counseling services. I saw on your website that you offer sliding scale fees. Due to my current financial circumstances, I wanted to ask what options you have around the sliding scale and if you need any information from a potential client in order to calculate a fee.
Phone Template for Reaching Out to a Therapist:
When calling a therapist to inquire about their services, don’t hesitate to ask any questions you may have around their sliding scale options. While it may feel awkward or uncomfortable, therapists routinely answer questions about their services, including their fees. They will be happy to answer questions that help you both determine whether you might be the right fit.
- “I know your fee is listed as $150, but unfortunately I’m not able to afford that right now. Do you have any sliding scale options available?”
- “I wanted to ask if you have any sliding scale options available because I can currently only afford a fee of $75. Is there a way we can make that work?”
While not every therapist may offer sliding scale options, or have sliding scale spots available when you call, it’s worth checking if you have found a therapist you think might be a good fit for you.
3. Community Mental Health Options
Since the Community Mental Health Act was signed into law in 1963,2 community mental health centers have played a key part in increasing access to mental health care. Community mental health centers are organizations that offer mental health services at a reduced (or free) rate. They often receive substantial funding from federal, state, and/or county sources which allows them to provide services at a lower cost for people who would otherwise be unable too.
Each community mental health center may offer a different range of services. While some may only provide individual therapy, others provide individual, group, and family therapy, psychiatry services, and addictions treatment. As these organizations are often local and based in specific counties, you may need to show your county or city residency in order to access services. As many of them offer services on a sliding-scale basis, you will also likely need to provide financial information during the intake process.
To learn more about community mental health centers near you, try searching for “community mental health center + the name of the county or city you live in.” Many counties now list the community mental health centers and associated organizations on their websites.
Due to the high demand for mental health services, you may not be able to be seen right away. In this case, you may be put on a waitlist. If you would like to get started sooner, many community mental health centers are able to provide referrals to providers in your area who offer reduced or sliding scale fees.
4. Check With Your Employee Assistance Program (EAP)
Your employer may offer an employee assistance program (EAP) which allows you to access mental health care for free. While there may be limits to the number of sessions provided (many offer 10 free sessions per issue, per year), it is an excellent resource to access when you have a mental health issue you want to address. If you need longer-term treatment, the therapist you work with through your EAP may be able to continue to see you through your insurance coverage or private pay, or they can provide appropriate referrals.
Although this benefit is provided by your company, the care you receive is confidential. What you share with a therapist providing services through an EAP will not be shared with your boss, colleagues, or other company employees.
To learn more about your access to an EAP, look through your benefits statement. Your company’s internal website may provide information on how to access EAP services. An HR representative will also be able to help navigate accessing EAP services if you have additional questions or concerns about the process. Most EAPs can be accessed through a website or phone number, where you can be matched with a provider and schedule an appointment.
5. Support Groups
Support groups are often a free or low-cost option that can be a valuable resource when dealing with a range of issues. Support groups are different from group therapy. Group therapy is led by a therapist or team of therapists, and typically follows a set protocol for addressing a specific mental health issue. In contrast, support groups may or may not be led by a mental health professional. They are typically organized by a focus that may or may not be directly related to mental health. There are support groups for a wide range of issues.
Some examples include those caring for a family member with Alzeheimer’s or dementia, those diagnosed with attention-deficit/hyperactivity disorder, and those recovering from addiction.
The benefit of support groups is connecting with others who are experiencing a similar issue or circumstance. In addition to social connection, groups are often a resource pool for dealing with challenges around the group’s focus. For example, a support group for individuals who have lost a spouse can share practical information such as how to navigate significant dates without the spouse, and recommendations for grief counselors or estate lawyers.
Many local organizations such as community mental health clinics, senior centers, and religious organizations host support groups for various topics. Check out the websites of organizations in your area to see what they offer. Virtual support groups are also available and can be accessed no matter where you live. Try searching “support group for insert topic” such as “support group for parent of child with Autism” or “support group for cancer diagnosis.”
Mental Health America provides an extensive list of support groups across the country that address a wide range of topics. The National Alliance on Mental Illness offers support groups for those experiencing a mental health condition as well as groups for family members of those with a mental health condition.
6. Ask What Resources Are Available at Local Universities
Many universities offer services at lower rates than seen in private practice settings. In some cases, mental health services may only be available to students enrolled at the university. If you are a student, check with your university’s website for information on available mental health services. They are often available for free or at a steeply discounted rate.
Outside of services for students, many universities offer discounted services to the general public. This is particularly common at universities that offer master’s or doctorate degree programs in counseling. As part of their training, students working towards their master’s degree provide therapy services. These students work under the supervision of licensed and experienced therapists, ensuring that the services they provide are high quality.
To find out what resources are available in your area, reach out to local universities and ask if they have a graduate training program or clinic that offers low-cost counseling to the general public.
7. Therapy Apps
A number of online therapy options have been developed in the last few years that aim to increase people’s access to mental health services. Because the providers who offer services through these platforms ostensibly don’t have the same overhead as providers who work in person, the cost is lower. BetterHelp is one provider of video-based therapy and Talkspace is its primary competitor. You can read more about these online therapy services in our BetterHelp review and Talkspace Review.
When considering a therapy app or online counseling platform, make sure to research exactly what is provided and consider whether or not that will meet your needs. While the cost may be much lower on some therapy apps, you may be limited to messaging or have difficulty finding a provider on that platform that is the right fit for you. There are tradeoffs you make when choosing between online therapy and traditional therapy. For example, online therapy is also not often covered under insurance plans so you may need to pay out of pocket, without that cost going towards your deductible.
Therapy apps are not an appropriate form of care for individuals with significant symptoms of mental health issues such as psychosis, those in crisis, and most children. For clients wishing to address milder symptoms of mental health conditions or other topics that are commonly addressed in therapy (such as stress management, relationship issues etc.), a therapy app may be helpful.
For Further Reading
- The Anxiety and Depression Association of America provides links to find affordable therapists and federally funded mental health centers near you, as well as links with information on accessing affordable medications.
- The Substance Abuse and Mental Health Services Administration provides a behavioral health treatment services locator.
- The National Alliance on Mental Illness offers a directory of services available in your geographic area, including support groups, education on a range of topics, and other local resources.
- The National Association of Free and Charitable Clinics offers a “find a clinic” page where you can see a list of free or reduced clinics in your area.