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Health as we know it is looking a little different these days, thanks to the COVID-19 pandemic. People are experiencing serious financial hardship and career disarray—not to mention they could be sick or watched loved ones get sick. All of this has an impact on mental health. Plus, widespread social distancing to prevent the spread of the novel coronavirus means that we are all experiencing more isolation in our day-to-day lives than most of us normally would. And that has an effect on mental health. A recent study in The Lancet found that the psychological effects of social distancing can range from anger to fear to post-traumatic stress.
This research is bringing a new mental health crisis into the conversation alongside COVID-19. A new report in JAMA Internal Medicine states that we should expect an “overflow of mental illness that will inevitably emerge from this pandemic.” Large-scale disasters “are almost always accompanied by increases in depression, post-traumatic stress disorder, substance abuse, a broad range of other mental and behavioral disorders, domestic violence, and child abuse,” write the authors.
The big numbers and large-scale theories are scary enough. But, when you’re experiencing poor sleep, nightmares, or seemingly never-ending stress—or trying to cope with anxiety, substance use and abuse, and loneliness—it’s even more challenging when stuck at home.
“We are seeing a few things that are becoming really prevalent for people right now—some people are feeling really isolated and lonely, some are feeling incredibly overwhelmed and suffocated being at home with their family or roommates or significant other, and some people are experiencing major sleep disturbances because your body doesn’t forget the stressors of your normal routine being upended,” says Jenn Weaver, CAGS, LMHC, CRC at Polaris Counseling & Consulting in Providence, Rhode Island. “Symptoms of depression are going up, but when you’re not showering and you’re staying in bed a lot of people are asking themselves, ‘Am I depressed or just surviving quarantine?’ It’s tricky, because they mirror each other. And we all need someone to talk to about this stuff.”
But talking to someone these days comes with new challenges. Because support groups and counseling resources are harder to access in person, the mental healthcare landscape is having to reshape itself. Now, we’re seeing a big shift of services and opportunities to connect with others being done remotely. This remote style of therapy is called “teletherapy” or “telepsychiatry.”
What is teletherapy?
Teletherapy is just like the mental health therapy services you’re familiar with—but instead of meeting in your therapist or counselor’s office, you meet via live video conferencing or by telephone. “After we closed our in-person appointments and offered our current clients teletherapy sessions, about 50% said that they would be willing to try it,” Weaver says. “Out of the clients who were opened-minded to it, all of them were like ‘Wow, that was way better than I thought it would be.’”
And other counselors around the country are also seeing a positive response from their clients who are transitioning from in-person visits to virtual meetings. “We asked our clients to give teletherapy a try because they thought it wouldn’t be the same or as helpful but those who were willing to give it a try after the first few minutes always remark how normal it feels—and how helpful and really reassuring it is,” says Evan Center, MS, LCPC, president of Center Counseling in Bozeman, Montana. “I would encourage anyone considering therapy right now to really give teletherapy a try. It’s worth it to have someone to talk to.”
But after you decide you’re ready to talk to someone, it’s important to know how you are going to pay for a session (or if you qualify for free teletherapy). Because of the COVID-19 crisis, Medicare and many insurance companies have expanded coverage (at least for the short-term) to include telehealth counseling from psychologists, psychiatrists, mental health counselors, and licensed clinical social workers. Certain forms of group therapy also may be covered. Read: You can have a therapy appointment—at-home, in the immediate future, at the same rates you otherwise would have paid for an in-person session.
How to access teletherapy
If you have private health insurance, providers such as Aetna and Blue Cross Blue Shield are currently waiving copays for in-network telehealth visits, including those not related to COVID-19 symptoms (i.e., mental health issues and symptoms). Currently states such as Montana, Massachusetts, California, and Arizona have ordered all insurers to cover telehealth services, and mandates in other states could be coming. But it’s all on a state-by-state basis—and as Weaver puts it, “It changes every day. But for the most part, during this pandemic most [in-network] telehealth counseling sessions are covered in full.”
Additionally, your employer may offer an employee assistance program (EAP) as part of your benefits package, which provides services (like counseling) that help employees address particular issues that interfere with their well-being and work performance, according to the American Psychiatric Association (APA). Call your HR department or speak to your employer about these opportunities.
To see if your insurance company covers your counseling sessions, call the customer service number on the back of your insurance card and ask. One possible exception of not being qualified for free teletherapy through your private insurance is if you are seeing someone over state line (like if you live in New Hampshire and are seeing a therapist in Massachusetts).
If you’re one of the 59 million Americans covered by Medicare, new pandemic-related legislation has waived the long-standing restrictions on your use of telehealth services (for the duration of this public health emergency, that is). The Health Insurance Portability and Accountability Act, or HIPAA, formerly restricted the use of phones to conduct telehealth visits due to privacy concerns, but those restrictions have now been lifted. That means you can have your appointments over apps with no repercussions to your Medicare coverage.
If you’re covered by Medicaid and Children’s Health Insurance Programs (CHIP), telehealth coverage typically varies by state. COVID-19 emergency coverage has extended services for new and established patients across the country—including individual and family therapy. Restrictions on location and services are temporarily lifted.
If you don’t have insurance at all—or if it doesn’t currently cover any telehealth or teletherapy services for you—there are other resources available, such as Federally Qualified Health Centers. These are community-based centers that offer care including mental health services and substance abuse resources. They’re authorized to provide telehealth services even if you’ve never been a patient at one before and are also required to prioritize patients who live inside their service areas. If this sounds like a good option for you, you can search for a health center in your neighborhood here. Privately paying for teletherapy is another option, if it’s affordable for you.
How to join substance abuse support groups
Struggling with addiction and substance use/abuse can feel impossible when you don’t have the support you need. But fortunately, group therapy such as Alcoholics Anonymous and Narcotics Anonymous resources are accessible virtually right now. Websites like Online Intergroup, provide a directory of Zoom meetings along with call-in numbers. Virtual Narcotics Anonymous offers meetings over the phone and online as well. You can search for meetings through Narcotics Anonymous here.
How to find a therapist
Now that you know what the financial freedoms and restrictions of teletherapy are, the next step is to find the best therapist, counselor, and program for you and your needs. And yes, that can be an intimidating search if you don’t already have a therapist who is offering teletherapy. But the good news is that once again, there are resources to find a good match.
1. Use an online directory
Teladoc, Amwell, Better Help, MDLive, and Doctor on Demand are all reputable websites that connect you with mental health professionals. Additionally, Psychology Today has a therapist directory that allows you to filter therapists who offer teletherapy, as well as filter by region and specialty. “If you know you would prefer to talk to a female therapist or a therapist that’s older than you, you can make sure that’s what you find,” Weaver says. “Think about what you need. Try to find that specifically, and don’t click on someone just because they are in your zip code.”
Many freestanding local mental health clinics or hospital-based psychiatric residency clinics are reasonable places to look too.
2. Schedule a meet and greet before your first appointment
Both Center and Weaver recommend searching online to find a therapist in your region that seems like they might be a good fit. And then try a baby step approach. “It’s such a normal, practical request to ask a potential therapist to simply talk on the phone for 10 or 15 minutes so that you can have a first impression of each other,” Center says. “There should be a natural trust and ease with talking to your potential therapist. With that, you will be able to jump more deeply into your conversations and sessions—and you will actually see and feel the benefits. Most people have the ability to read others quickly and you shouldn’t be bashful if the first short phone call isn’t the right fit. That’s okay. Just say it and move on.”
Weaver agrees: “Any good therapist would agree to take a 10-minute phone call with you to answer questions and meet one another to determine if it’s the right match or not. Simply ask, ‘I’m new to this, can I have a 10-minute phone call with you to see if this is a good fit?’ Worst case scenario is someone says no and in that case you wouldn’t want to work with that therapist regardless.”
3. Ask for a recommendation
Another way to find a reputable therapist in your area is by the good old-fashioned word of mouth method. “It’s more common in 2020 to talk about your therapist, so if you’re comfortable ask the people in your circle,” Weaver says.
After you find the right fit, schedule your sessions to be most optimal for you. “Therapy is what you need it to be,” Center says. “It’s really nice to talk to someone who is not emotionally invested in your life. I’m not going to come into play—this is about you and your thoughts and feelings. Get it off your chest. To have someone who is not locked in the house with you who can listen and speak to you impartially is really powerful.”
And the other bright side? All the time saved that you would’ve spent commuting to and from your appointment, sitting in the waiting room, and getting yourself ready to get out the door. “We see a lot of people who try teletherapy stick with it because it’s way easier to fit into your day—and whether there’s a pandemic or not, it’s sometimes hard to find the time. When you can hop in and out of a call in 45 minutes and get all the benefits of traditional therapy, it’s tough to have any excuses not to do it,” Center says.
If you need more general help with finding mental health resources, contact the National Alliance on Mental Illness at 1-800-950-NAMI (6264) or email them at email@example.com. Additionally, if you are in a crisis and need help immediately, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat online with a counselor for free.