Sliding-Scale Psychiatric and Counseling Services

Update on 3/26/14

With the Affordable Care Act (aka Obamacare), it’s hopefully easier for people to become insured and thus to find affordable psychiatric and counseling services.

The deadline to sign up is March 31st. To be honest, I’m not sure what will happen if you find yourself uninsured after March 31st.

For more details on the Affordable Care Act, please see my post on that subject.

(Last updated 5/14/12)

If you are uninsured or cannot afford your copay for counseling, it’s often helpful to contact universities and hospitals to see if they offer sliding-scale services and to call DBSA or your local NAMI to ask if they can provide you with some suggestions based on your location.

Compared to finding a therapist, it is much more difficult to find a place that offers sliding-scale psychiatric services so that you can see a psychiatrist and get prescription medication. It would be best to start out by calling DBSA or your local NAMI to ask for referrals. If those referrals don’t pan out, you might want to contact the closest City of Chicago Mental Health Center. Please note that due to budget cuts, several locations have been closed. There is a way to see a psychiatrist and get free medications from Stroger Hospital, but it is very time-consuming.

Below are some places that I have found so far. Please call them first to verify that they offer sliding-scale and to ask if their fees have changed. If you know of a resource that isn’t in this list, please feel free to leave a comment or email me.

Please also read my post How to Choose a Therapist.

Adler School of Professional Psychology
Dreikurs Psychological Services Center
65 E. Wacker Place
(312) 327-0959

Advocate Illinois Masonic Hospital
938 W Nelson (Wellington Brown)
(773) 296-3220

C4
multiple locations
(773) 761-9000
Lowest is $8

Cathedral Counseling
50 East Washington Street
(312) 252-9500

Catholic Charities
641 W. Lake Street
(312) 655-7725

Chicago Center for Family Health
20 North Wacker Drive
(312) 372-4731

Jewish Child and Family Services
(773) 866-5035
Multiple locations including:
Adult and Family Services
3525 W Peterson Ave, Chicago, IL
773 866 5035

Family Institute at Northwestern University
(847) 773-4300
Multiple locations including one in Loop and one in Evanston
Therapist is a doctoral student
Individual and couples: lowest may be $0

Lakeview Center on Psychotherapy
3322 North Ashland Avenue
Chicago, IL 60657
(773) 525-3322
DBT group led by doctoral student: lowest is $1
Individual DBT: lowest is $5
Might have other forms of individual and group therapy
*Also has a mental illness support group

Swedish Covenant Hospital
Anderson Pavilion
2751 W Winona Ave. Suite 253
Chicago, IL 60625
(773) 878-8200
Therapist is a doctoral student
Individual and couples: lowest is $0 – $5
Does not offer group

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City of Chicago Mental Health Centers (MHC)

Please call in advance to verify that the location you’re interested in hasn’t been shut down.

Englewood MHC
641 W. 63rd Street
(312) 747-7496
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm

Greater Grand/MID-South MHC
4314 S Cottage Grove
(312) 747-0036
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm.

Greater Lawn MHC
4150 West 55th Street
(312) 747-1020
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm

Lawndale MHC
1201 S Campbell Street
(312) 746-5905
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm.

North River MHC
5801 North Pulaski Road
(312) 744-1906
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm.

Roseland MHC
200 East 115th Street
(312) 747-7320
Hours of Operation: Mon – Fri: 8:30 am – 4:30 pm.

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John H. Stroger Hospital
Fantus Health Center aka Fantus Clinic
(the walk-in clinic at Stroger Hospital)

621 S. Winchester Ave
Chicago, IL 60612
312-864-6221

From a guest editor in 2009:

Stroger is the absolute last-ditch option for anyone in Chicago with no health insurance. It is the city-run hospital, and one that is absolutely swamped with people right now. You can see a doctor every day (with common specialists also available), as long as you are willing to jump through as many hoops as possible.

First, you have to make it to the West Loop location by 7AM, or you’ve lost your chance completely. Then, you have to be one of the first 85 people checked in, or again they turn you away. Then you wait in the waiting room until they call your name, and you have to be seen before closing time, or you don’t get seen at all and are told to come back again the next day.

If you’re lucky enough to get seen, you also have to file additional paperwork for Stroger’s discount plan, information on which is only given out if you are already being seen. Luckily, any medications prescribed to you are then free, but you may have to wait a large number of hours to be seen at all.

Domestic Violence Resources in Chicago

SAFETY TIPS

If you are viewing websites that you don’t want the abuser to see, make sure you clear your browser history when you are finished, use a password protected computer, or use a computer that s/he doesn’t have access to, such as a friend’s or library’s computer.

For making phone calls, avoid using your home phone or regular cell phone, because the abuser may be able to look through the phone records. Instead, try to get a cell phone that’s free to people experiencing domestic violence or pay for another phone that the abuser doesn’t know about, such as a prepaid phone. If you need to give out your regular phone number while you acquire a secret phone, instruct callers to call from a restricted number.

Domestic Violence Courthouse
Circuit Court of Cook County
555 West Harrison Street, Suite 4400
Chicago, IL 60607
312-325-9000
TTY 312-603-6673
Fax 312-325-9017

You can go to this courthouse to file an Order of Protection (OP), which is one of the first steps in separating yourself from an abuser. Onsite there are legal advocates who can help you file for an Order of Protection for free. It’s best to go early in the day and dress professionally if you can. Bring with you any records and evidence of domestic violence that you may have, such as copies of threatening emails or letters, photos of bruises, medical records if you saw a doctor related to your injuries, police reports, etc.

DOMESTIC VIOLENCE-RELATED SERVICES
There are also a number of agencies that can help you if you are experiencing domestic violence. Services can include therapy, support groups, finding safe housing, legal services, childcare, an emergency cell phone, food, clothing, and rental assistance. Their addresses are generally not publicized as a way of keeping their clients safe.

Here are some:

Apna Ghar
*NOT recommended by a dv survivor

Between Friends
www.betweenfriendschicago.org
Crisis Hotline: 800-603-HELP (4357)
Main: 773-274-5232
TTY: 773-274-6508
Fax: 773-262-2543
Intakes on Tuesdays and Thursdays, from 9:30 am to 12:00 pm, (312) 408 — 1210
Has a legal advocate that can help you get an Order of Protection and a free legal clinic where you can get legal questions answered.
* STRONGLY recommended by a dv survivor

Metropolitian Family Services
http://www.metrofamily.org/
1 N Dearborn St # 10, Chicago IL
Main: 312-986-4000
Emergency Hotline: 773-884-3310
Has a Legal Aid program at the same location.
312-986-4200, M – F, 9 a.m. – noon or 1 p.m. – 4 p.m
* recommended by a dv survivor

Neopolitican Lighthouse
773-278-4566
*recommended by a dv survivor

Rainbow House
773-521-1815
*NOT recommended by a dv survivor

Shalva
*NOT recommended by a dv survivor

YWCA of Metropolitian Chicago
ywcachicago.org
Hotline: 888-293-2080
*recommended by a dv survivor

LEGAL SERVICES
These are agencies that can help you obtain free legal help from a lawyer, including help getting a divorce if you are married to the abuser. There may be eligibility restrictions based on income, the presence of children, and if you have an existing Order of Protection. Many of these agencies experienced budget cuts in 2011, and so it may take time and many phonecalls to find a place that can take your case.

CARPLS
www.carpls.org/
17 N State St # 1850 Chicago, IL 60602
(312) 738-9200
9am – 4:30pm, Wed 9am – 7:30pm
* recommended by a dv survivor

Chicago Volunteer Legal Services
www.cvls.org/
100 North La Salle Street Chicago, IL 60602
312-332-1624
* was recommended by another legal aid agency

Legal Assistance Foundation of Metropolitian Chicago
lafchicago.org
111 W. Jackson Blvd., 3rd Fl, 60604
312-341-1070, M-F 8-4pm
800-824-4050
*recommended by a dv survivor

Lifespan Center for Legal Services
http://life-span.org/
20 E. Jackson, Suite 500, Chicago, IL 60604
312-408-1210
Phone intakes on Tuesdays and Thursdays between 9:30am and 11am.
This consists of a phone interview to determine eligibility and they only take the first 12 callers. The intake will take about an hour. Help is free to those living below the poverty line.
* recommended by a dv survivor

Understanding Those Letters that Come After People’s Names

There are lots of college and graduate degrees and even more initials for them. Below is a list of some of the most common ones. The reason this is important is to get an idea of what credentials the professional you are looking into or working with has (or does not have). If you are interested in what their credentials and work experience are, ask them about it. If you do not like their answer, consider seeking out another professional.

However, in my personal opinion, all that really matters is that they have a Bachelor’s degree or higher and that you feel comfortable working with them. My personal preference is to work with people who already have their Master’s degree under the assumption that they have some work experience.

Bachelor’s Level
– Bachelor of Arts: BA or AB
– Bachelor of Science: BS
– Bachelor of Social Work: BSW
This means they completed undergrad. They may or may not have any experience. You are probably unlikely to have a therapist how only has this degree.

Master’s Level
– Master’s of Social Work: MSW or MA / AM depending on the school
This means they completed their Master’s program. They may also be able to list themselves as LSW or LCSW, but choose not to do so in order to confuse non-social workers.
– Licensed Social Worker: LSW
This means they have passed the licensing exam after graduation. They are likely still being supervised by someone with more experience.
– Licensed Clinical Social Worker: LCSW
The means they have undergone two years of clinical supervision and have passed another licensing exam.

Other relevant Master’s degrees:
– Master’s of Counseling Psychology (or some other form of psychology)

Doctoral Level
– People in a PhD or PsyD program are called “doctoral students.” They might also have the title of “extern” and generally have more experience providing counseling than someone in a Master’s program. Someone who is in a doctoral program will have already earned their Master’s degree and thus might have some of the initials listed above (MSW, MA, LSW, etc) after their name. If you are working with a doctoral student, their externship may only last for a year, which means that at the end of their school year, you will likely need to see someone new.
– Doctorate: PhD
This degree is generally more research focused than a PsyD.
Your therapist might have either degree.
– Doctorate of Psychology: PsyD
This degree is generally more practice focused than a PhD. Your therapist might have either degree.
– Doctorate of Social Work: DSW
– Medical Doctor: MD
This is the degree your psychiatrist has and is what allows them to prescribe medication.

Please note:

Social workers offer therapy and/or case management services. You will likely encounter them a lot if you are going to social service organizations.

Psychologists offer therapy. They cannot prescribe medication, but often work with psychiatrists who can. You will most often find them in private offices or hospitals.

Psychiatrists can prescribe medication. If they wish, they can also offer therapy. Like psychologists, you will most often find them in private offices or hospitals.

How to Choose a Therapist

Another great post by therapydoc:

Choosing a Therapy Doc, Or Is That A Dodo Bird?

[…]

Bottom line? If you don’t feel a connection with your therapist after the second visit, if you don’t feel you can relate, then you probably should discuss it to see why you may not make a good team. There isn’t a therapist on earth who relates to everyone, and that’s as it should be.

Now. Armed with that very limited treatment overview, that first phone call should go as follow:

Patient: Hi, I got your name from ________ and wondered if you were taking new patients.

Therapist: Sure, but first, very briefly, tell me what you’re looking for.

Then the patient provides a brief summary of the problem, i.e., I want to save my marriage, or I lost my mother, or My wife if cheating on me, or My kid is thirty and won’t leave home, that sort of thing. Whatever it is. Brief.

The therapist then hopefully responds with an empathetic remark, like, Oh, dear. That must not feel so good. Let me see what I have for you, see if our schedules match up, if I can get you in. When did you want to come in? What day/time is best for you?

IT DOESN’T HAVE TO BE ANY MORE COMPLICATED THAN THAT.

Then, at the set appointment time, the patient discusses the problem and the goals and objectives of the therapy, assuming that these are actually important to him. Sometimes they’re not. Sometimes people really do just want to talk, and talk, for weeks and months, indefinitely, and that’s fine, too.

But if a patient has something in mind, certain goals to accomplish, the therapist should somehow communicate that these can be accomplish. The therapist should have a clue as to how. Because face it, the patient doesn’t.

It’s like a first and second date. You really don’t have to see a person a second or third time if you know, deep down, that it’s not a good fit. ….”

——-

My two cents:

Oftentimes your first meeting with a therapist is an intake, during which the therapist may do little more than take notes, so it may take several meetings with him or her to decide if you like the therapist.

While it is troublesome and time consuming to switch therapists and go through the intake process all over it again, it is likely better than staying with a therapist that you think is not helpful to you. If the therapist has a practice with other therapists, you may be able to switch therapists without going through the intake process all over again.

Some helpful hints:

– Research different forms of therapy to see which forms you may like better and which ones you do not think will work for you, then ask the therapist (or the receptionist) if the therapist practices that form of therapy. Unfortunately, the receptionist will probably not know and the therapist might just say he or she is eclectic, but it is worth asking.

– ALWAYS make sure that you understand the billing process. Does the therapist take your insurance(s)? If not, what is the fee? Is there a copay? How is payment made? This should be done for any medical appointment.

– As you people you trust for suggestions, whether they be a friend, fellow support group member, or a professional you are already seeing. Word of mouth is an excellent way to quality therapists, psychiatrists, social workers, etc.

– Be open to seeing a student who offers sliding-scale fees if you cannot afford a licensed therapist. Usually, the student is being supervised by a licensed clinician. While a Master’s student is not likely to have a lot of experience, a Doctoral student might.

– To figure out what degree your potential or current therapist has, please see my post “Understanding Those Letters that Come After People’s Names.” Of course, you can always ask them directly. 🙂

Getting Medicaid When You’re Disabled

Eligibility

In Illinois, once you are certified as disabled by the federal government, that is, you are receiving Social Security Disability payments, you become eligible for Medicare regardless of income or assets depending on when you were certified as disabled. There is no further application process and you receive your medical card in the mail. In order to find out when you can expect the card, it might be a good idea to call and ask the caseworker who handled your Social Security Disability case.

In addition, once you are certified as disabled you may become eligible for Medicaid if you meet additional income and assets guidelines. Medicaid will help cover the costs of the Medicare premiums and co-pays. In this case, Medicare will become your primary insurance and Medicaid will be your secondary insurance.

Applying for Medicaid

However, you don’t automatically get Medicaid; you have to apply for it first.

Working with DHS offices can be very time consuming and difficult. While applications can be done online or by mail, if you have the time, it is generally best to go in person. Otherwise, when you follow-up on your application, you may find that DHS has no record of it and thus has not considered your case. By waiting in line and submitting the application in person, you can at least be assured that it got there.

It should also be noted that the Wicker Park DHS office has a tendency to not return calls, so if you are seeking to follow-up on your case, it is best to go in-person. The same is true if you need to reschedule an appointment. For each visit to this location, plan to allot at least forty-five minutes if you need drop off something and at least two to three hours if you need to speak to someone unless you have an appointment.

Once You Have Medicaid

Your Medicaid card will come monthly in the mail. It is actually a large slip of paper and not business card-sized. Be sure to look out for each new card so as to make sure that your coverage has not been interrupted.

Questions I Would Greatly Appreciate Help With

1) Can you get Medicaid once you are receiving Social Security Disability payments or do you have to wait until you are enrolled in Medicare?

2) What conditions can people without children gain coverage for without having been first found disabled by Social Security?

3) What is the best way to get questions about Medicaid
answered? While it is often easy to talk to a live person when calling Medicare, it is more difficult to do this when calling Medicaid.

If you’ve applied to or are enrolled in Medicaid, please feel free to leave comments about your experiences.

Evaluating Other Mental Health Blogs

I’ve been procrastinating by looking through other people’s blogs for ones that I feel support the messages that I’m trying to get across in this blog rather than duplicating what they’ve already written. In the future, I’ll probably copy and paste their entries and do my best to do full attributions to give them credit for their work.

One that I came across is:
Marine Snow
http://operationlola.wordpress.com/

It’s written from the point of view of someone struggling with anorexia. I like the blog because it details what it’s like for her to have anorexia, her mentality behind it, her view of her disorder and its effects, and well as how she feels about her treatment staff.

The last part is of great concern to my husband, who is concerned about people who appear to advocate on behalf of those who reject their treatment plans and think that their mental health staff are conspiring against them. Hence, I’m talking about this blog in a post rather than directly linking to it in the blog roll.

Personally, I can see his point of view as I agree that people need to become educated consumers and understand that the mental health profession is there to help people, not control them. While it did used to be this way decades ago, it’s not anymore. Also, people have more choices. If you don’t like your doctor or therapist, you are free to select another one that is a better fit for you. At the same time, you need to be honest with yourself as to whether or not you are switching doctors because you don’t think they’re suited to treat you or because you’re just using it as a way to avoid treatment altogether.

One of the objectives of this blog is to advocate for the use of therapy, medication, and support groups to treat mental illness while acknowledging the misgivings that I and other people have. Many Americans are highly skeptical of the medical profession because they are touted as knowing more about ourselves than we do. I think this is purely a construction of the mainstream media, which is often incorrect in it’s depiction of mental illness in many regards, especially symptoms, treatment, and humanity.

As stated before, I am not very knowledgeable about medications myself and rely heavily on my husband. Physical science is above my head. He suggests Crazy Meds and often relies as well on more scientific materials that are not written in laymen’s terms. (He already has a BA and wants to go to med school so he’s better trained in reading this stuff.)

Since social sciences and humanities are more my thing, I’ve read up on issues related to mental illness, therapeutic treatments like CBT, and general wellness advice from professors teaching at reputable schools.

From an education point of view, the most important things are to learn how to learn and to use critical thinking. Always know your sources and what their agenda is. This is what being educated really is.