It can often seem close to impossible to find help for a child with mental illness. But it's possible with persistence and getting the right support team.
Jill Alexander worries about her seven-year-old daughter. She suffers from depression and anxiety, just like her dad. Mental illness often runs in families. Alexander’s husband sees a psychiatrist and takes medication. But finding a mental health therapist for a young child can be like finding a needle in a haystack. It’s possible, but parents need to be persistent.
“It’s heartbreaking,” Alexander said. “She’ll tell me that her entire body gets angry and she just doesn’t know how to control it. She’s even asked me to get her help.”
Both parents are open to therapy. “We’ve seen how it benefits my husband,” Alexander said. “It’s just hard finding someone who’ll take our insurance.”
Alexander knows other parents who have been on the same journey. “They’re willing to drive three hours one way so their child can have someone good to talk to,” she said. “We want someone who’ll connect with our children, someone who can prescribe medication, someone who has office hours after school, and someone in our health insurance plan.”
Alexander and many of her friends don’t want to go out of network. “I’m baffled that it’s so hard to find someone,” she said. “I live in a major metropolitan city and should be able to find someone without paying out of pocket.”
While she continues to look for someone to treat her daughter in her health insurance’s network, she’s paying $125 for a 50-minute session every week.
“It’s true that many psychiatrists, in general, not just those who treat children, do not take insurance,” said Carole Lieberman, MD, a psychiatrist. “This is because insurance pays so little for psychiatrists’ time and the insurance bureaucracy makes it a full-time job just to bill and get paid. It ends up taking more time to try to chase your payment than to treat the patient.”
“Many insurance companies have limits as to how many sessions they’ll authorize,” said Lieberman. “This puts the psychiatrist in a very difficult situation. The insurance never authorizes as many sessions as necessary, and, if the parents can’t afford to pay out-of-pocket, what usually happens is that the parent just decides not to have the child continue in treatment, which can be very dangerous.”
Lieberman says parents need to understand that it’s essential to get psychotherapy, not just medical visits for medications. “Many psychiatrists just do short med visits,” she said. “These do not help at all because medication is only a temporary band-aid.”
Myrna Rodgers went that route. Her 14-year-old son, who has oppositional defiant disorder and is on the autism spectrum, talks to a licensed social worker once a week and sees a psychiatrist 15 minutes a month who monitors his medications. “I make sure that the social worker talks to the psychiatrist,” Rodgers said. “My son’s teachers and the social workers at his school also discuss my son with the social worker.”
Rodgers pulled her son out of their local school district. He attends a school for children with special needs. “The attention he gets is amazing,” she said. “Academically, the school is on par with the public school. In fact, it’s probably better because the classes are smaller, and the teachers are trained to work with special needs kids. Our local public school just wasn’t able to handle my son.”
Her close friend also enrolled her child in a school for kids with special needs because the services weren’t adequate at the public school.
“It really does take a village to raise a child,” she said. “The therapists at his school are working with the therapist my son sees outside the classroom. I couldn’t find someone good in network. I’m working with my health insurance company. I get a coded bill from my son’s therapist, which I submit to the insurance company. I pay something upfront, and part of the balance is reimbursed. I usually have to wait for the reimbursement check, but it’s better than paying completely out of pocket.”
Staying in network and finding good mental health therapists for young adults is also a challenge. When Marjorie Baldwin’s son David was a junior in college, she got a call that her son was in a hospital psychiatric ward having psychotic hallucinations. The doctors diagnosed him with schizophrenia. Baldwin, a professor in the department of economics at the W.P. Carey School of Business at Arizona State University, was determined to help her son finish college, get a job, and lead a normal life.
Navigating the system proved to be challenging, so much so that she wrote a book called “Beyond Schizophrenia: Living and Working with a Serious Mental Illness.”
Baldwin was able to get help for her son through a clinical trial her health insurance covered. But she had trouble getting her son back into college and, once he was there, finding the mental health services he needed on campus. “When you have a child with a mental illness, you have to become that child’s advocate,” she said.
She recommends starting with your health insurance company, particularly asking for a list of child therapists instead of a couple of names. If that doesn’t work, talk to the health workers at your child’s school, and friends and colleagues. From there, you can find out about mental health services through your state.
She found the National Alliance on Mental Illness offered a wide range of services. “The trick is to be persistent and don’t give up,” she said.
August 29, 2023
Janet O’Dell, RN