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For most Americans, health issues and income aren’t mutually exclusive concerns. A lack of financial resources can make the difference between finding good care and more suffering, for physical or mental health concerns. In this list, we’ll run through some of the most affordable avenues for mental health treatment, because being broke shouldn’t mean being helpless.

JOIN A SUPPORT GROUP

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Many clinics and community centers provide free to cheap support groups — some for around $15 per session — where people can connect with others with similar ailments, from codependency and drug addiction to anxiety and bipolar disorder. Ask therapists about group sessions when you can’t afford their individual therapy services, or research local meetups of suitable support organizations such as Narcotics Anonymous or the Anxiety and Depression Association of America.

USE PUBLIC SCHOOL OR COLLEGE SERVICES

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Most colleges and universities with graduate or undergraduate psychology programs will offer clinical trials and therapy options, so qualifying patients can get low-cost help while students gain on-the-job experience. These training clinic services might be available only to tuition-paying students, however, similar to the counseling services available at most K-12 schools. You can find a list of university-associated training clinics here.

VISIT A PSYCHOANALYTIC TRAINING INSTITUTE

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Psychoanalytic Training Institutes are educational facilities with programs that let university graduates gain clinical experience before starting their own practices. Patients can generally use the services of these psychoanalysts-in-training for free by committing to repeat weekly sessions over one to two years. Find programs near you through the American Psychoanalytic Association.

VISIT A TEACHING HOSPITAL

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Teaching hospitals are another institution that may provide discounted mental health services such as psychotherapy in exchange for the experience your participation affords residents and interns. Most offer sliding-scale fee systems for therapy sessions based on individual income brackets. Start by finding teaching hospitals.

NEGOTIATE FOR DISCOUNTS

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Therapists can charge as much as $100 per hour for clinical treatments such as cognitive-behavioral therapy, but many will also offer services on a sliding scale for cash-strapped patients. It’s always worth asking how steep a discount the therapist or clinic is willing to offer based on financial need, which could bring the cost to as little as $50 an hour or even $10 for sessions with an intern or therapist-in-training. Search for sliding-scale therapists and clinics through directories at Psychology Today and GoodTherapy.org. Finding the right therapist willing to work with you on costs may be one of the most important steps to finding adequate treatment.

SEARCH OPEN PATH PSYCHOTHERAPY COLLECTIVE

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Check out the Open Path Psychotherapy Collective for a nationwide directory of low-cost mental health professionals whose services range from $30 to $80 per hour-long session. There’s a one-time fee of $49 to gain access to the nonprofit’s searchable database of licensed therapists with sensitivity toward affordability.

CHECK SAMHSA’S FACILITIES LOCATOR

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Another online resource for finding treatment centers with helpful focuses and pay structures comes courtesy of the Substance Abuse and Mental Health Services Administration. It has an all-purpose locator for facilities specializing in mental illness as well as substance abuse treatment, many of which offer dual diagnosis services for patients suffering from both, with numerous search tools to screen for the services and affordability.

VISIT A FEDERALLY QUALIFIED HEALTH CENTER

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FQHCs are federally funded health care providers that offer mental health and other treatment services to underserved areas on a sliding fee scale, including free services for those on Medicaid or unable to pay anything. There’s a directory on the Health Resources and Services Administration’s site — just check with an individual center to see if they provide mental health services.

VISIT A COMMUNITY MENTAL HEALTH CENTER

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Similar to FQHCs, state and county governments offer low-cost therapy options through community mental health centers, where trained support staff provide free treatment and feedback over the phone or in person. Look through government human services departments, keeping in mind that many cater first to patients with Medicaid and then to other cash-strapped patients as availability dictates. There are similar services run by nonprofit organizations such as the YMCA.

LOOK TO OTHER COMMUNITY RESOURCES

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There are other local institutions offering free emotional support. Spiritual centers such as churches and temples will usually offer support groups, retreats, and informal counseling services for charitably low costs, as will many schools, hospitals, and community centers. Checking organizations’ websites for information or calling 211 can be good places to start in finding community-based care.

LOOK INTO EMPLOYEE ASSISTANCE PROGRAMS

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Even if employers don’t cover health insurance, they may still offer an employee assistance program designed to help employees manage personal and work-related problems that could affect job performance. This usually means accessing counseling services at no cost for 10 sessions or less; consult the HR department for more specifics.

GET HELP PAYING FOR PRESCRIPTIONS

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Prescription medications can alleviate symptoms of common psychological disorders such as anxiety or depression, but prohibitive costs can be a problem for sufferers without health insurance. To help, most pharmaceutical companies offer patient-assistance programs that provide prescriptions at little to no cost, including Pfizer’s RxPathways Assistance or AstraZeneca’s Prescription Savings Program. Also: Make sure your doctor writes prescriptions that can apply for cheaper generic drugs as well as name-brand ones, and look to third-party assistance programs such as Needy Meds and the Partnership for Prescription Assistance for guidance.

BUY PRESCRIPTIONS ONLINE

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Given the lack of price transparency in the medical field as a whole, it’s easy for pharmaceutical companies to charge exorbitant amounts on prescription drug treatments. Consumers can compare prices and find cost-effective prescriptions through online avenues, but that also means vetting online pharmacies and drug sellers to see that they’re safe. Use the FDA’s guide for information on identifying trustworthy prescription sellers online.

SEE IF YOU QUALIFY FOR MEDICAID

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If you’re a U.S. citizen with low income or over the age of 65, you may already qualify for government-assisted health insurance in the form of Medicaid or Medicare, respectively, both of which cover mental health care costs. According to the 2019 eligibility standards, individuals in the contiguous United States must be making a monthly income of $1,061 or less to qualify for Medicaid, or $1,430 for couples.

FIND OTHER FEDERAL HELP THROUGH HEALTHCARE.GOV

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If you make too much to qualify for Medicaid but still can’t afford health insurance, try applying for insurance at Healthcare.gov for other government-funded assistance. Otherwise, you could be subject to an additional fee for lacking coverage under the Affordable Care Act’s individual mandate.

PARTICIPATE IN CLINICAL TRIALS

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If you’re in serious need of treatment and willing to try something experimental for a lower cost, participating in a clinical trial may be your best option. ClinicalTrials.gov and ResearchMatch are two services that can connect you with upcoming or ongoing clinical trials focused on your condition, with access to new treatments that haven’t yet been approved by the U.S. Food and Drug Administration. There’s no guarantee these will be effective or even free of undesirable side effects, but it may be worth a shot for the potential success and varying reimbursement.

TRY TELEHEALTH SERVICES

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You can do virtually anything online nowadays, and mental health therapy is no exception. Websites such as Breakthrough.com and Betterhelp.com let you book and attend individual sessions with licensed therapists over the phone with varying rates for different providers, while Talkspace lets you text for therapeutic feedback at any time with plans starting at $49 a week. While no substitute for face-to-face therapy, studies have proven the potential positive impacts of these electronic-based forms of mental care.

DOWNLOAD FREE MENTAL CARE APPS

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Computer and smartphone-accessible mental health-oriented apps including Calm and Headspace don’t provide dedicated treatment, but instead promote education and therapeutic practices such as meditation or controlled breathing that are research-proven to help moderate mental health issues. Both offer free trial packages — but remember that no electronic service will be an adequate replacement for the opportunity of face-to-face connection offered by in-person therapy.

CONSULT ONLINE RESOURCES

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Online research is no substitute for actual mental health treatment, but the surplus of medical information available via Google means that educating oneself on mental health issues is easier than ever. Since awareness makes a big difference in mental health outcomes, look to professional organizations for specific disorders, such as the Anxiety and Depression Association of America or the Association for Behavioral and Cognitive Therapies to help get a grasp on what you’re up against and identify the most proven treatment practices. Use only trusted and official sources and beware bad information online — it’s everywhere.

PERFORM A MENTAL HEALTH CHECKUP ON YOURSELF

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Treatment services have a long way to go before catching up to our ever-evolving understanding of mental health, so until insurance plans start covering annual preventative mental health checkups, it might be prudent to conduct one on yourself. The American Psychiatric Association offers guidelines for a minimal mental health screening anyone can perform at home, which can serve as a good jumping-off point for knowing when and how to seek further help. Find similar resources here.

CALL THE NATIONAL ALLIANCE ON MENTAL ILLNESS HELPLINE

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One of the best resources for immediate (and free) help in coping with mental illness and finding the right treatment is the National Alliance on Mental Health’s helpline. You can call 1-800-950-NAMI from 10 a.m. to 6 p.m. weekdays to speak with volunteers prepared to answer questions about symptoms and point you toward appropriate treatment options.

TEXT A CRISIS COUNSELOR

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If you need immediate and affordable counseling but aren’t comfortable speaking over the phone, there’s always text messaging.  Text “hello” or “start” to 741741 any time you’re feeling distressed or overwhelmed, and a trained crisis counselor will respond, usually within five minutes, through the Crisis Text Line’s secure platform. Conversations usually last from 15 to 45 minutes, or however long it takes to get you back to a calm and safe mental space, whether that means providing a referral for treatment or simply listening to your problems.

CALL THE NATIONAL SUICIDE PREVENTION LIFELINE

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If you’re worried you or a loved one may be at risk for self-harm or suicide, don’t hesitate to call the National Suicide Prevention Lifeline’s toll-free, 24-hour hotline at 1-800-273-TALK. Talking problems through with an empathetic stranger can truly make the difference between an impulsive tragedy and continuing mental health treatment, and operators can put you in contact with a local crisis center or other resources for immediate help nearby.

APPLY FOR DISABILITY

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If mental health issues consistently interrupt your ability to work, you may be eligible for disability benefits and supplemental income through Social Security. This can entail a lengthy legal process to prove mental illness has hindered your working abilities, but you’ll get medical coverage and back pay for work missed if a qualifying condition (including schizophrenia, substance addiction, and anxiety disorders) is evaluated to meet their specified criteria.

Meet the Writer

Born and raised in southern California, Jeffrey Rindskopf is a freelance writer based in Seattle, focusing on fiction as well as feature articles pertaining to travel, food, film, personal finance, music and local arts.