Times are tough. Everywhere you look, people are stressed out, anxious, depressed. But at a time when addressing some people's mental-health problems may be even more important than ministering to their physical aches and pains, two thirds of primary-care doctors say they have a tough time getting mental-health services for their patients. Doctors in a new Health Affairs study said several factors, from a shortage of professionals in some regions or in some specialties to problems with insurance coverage, make getting mental-health services challenging. (The study data came from 2004 and 2005, so chances are it's even more difficult now.) "It's a big problem," says Ted Epperly, president of the American Academy of Family Physicians, who says referrals are toughest in rural areas and the urban inner city.
There are no easy answers. Safety net organizations are feeling the pinch of increased demand and funding shortfalls. Meanwhile, if you've lost your job and your health insurance, you're most likely struggling with funding shortfalls of your own. But here are options that you (or even your doctor) may not be aware of:
1. Mental Health America, an advocacy organization with over 300 affiliates in 41 states, works with people to connect them with affordable mental-health services in their communities. Click on "local MHAs" on their homepage to find services in your area. "We spend an enormous amount of time helping people navigate the system, doing problem solving," says David Shern, the group's president and CEO.
2. Community health centers. Currently operating in more than 7,000 locations nationwide, these centers got a $155 million boost under the economic stimulus package to add another 126 centers. In addition to primary-care services, they are increasingly offering mental-health services. Fees are charged on a sliding scale based on income. Find a center in your area here.
3. Community mental-health centers. These centers serve Medicaid and other low-income patients. State income limits vary. Click on "find a provider" here, and call to find out whether you may qualify.
4. Employee Assistance Programs. Many employers offer a limited number of counseling sessions and referrals to mental-health professionals through an EAP service. For some people, this may be all they need. "A short-term intervention may help someone develop the flexibility they need to deal with the problem," says Lynn Bufka, a psychologist who is the assistant executive director for practice research and policy at the American Psychological Association.
5. Churches, synagogues, and other places of worship. Clergy members are trained in counseling, and their services are generally free.
6. Group therapy. Many therapists offer group sessions, which are often a less expensive alternative to traditional one-on-one counseling. You can find a psychologist in your area here through the APA or through U.S. News's Find a Therapist search engine.
Remember, one of the best—and most affordable—ways to manage stress and anxiety is by taking care of your physical health. Get regular exercise, stick to a healthful diet, and get enough sleep. Although job and other worries may ignite cravings for all kinds of unwholesome mood modifiers—gin and tonic, anyone?—try to steer clear. And remember: Even if you don't get professional counseling, discussing your troubles with friends and family can help make problems seem more manageable. "Just being able to talk, there's therapy in that," says Epperly.
Check out recent posts on using meditation to help reduce stress, the new COBRA subsidy that may make it easier to hang on to health insurance after a layoff, and on expanded mental-health coverage for kids under the new SCHIP law.