Lesley Alderman

Stressed? Depressed? Or worse? You wouldn?t be alone. Unstable economic times can lead to unstable states of mind. ?As life becomes more unpredictable, levels of toxic stress increase,? says David L Shern, President, Mental Health America, a non-profit advocacy group based in Alexandria, Virginia.

But when you?re worrying about money, it?s hard to spend money on getting help?as in $200-an-hour therapy sessions.

That?s how Karen Nienhauser felt. Her family had experienced considerable turmoil over the last year, and she knew they could benefit from therapy. But because she and her husband were both working only part time and money was tight. Nienhauser, who lives in Scottsdale, Arizona, did something she had never done before. The family has insurance through her husband?s part-time teaching job, so she went to the insurer?s list of approved psychologists and chose one.

In the past she would have gotten a recommendation from a friend or doctor and paid the going rate. ?I used to think network therapists were not as good,? she said. ?But I was wrong.? She?s delighted with her choice and the cost: just $30 a session, no matter how many family members attend.

If you have a job, and insurance that includes mental health benefits, you can find affordable care ? but you need to shop wisely.

You also need to be aware that your benefits might be changing in the coming year. Because of a new federal law in the US, that takes effect for most insurance plans on January 1, the Mental Health Parity Act, there is a very good chance that your mental health coverage has indeed changed ? possibly for the better. Here, through the following points, we explore how to make the most of your mental health benefits.

THE CHANGES

You might have noticed in the materials your employer handed out recently during open enrollment that your mental health benefits would look different in 2010. That?s because of that Mental Health Parity Act, which the US Congress passed last year. As of January 1, the law requires that group plans covering more than 50 people provide the same level of care for mental health and substance abuse problems as for medical ones. The law?s changes can be good and not so good. Good, because you might have access to more care. Not so good if there are new requirements, like getting precertification for coverage, that place additional barriers to getting treatment.

TRY EMPLOYEE ASSISTANCE

If you need care, and your situation is not dire, consider going to your company?s employee assistance programme, which might be able to arrange free counselling sessions with a nearby therapist.

FOR URGENT HELP

If your situation is dire, say you or a family member is dangerously depressed, call your insurer, explain your situation and ask for guidance. The plan can help match you with a therapist who specialises in the issue you are facing.

TRY BARGAINING

The most cost-effective approach is to stay in network, because rates are lower. But what if the therapist you like is out of network? You might be reimbursed for part of that bill, but if that’s still too high for your current budget, bargain. Yes, it?s appropriate to ask your therapist for a discount, especially if it?s for short-term therapy or as a temporary measure.

IF DRUGS ARE NEEDED

If you need medication to help stabilise your mood, explain to your doctor that cost is an issue. Some of the newer drugs prescribed for depression can be steeply priced. Some insurers are now insisting that doctors first try generic drugs before prescribing pricier ones.

FURTHER TREATMENT

If you or a family member is in therapy and needs to be hospitalised or requires a more expensive type of treatment, ask for the ?medical necessity criteria? for the condition, which insurers use to determine whether the requested treatment is medically necessary.

BE PUSHY

During times of high anxiety you need all the support you can get. Don?t be shy about using your mental health benefits, and don’t be shy about challenging your insurer if you are not getting the help you need. The new law provides people with mental health issues greater access to care?take advantage of it.