More than half of psychiatrists don’t accept insurance, according to a recent study published in the journal JAMA Psychiatry. And often their rates are too high for many people to pay out of pocket.
Two year ago, “Jen” who asked we not use her real name to protect her privacy, lost her job because of debilitating migraines. With no job, no insurance, and a migraine everyday – she was at a loss for how to support herself and get by. She found the Pro Bono Counseling Project and started with therapy and an anti-depressant. Now, she’s back at work, full time.
She’s one of the roughly 23,000 people the project has helped—for free- in its 22 years.
Merlene Blair-Brown, one of the almost 1,700 therapists who have worked with the project, says it's a great experience to be able to share her knowledge with those who need it. A licensed marriage and family therapist, she sees 30 patients a week who pay either out of pocket or with one of the few insurance plans she accepts. And she takes another three or four patients a week pro bono. She says she never calculates how much money that costs her, "I just think I'm going to help where I'm needed. I never think "if I help this one and not this, I'll get paid". No, because I figure each one helps another".
The project began in 1991 when Maryland psychologists, clinical workers, and psychiatrists were trying to collect data to show mental health care was out of reach for many people. The data they collected soon became the basis of the project’s grants.
Based in Towson, it screens potential patients for income levels—a maximum of $27,000 a year for individuals, $51,000 for a family of four--and puts them in touch with participating mental health professionals. Barbara Anderson, the executive director, says they’ve helped several other states set up their own pro bono counseling centers – the idea is catching on, " if you’re in the middle ground, particularly folks earning minimum wage or making money under the table, there’s very little access to healthcare particularly mental healthcare".
Blair-Brown and other providers say low- income patients aren’t the only ones who suffer with anxiety and depression because of their finances, especially this time of year. Dr. LizbethBinks, a licensed psychologist who’s participated with The Pro Bono Counseling Project from the beginning, says the Christmas holidays are far from the merriest time of the year for many. She says this time of year triggers deeply-rooted anxiety, "at this time of year everybody either visits with their family, has more exposure to them or thinks about them, or thinks about what they’re not doing with them. But all at once, everybody’s family of origin issues comes up". Dr. Binks has two clients a week who come through the project. She says it gives her a chance to connect to people she may have not had the opportunity to treat otherwise.
Anderson, executive director of The Pro Bono Counseling Project, says 99% of their clients do not have health insurance while the rest have high deductibles. That may change with The Affordable Care Act as more of the uninsured are expected to sign up and receive mental health care benefits. She says she'd love to see the project, often referred to as a "safety net" program, go out of business as more people sign up. But, she thinks that’s unlikely because many policies will have high deductibles and there is a shortage of mental health providers on insurance networks.
For instance, “Jen” has health insurance through her new job, but says mental health care is still too expensive. And yet, she makes too much now to qualify for The Pro Bono Counseling Project.