“Text Tom” Questions

What about narcissistic people. Is that a trait of a mental health problem?

Narcissistic personality disorder is in fact a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, they often encounter troubled relationships, and have a lack of empathy for others. However, behind this “mask” of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.

Individuals with narcissistic personality disorders experience problems in many areas of life, such as relationships, work, school or financial affairs. They may be generally unhappy and disappointed when they’re not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Treatment for narcissistic personality disorder centers around talk therapy (psychotherapy). Medications may be used to treat depression and/or anxiety, which commonly co-exists with this personality disorder.

How does someone on the low-income spectrum afford to take the right step for saving their child?

When you have poor or no health insurance, you may prioritize other issues over mental health care. This could mean ignoring undiagnosed issues or skipping treatment that causes further problems. The following are some suggestions of locating affordable or free counseling and other mental health care services.

1. Apply for Affordable Health Care

If your employer does not provide insurance coverage or the cost of private insurance is too costly, you will likely have to pay a fee under the Affordable Healthcare Act.

For assistance, apply at Healthcare.gov. You could receive help covering insurance costs, or you may qualify for free health insurance coverage through your state’s Medicaid program.

When insurance fails you, here are some more options to get the care you need for you and your family.

2. Locate a Training Clinic

Like other areas of medicine, doctors of psychology need to practice working with the public before they become clinical or counseling psychologists.

This is helpful for individuals and families who are uninsured or want to save money on therapy.

Training clinics are usually located near or as part of universities. Therapy sessions are scheduled with a professional / graduate student and are supervised by a licensed psychologist. These clinics typically use sliding scale fees (which could be as low as $0.)

To locate a training clinic for therapy near you, go to: Association of Psychology Training Clinics. You can also search “[your city] psychology training clinic.”

3. Visit a Community Mental Health Center

Community mental health centers provide free or low-cost therapy options and other mental health services covered by Medicaid insurance.

Here are suggestions of locating these services within your community:

1) Locate a center through the Department of Human Services at your state’s government website.

2) You can also find services through private non-for-profit organizations. For example, YMCA offers low-cost/sliding scale behavior health and family services for kids and adults.

3) The Partnership for Prescription Assistance has a Free Clinic Finder . Use your zip code to locate clinics in your area.

4) The U.S. Department of Health and Human Resources also has a listing of free clinics in your community. You may find that listing here.

5) The National Alliance on Mental Illness may also provide information of where to find mental health care and treatment in your area. Call them toll free at 1-800-950-NAMI or contact them through their web site which you may find here.

6) Here is a listing of toll free numbers to call to mental health clinics across the country.

7) Here is another listing of free clinics to search for in your community.

8) Find a Community Mental Health Center here.

9) The federal government provides a Mental Health Services locator here.

4. Attend a Support Group

You miss out on the individualized care and complete anonymity of private sessions, however support groups can be the perfect solution for free or low-cost therapy.

Organizations like the Depression and Bipolar Support Alliance (DBSA), the Anxiety and Depression Association of America (ADAA), Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) host free community support groups in person or online.

If you want to work with a particular therapist but can’t afford private sessions — because you lost insurance coverage, for example — ask if they offer group sessions. These services are usually offered at a lower rate.

5. Negotiate and ask for discounts

You might not realize it, but your medical bills are totally negotiable. By a lot.

Don’t be afraid to negotiate the cost of services— this isn’t a business deal, so you don’t have to worry about making a bad impression.

I recommend asking about negotiated rates prior to scheduling your appointment. They may be willing to cut the cost by more than half if you can pay upfront.

Another option is to ask if they accept monthly payment plans you can afford to avoid a hit to your credit for late payments.

6. See a Doctor Online

Completing mental health appointments online has been an attractive and growing option for my personal private practice, ADHD Wellness Center!  in Houston, TX. I am also licensed in Illinois and instead of me flying to the state or my patients flying to Texas, we are able to complete their mental health care needs online!

Telepsychiatry / telepsych is legitimate, professional, provides you with the “standard of care” and could save you money on mental health care. In many states, it is also covered by insurance plans!

Telepsych is another means of meeting with a mental healthcare professional using a HIPPA-regulated (private/secure) online portal to complete appointments. It works well for families who may: live far from the office, have scheduling conflicts or for those who desire to complete appointments form the comfort of their homes, car or office. Telemedicine doctors can diagnose, recommend treatment and even prescribe medication, if necessary.

7. Lean on your Spiritual Community and Leaders

If you’re involved with an organized religious group, you can find help within that community.

Community churches and religious organizations host free support groups and retreats where you can connect with others in your situation. Ministers and other leaders in the community offer free individual or couple’s counseling.

If you’re worried about exposing about your struggles within a small community, remember: Everyone that attends individual or group therapy is looking for help, just like you.

8. Services at colleges and schools

College or university students (and faculty) likely have access to mental health care services through their schools and universities. Tuition and fees subsidize these services, so take advantage of them! Children enrolled in a K-12 school may have access to sessions with a school counselor as well. This is another option available when your family can’t afford private mental health services.

9. Consult the Internet

Going online to self-diagnose your ailments is not a replacement for professional advice, diagnosis and treatment.

But if you already know what you’re dealing with, consulting a relevant association’s website could help when you have questions and lack access to a doctor.

For example, if you suffer from anxiety, you can find reliable resources at these websites:

• Association for Behavioral and Cognitive Therapies

• Anxiety and Depression Association of America

• International OCD Foundation

Some people also find online forums like Reddit or Facebook groups useful for connecting with other people who understand your situation.

Just be careful to take advice from random individuals with a grain of salt, and never rely on them for a diagnosis.

If you prefer to speak with someone directly, you can call the NAMI Helpline (National Alliance on Mental Illness) to get answers about symptoms, treatments and resources. The Helpline itself doesn’t offer counseling, but it can help you connect with programs in your area.


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