Accessibility to Mental Health Investigation

Ashley Schultz
Portland State University, School of Social Work
Gianna Russo-Mitma, LMFT
CFS 382U- Mental Disorders: Issues for Family and Community
October 16th, 2022
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Receiving Mental Health Care with Insurance

Through my work I have health insurance that covers mental health care. It covers

outpatient and inpatient care and covers different amounts depending on the services. Finding a

therapist can be a very daunting and difficult task. One way you can do so is to call your

insurance and ask for a list of therapists that accept your insurance. I have had a personal

experience of doing this and they gave me a list with over 4,000 numbers. Receiving such a large

list of therapists can be very overwhelming and off-putting. A great tool that someone showed

me was the “Find a Therapist” tool on the website Psychology Today. This tool allows you to

filter the location, what insurance is accepted, specialities, and social identities of the therapist to

help you find a potential great fit. One problem with that tool is that sometimes the clinicians do

not update their pages and when you contact them they are not taking on more clients.

Kaiser Permanente operates differently than other insurances I have had experiences

with. First, you need a referral from your PCP to engage in behavioral health services. After you

receive a referral you have to go through an intake interview with Kaiser before they refer you to

a therapist. It does seem like at that time they do give you an initial diagnosis so that they can

bill. Prior to COVID-19 you had to meet with a Kaiser clinician but since COVID-19 they have

been doing out of network providers as well. Unfortunately, I did attempt to have Kaiser approve

my old therapist who was out of network and submitted a letter myself and from my therapist

and they denied it. Kaiser will let you see out of network providers that they refer you to.

Receiving Mental Healthcare with No Insurance

As a student at Portland State University (PSU) you are required to have insurance and if

you are not able to provide proof of insurance PSU they will make you go on their student
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insurance plan. If I did not have insurance I would try to get on OHP and would apply for OHP

online. In the meantime there are mutual aid support groups and sliding scare providers. For

mental health care I would budget $50-100, which is not much. I would attempt to meet with

someone bi-weekly for $50. To find sliding scale providers I would type into google “sliding

scale therapists Portland, OR” and contact all providers that showed up.

Receiving Mental Healthcare with Partner, Minor Child and During COVID-19

I would like to attend therapy with my partner, but the difficult task of finding out more

information around that has held me back. After reviewing my insurance coverage, I do not

believe that my insurance covers couples or family counseling. To confirm this, I could contact

Kaiser and inquire if I had coverage or if they pay for maybe 50% of the cost. If I were to gain

clarity around the costs involved I would probably take the same route that I do with finding an

individual therapist. I would look on Psychology Today and send out emails to multiple

providers until I found one that had openings and those openings match our availability. This

might be where it gets difficult, as we only have one weekday off together so that would limit

our options greatly. Since we do have a strong overarching issue we might not need to search for

a specific speciality and would more than likely go with whomever could take us.

I do not have children, so I have not done much research into insurance coverage for

minor children. I do believe that I would need to add a child to my insurance plan and pay an

additional rate for them on my plan. They would get the same coverage that I would get for

therapy. It would be difficult to find a therapist that would meet after school times and maybe I

would contact the school counselor (if there was one) to see if they had any references that took

my insurance.
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My insurance pays for telehealth and I believe this is indefinite. It does not seem like

everything will return back to the way it was pre-pandemic. I am not sure if they offered lower

coverage at times for telehealth services but at this time my insurance pays the same for in

person and telehealth sessions.

Reflection on Process

This process was slightly stressful because finding mental health care can be really

challenging and overwhelming. I used my insurance overview form and my previous experiences

to assist me with writing my paper. One barrier that I faced was being unaware about the

insurance coverage for couples counseling and being unable to clarify this with my insurance. I

would need to schedule an appointment and would not be able to get in before this paper was

due. The biggest barrier is I do not have someone I could call or email to ask about this

information, or if I do it is not information that was ever given to me.

One privilege I believe I have is having a good amount of experience changing therapists

and finding new therapists as I have changed my job three times in the past few years and each

time my insurance changes. The biggest privilege I believe that I have is at this time having a

high tolerance for frustration and emotional balance to make emails, calls, and jump through the

hoops needed to get an appointment and mental health care. There have been many times where I

have had to hang up from phone calls or take a step away from my email because people have

been unkind or asked questions I was not comfortable with. If I was in a bigger state of distress

or had more emotional vulnerability at those times, I might have given up and would not be

receiving mental health care. The biggest barrier is the huge amount of emotional labor and

jumping over barriers put in place for people who are already having challenges with mental

health which increases their likelihood to give up on the idea of getting mental health support.