Updated August 04, 2006

Navigating Mental Health Care

by Joseph B. Nelson, M.A., L.P.

Navigating the process of seeking mental health care and then getting it is a daunting task for many. Even if it feels like you are adrift and have reached the point where you need therapy, making that final decision can still be uncomfortable. A range of questions may fill your head, from “I know I’m sad, but I’m not really that bad off, am I?” to “I feel nervous and edgy all the time. I wonder why, and what it means? Am I crazy?” You may even find yourself thinking, “Maybe it’s all related to my blood glucose” or “I wonder what everyone will think if they find out that I’m seeing a psychotherapist.”

These types of thoughts can make you feel as though you have no direction or simply prevent you from picking up the phone, and it may take a long time before you finally decide to seek help. In fact, of the 13–14 million Americans who experience depression each year, only about half get treatment. That figure is up from just one-third 10 years ago, but it still leaves millions of people out in the cold. While there may have been a stigma associated with seeking out psychotherapy in the past, we now live in an age where high levels of stress are commonplace, and the resulting depression and anxiety are clearly serious problems. But people don’t have to go down with the ship anymore—these problems can be treated effectively. Meeting with a mental health professional for a session to screen for emotional problems can determine if psychotherapy may be a life preserver for you. This is good idea if you have some of those thoughts and questions mentioned earlier. Particularly for people who have diabetes, such a consultation is becoming an accepted part of regular health screenings.

In the course of getting mental health treatment, however, there can some big questions. How do I find the right therapist? Is this covered by my insurance? What’s my role in sessions and at home? How long will I be in therapy? This article presents some basic information to point you in the direction of getting all of your questions answered and getting the help you need.

Who can help?
The first big question is “Who do I go to see?” There are a variety of mental health providers who can be helpful: psychologists, social workers, licensed mental health counselors, and psychiatrists. The first question to ask about a given practitioner is “Is this person licensed?” This is important because it assures you that the provider has had a standard of training that qualifies him or her to provide help. The second question is equally important: “What type of training has he had?” This question is usually best answered by simply asking the person directly. His answer should give you a sense of how he views and treats emotional problems and what you can expect to happen in psychotherapy sessions.

Some other questions to ask include: Does the person know anything about diabetes? Is he willing to learn? Does he understand the interaction between emotional issues and diabetes control? It is a good idea to have some questions ready when you first speak with a mental health provider since you are, in effect, interviewing the provider first to find out whether he or she will meet your needs. Remember, you are employing this person to help you navigate unfamiliar waters.

It is also very important that you feel comfortable with the provider you select. Your relationship should be based on trust, as it is with any good captain and navigator. If it is, you will be more open to accepting the guidance your therapist has to offer. To establish this dynamic, you will have to have a sense of comfort and ease of communication. You should feel that you have the ability to connect to your therapist without too much difficulty. Such feelings are not always easy to measure, but like good art, you’re likely to know it when you see it, or in this case, feel it.

In addition to credentials, comfort, and connection, it is important to recognize that therapy is a confidential process, so make sure that you and the therapist discuss the nature and limits of confidentiality. Feeling secure enough to express yourself freely is a vital part of this trusting relationship. However, if your health insurance is covering some of the cost of your therapy, it will have to be made aware that you’re seeking mental health care and will most likely require your therapist to submit a diagnosis (such as “depression”) for you.

Joseph Nelson is a psychotherapist in private practice in Minnesota.

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