Meet the mental health team: An Obamacare essential benefit

Aisha Langford

Mental illness affects nearly 1 in 5 Americans and until recently, there was no guarantee your health insurance plan would cover treatment of a mental illness.

However, the 2010 passage of the Affordable Care Act (also known as Obamacare) mandated that mental illness coverage is one of the 10 essential benefits all qualified health insurance plans must cover starting in 2014.

Plans now will cover mental health services and treatments including medications, psychotherapy, and counseling.

Also, there are no lifetime limits on the amount of mental health services that you can receive and you can’t be denied health insurance because of a preexisting mental health condition.

What is considered a mental illness?

A mental illness can affect your thinking, mood, behavior, relationships and daily activities. Examples of mental illnesses include depression, anxiety and eating disorders.

Dealing with a mental illness can be overwhelming and frightening. The good news is there are many professionals who can help you.

Meet the members of the mental health team, and how you can find the right professional — or combination of professionals — for your needs. In general, each member of mental health team is covered by health insurance plans – however you should carefully read the details of your individual policy.

1. Primary care doctors.

Your primary care doctor is usually the first person you’ll see for a medical concern. Primary care doctors include pediatricians, general medicine and family medicine physicians.

Many primary care doctors use mental health screening tools to identify potential problems in children and adults, says Debbie Plotnick, senior director of state policy at Mental Health America in Alexandria, Va.

Screening tools help identify patients that may be at risk for getting a mental illness or those who already are suffering from a mental illness like depression.

Doctors ask patients a series of questions and based on the answers, they have a better idea about the patient’s mental health overall. These screening questions are often part of a routine exam.

In many cases, the primary care doctor will be the first person to identify a mental health condition because they see their patients regularly. “The earlier a condition is identified, the better it is because it prevents people from having other major interruptions in their life,” Plotnick says.

Primary care doctors can prescribe medications for conditions like depression and anxiety. However, depending on your problem, they may refer you to another member of the mental health team for specific medications or other forms of therapy.

2. Psychiatrists.

A psychiatrist is a medical doctor who specializes in diagnosing, treating, and preventing mental health and emotional problems.

Psychiatrists prescribe medication and often see people with serious mental illnesses such as major depression or post-traumatic stress disorder (PTSD). You usually need a referral from your primary care doctor to see a psychiatrist.

Psychiatrists can help determine if the cause of your mental illness is physical — a chemical imbalance — or psychological, like from a childhood trauma.

Some psychiatrists provide psychotherapy (also known as talk therapy), but most focus on medication management.

Talk therapy is when you speak to a mental health professional to better understand your condition and to learn coping strategies so that you can function in daily activities.

3. Mental health nurses.

A registered nurse practitioner has a graduate degree and specializes in mental and emotional illnesses. Nurse practitioners are trained to manage patient care, order diagnostic tests and prescribe medication.

Sometimes patients will see a nurse practitioner because they are the only mental health professional in the area. Other patients will choose a nurse practitioner because they like his or her style of communication.

Most nurse practitioners focus on medication management although some nurses provide talk therapy. Like psychiatrists, a referral from a primary care doctor is often needed to see a nurse practitioner that specializes in mental health.

4. Psychologists.

Psychologists are the only members of the mental health team who can administer personality, intellectual and cognitive tests.

Limited license psychologists typically have two years of graduate training, while clinical psychologists have at least four years of graduate training (including two years of research experience).

Both types of psychologists can provide therapy to patients.

Angelita Jacobs, a limited license psychologist in Ann Arbor, Mich., recommends you seek help whenever your problem starts getting in the way of your job or your relationships.

5. Social workers.

Social workers provide talk therapy to clients and are covered by most health insurance plans. Some social workers specialize in marriage and family therapy, while others focus on specific areas likes anxiety, grief, or anger management.

Because licensed social workers are generally less expensive than psychologists and trained to work with a variety of clients, they may be the preferred mental health provider within health insurance plans.

You may want to see a social worker if you feel “stuck” in your life and unable to move forward, notes Joan Sykes-Miessi, an associate social worker in San Francisco.
“Therapy with a social worker often focuses on problem-solving and goal-setting,” Sykes-Miessi says.

Many social workers are also community-based. “We sometimes make home visits and accompany clients to doctor visits, trips to pharmacy, and other appointments related to daily life,” Sykes-Miessi says.

For more information about mental health treatments and mental illnesses, visit Mental Health America and the Centers for Disease Prevention and Control.