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I miss almost nothing about college, except for one thing: the ability to waltz into the health center whenever I pleased and immediately be connected with a mental health professional. No phone calls ending in rejection, no clawing with medical billing, no database of smiling therapist faces and promises of ~*~healing~*~.
Trying to find a counselor or therapist (especially for young people, but also for everyone) is a terrible experience, for at least a dozen reasons. It’s like a layer cake of emotional garbage, each layer compounding the horrible nature of the layer before it. It’s so bad that it legitimately keeps people in need away from necessary services. Under 40% of people who say they need mental health care actually get it.
First, there’s admitting that you even need to talk to someone. In a world where mental health care is so forbidden most of us are ashamed to even tell anyone what’s the matter with us, even admitting to being curious about help is crushing. And if you’re in the throes of a depressive episode, it can be literally impossible.
Next, you have to decide if you can even pay for it. Health care is strangely not that helpful in this situation because a lot of plans cover almost no mental health care whatsoever, or, if they do, it’s extremely limited. And while there are resources out there for uninsured or underinsured individuals, cost of therapy is the most-cited reason for not seeking help.
When I was very, very broke, I tried to sign up for a clinical trial for an experimental drug (I’m diagnosed bipolar and was uninsured and unmedicated at the time) but when the doctor found out I also had a history of eating issues she rejected me and I cried the entire bus ride home. She did, however, kindly give me a bus pass so I guess it wasn’t a total wash.
Anyway, once you figure out that you want to find help AND you can possibly afford it in some way, you have to try to find a specific person who can help you. I asked a therapist I know socially a few months ago what the best way to find one of her ilk was and she turned me onto the Psychology Today database. It is helpful-ish, but only because I live in a city with somewhat bountiful mental health services. In a lot of areas, that is not the case; over 90 million Americans live in a place where a lack of mental health care professionals make it hard to even find someone to provide services for you, assuming you can pay.
So say you live in a city where you even have the option to sort through a long list of potential counselors, psychiatrists, or therapists. Here enters a new challenge.
Because much like finding a match on OKCupid, your hunt for the right mental health professional is really a game of lowered expectations. You need to find someone in your network or who has a sliding scale. You need to find someone who has experience with your needs. You need to find someone who doesn’t look like they will gentle-talk you to death (or maybe that’s what you need!) or, even worse, sit there in utter silence and bore into your soul with those I Care Deeply Honest eyes.
Once you’ve finally found the person whose profile or information at least closely resembles your needs, you -- a person who is in need of mental health care -- are then charged with, often, picking up the telephone and calling to basically plead for help.
I cannot emphasize enough how miserable this experience is.
The phone call often goes like this:
“Hi, I’m on the hunt for a new therapist and I found Dr. Smith through my health care provider. I was wondering if he was accepting new patients?”
You do this dance several times, assuming you live in a place where there even are enough mental health resources to merit several calls. Actually, statistically, you do this dance four times before you get an appointment.
If you’re very lucky, you do finally make an appointment and then begin the weeks-or-possibly-months-long slog of getting to know this newfound therapist in hopes that you are a personality match and that this person will help make your life better.
If you’re not so lucky, you may give up. Or find a therapist who turns out to be a terrible match (the children's art therapist my health care provider once assigned to me? Not good) and also possibly not even in your network (that $370 bill for two sessions was a fun surprise that one time).
One of my best friends and I have often joked -- through hot tears of “please someone just let me sit on your couch and cry” shame -- that someone should create a kind of Therapist Speed Dating, where all of the people who need counseling and all of the mental health care providers who are accepting new patients go to a hotel conference room or something and meet each other for very quick chats, wherein you could decide if you’re a good fit. This would make the process a lot less painful.
But in all seriousness, this is a legitimate problem for a lot of individuals who are really struggling. Despite what Carrie Bradshaw once said -- that therapy is “indulgent” -- for a lot of people, it’s necessary. It is the difference between OK and Definitely Not OK. It might even be the difference between Alive and Not Alive.
This is, like all things, a multi-fold problem. Partially, it’s due to the ongoing issue of the lack of rural doctors in North America. Mental health care professionals, like a lot of us in other fields, also have to sometimes make difficult choices wherein they balance what kind of education they want to get with how much they can ostensibly make down the road. Add in the stigma of seeking (or even providing) mental health care, and you’ve basically got a garbage stew of a situation that serves almost no one well.
And, like basically everything else in life, there’s no easy answer.