Adding stress and confusion during an already challenging time, navigation of the mental health system is very difficult. So many different types of care, programs, specialties and providers exist it is difficult to know who to contact. Every organization is limited in type and amount of service it can provide. Many agencies have eligibility requirements based on a patient’s age, income, insurance, diagnosis, place of residence, or other factors.
The many financial aspects of receiving care also create challenges. Your health insurance, whether Medicare, Medicaid, an employer plan or a health exchange plan, or the lack of health insurance, directly effects which services are available to you. Some organizations (e.g., health homes), however, have implemented programs for people who meet certain criteria to receive most services through its one organization.
Also, health and mental health providers, social services, schools and colleges, and families may not share information, many times due to privacy laws, thus impeding coordination of services. Sometimes services are available only to patients within a certain agency.
Other factors making it difficult to find services are: limitations based on access such as office hours, appointment wait times, and location. Occasionally, people are denied services to which they are legally entitled. See Legal Services for more information.
Finding a Mental Health Professional
Although finding the right care for yourself or loved one, the tips below should provide some guidance. If you are seeking help for your loved one who has mental illness, remember that treatment usually cannot be given without the patient’s consent. Therefore, it is usually best to involve your relative in arranging services to the degree that this is possible and obtain necessary HIPAA and other confidentiality forms.
NAMI Buffalo (716-226-6264) and this website, as well as other local resources such as 211WNY or the Erie County Department of Mental Health, can help you find a mental health provider or program. Following are other tips:
Step 1: Who Are You Looking for?
People have many different reasons to consult a mental health professional. Are you looking primarily for someone to talk to? Are you looking for someone who is licensed to prescribe medication? Many people receiving treatment for a serious mental health condition have at least two separate professionals, one focusing on medication and the other focusing on emotional or behavioral therapies.
Here are some things to think about:
- If you have not yet done so, visit a primary care doctor or a pediatrician for a physical. Other illnesses can cause symptoms similar to those for mental illness, e.g., thyroid disease. Depression screening should be a part of a physical exam and may lead your physician to provide referrals to a therapist or psychiatrist as necessary.
- If you are seeking help with emotions, behaviors and thinking patterns, you should locate a therapist or counselor. Depending on your particular diagnosis or symptoms, you may want to seek out a therapist specializing in your condition. Most therapists treat general conditions like depression and anxiety but some others also specialize in certain areas, such as PTSD, borderline personality disorder, family counseling or eating disorders, as well as age groups. Some may have training in specific forms of therapy, e.g. cognitive behavioral therapy (CBT) in which the therapist helps the client to see unhealthy patterns of thought and how they lead to self-destructive behaviors and beliefs.
- If you have been told by a professional that you may be helped by medication, or you feel your symptoms have not been lessened by your current treatment, you may need to see a psychiatrist or other specialist who prescribes medicine.
Step 2: How do I find a professional?
Finding a mental health professional may not always be easy. As previously mentioned, our mental health system is difficult to navigate. The resources provided here accept Medicaid or other options for low-income patients. Private practice professionals are not listed here but may be researched online or referred through other doctors and/or family and friends.
To find a mental health provider:
- Ask your primary care doctor or pediatrician, or another health professional (e.g., your therapist or counselor).
- Ask family and friends.
- Ask for a referral from your school social worker or guidance counselor, or university Student Services Department or health services.
- Contact your area community mental health centers or mental health groups.
- Contact your place of worship.
- Contact your health insurance plan for a list of network providers.
- Call your local or state psychological or psychiatric association.
- Visit NAMI’s website at https://www.nami.org/Find-Support/Living-with-a-Mental-HealthCondition/Finding-a-Mental-Health-Professional
- Use APA’s Psychologist Locator service at http://locator.apa.org/
- Do an online search for specific providers in your geographic area.
Always be sure to check a professional’s credentials and licensure.
When searching for a mental health provider, it is important to check with your health insurance plan, whether it is employer-sponsored, Medicare, Medicaid, health exchange plan or other insurance, to see what services or providers are covered. Here are some questions you should ask:
- Is my provider (or potential provider) covered under the plan?
- How much of the cost of a visit is covered by the plan? Be aware your cost may be much higher before you reach your deductible. Be sure to ask for this cost too.
- Can you make a direct appointment with a psychiatrist, or do you need to see a primary care doctor or other doctor first for a referral?
If you do not have health insurance, ask the provider if they can assist in signing you up for insurance. Most of the larger mental health agencies will help you do this. You can go to New York State of Health at https://nystateofhealth.ny.gov/ to access Marketplace insurance.
Also, you may contact other agencies who assist you in accessing health insurance, as well as other basic needs and resources, later in this section under Other Non-Medical Resources.
Step 3: Making an appointment
For some professionals, especially psychiatrists, new patients may have to wait many weeks or months for an appointment, which unfortunately is not uncommon. Make an appointment anyway since, after calling other offices, you may find it is the earliest appointment you can get. You can always cancel later if you can be seen sooner by another professional. Also, having made an appointment, you can ask to be put on the cancelation list.
Sometimes you may find that before seeing a psychiatrist, you may first have to be seen by a nurse practitioner, physician assistant or therapist prior to scheduling an appointment with the doctor.
You can be seen earlier if you contact one of the larger mental health agencies (BestSelf, Horizon, Spectrum or Endeavor). If you feel you cannot wait for an appointment, you may contact any of the organizations that have same day access or urgent care. See Same Day Access and Urgent Care.
When making an appointment, consider asking the following questions if the intake person does not ask you them first:
- Does the provider take your insurance?
- What are the days and hours they are open?
- If you cannot get an appointment quickly, ask to put on the cancelation or wait list.
- Do they provide telehealth or Zoom appointments?
- What is the cancelation policy?
- What are the person’s credentials and do they see patients with your concerns or condition? (You may also research qualifications and licenses in advance).
Step 4: Your first visit
At your first visit with a doctor or therapist, you are not only seeking advice but you are also looking for someone you feel comfortable working with. It’s reasonable to ask questions. Here are some questions you might want to think about or ask:
- Do you feel comfortable with this person? Even if this person has a good reputation or a high level of education, the most important thing is whether you can work well together. What “vibe” do you get? Some of the questions you are asked may be quite personal, but the mental health professional should not make you feel uncomfortable. You should feel this person will take your feelings into account. The ideal provider listens attentively to your concerns, is patient and non-judgmental. Sometimes the first person you visit might not “feel right” or lack experience with your particular mental health condition. It is best to look for another person after one or two appointments.
- What can you expect if you work together? How often will you meet and how hard will it be to get an appointment? Can you call on the phone or email between appointments?
- If you are concerned about your ability to meet insurance co-pays or deductibles, bring it up now rather than later. Ask if you can pay on a sliding scale or at a discount. Doctors and therapists would like to know ahead of time if these problems might arise because it’s important to continue treatment without interruption.
How to prepare for the visit:
- Bring a list of your medications and dosages including any over-the-counter drugs.
- Make a list of problems you are experiencing:
- Side effects of medications
- With life in general
- What brought you to them – they need to know your problems in order to help you.
- Any new or recurring difficulties
- Write down your questions and concerns. Be honest and up-front. Don’t be embarrassed. Most professionals have heard everything before.
- Ask about what medical testing you might need such as blood work, thyroid levels, enzymes, EEG, MRI.
Family Involvement with Professionals
Sometimes a family member with serious mental illness may not be well enough to manage their own health or treatment. At times they may lack insight into their illness (anosognosia) and do not believe they are ill. Just as when a person is ill with any other illness, having an advocate and a “second set of eyes” is important.
If you are a family member of someone with mental illness, especially severe mental illness, you may want to be involved in their treatment. Families often help their loved ones make and keep appointments, provide transportation, pick up and manage medication, locate services and advocate for appropriate treatment – leading to more positive health outcomes. They can detect early signs of deterioration and encourage action. Their financial, logistical and most of all emotional support is extremely valuable for stabilization and recovery. Families should be allowed, even encouraged, to work as a team with mental health providers. Establishing and maintaining a good relationship with professional providers can be critical to a person’s treatment success.
Privacy is important for an individual in order to seek treatment without fear of embarrassment or disclosure. However, some professionals may use confidentiality as a barrier to family input or involvement. A professional is permitted to speak or meet with family members or caregivers without divulging any confidential information. Privacy rules are still honored when you give input or information which may be useful to the professional even if they cannot discuss the case or give you information. They can also provide general help, guidance or information without breaking confidences. You should question having a provider’s who is unwilling to work with the family, regardless if they feel they are too busy or do not see value in the value of family involvement.
Much of a family’s help depends on HIPAA and other confidentiality rules. Ask your relative to sign a consent for release of information, if only in the case of a serious situation or an emergency. Note that a person may sign HIPAA (Health Insurance Portability and Accountability) forms limiting the sharing of information to a particular time period (even for one day, e.g., for discharge planning or a doctor appointment) or for certain information (e.g., mental health information from one doctor but not another one, or, for mental health information but not for other medical information).
It is especially useful for family to be involved in initial meetings related to treatment, when major treatment decisions are being decided, or when a person is being discharged from the hospital or housing facility.
When a person is incarcerated, if they do not sign a HIPAA form, the family member will not be given any information including when the person is transferred to another prison or when they will be released. Many incarcerated individuals are not aware of this limitation.
If you have a complaint about a mental health service, agency, or professional, you are permitted to register it. If you are unsure about the procedures, call NAMI Buffalo & Erie County (716-226-6264) for help with understanding the process.
Professional Titles & Definitions
Case Manager: A professional (generally a social worker) or paraprofessional (someone with a two-year degree or limited formal college training) who helps a client to arrange for needed services or entitlements and acts as a client advocate. Such persons may receive specialized on-the-job or in-service training.
Certified Alcoholism Counselor (CAC)/Credentialed Alcoholism and Substance Abuse Counselor (CASAC): A counselor with experience in the field of addictions who has passed a national exam and who regularly completes continuing education in the field of addictions.
Certified Mental Health Counselor (CMHC): Licensed counselor, with a master’s or doctoral degree from an accredited program with 60 or more semester credit hours. Also, completed a minimum 3,000 hours training under professional supervision. These individuals may not be covered by health insurance plans.
LCSW or LMSW, see Social Worker below.
Nurse Practitioner (NP): An individual who has a currently registered NYS license as a registered professional nurse (RN) and is certified to practice in a specific specialty area through additional education approved for training nurse practitioners. Certified nurse practitioners may diagnose, treat, and prescribe medications in collaboration with a licensed physician qualified in the same specialty.
Occupational Therapist (OT): is trained to provide leisure and arts activities and rehabilitation for people with physical and mental disabilities.
Peer Specialist: An individual with personal experience with mental illness who is credentialed by the Academy of Peer Services or a national credentialing body to provide Peer Services to other individuals with mental illness.
Psychiatrist: A medical doctor (MD) who specializes in the diagnosis, treatment, and prevention of mental and emotional disorders. While any physician may practice psychiatry, most psychiatrists have completed an approved residency program of specialized training. After completing a residency program and practicing for one year, a psychiatrist is eligible to take a certification examination given by the American Board of Psychiatry and Neurology. Such psychiatrists are called “Board Eligible.” After passing the examination, a psychiatrist is “Board Certified.”
Psychiatric Mental Health Nurse Practitioner (PMHNP): A nurse practitioner who specializes in psychiatry and is licensed to prescribe psychotropic medications only.
Psychologist: A person trained in the science of human behavior and personality. To be licensed in New York State a psychologist must have a doctoral degree (PhD, EdD, PsyD or equivalent), at least two years of supervised experience, and completed a state licensing examination. Only licensed psychologists, or non-licensed psychologists while working in “exempt settings” (school or government agencies), can use the term “psychologist” or “psychological” in describing their practice.
Recreational Therapist (RT) is often part of the team on a psychiatric inpatient unit. An RT plans, organizes, and directs medically approved recreation programs for patients in hospitals and other institutions. They may coordinate and supervise activities such as games, sports, arts and crafts, and music to enable patients to socialize appropriately and to develop confidence needed to participate in group activities.
Registered Nurse (RN): A registered nurse has received a diploma from an accredited school of nursing or a degree in nursing from an accredited college program in nursing, and has passed an examination administered by the New York State Department of Education. A certified Clinical Specialist in Psychiatric Nursing is a registered nurse with a master’s degree (MS or MSN) in psychiatric nursing, supervised experience in psychiatric care, and has passed a qualifying examination given by the New York State Nurses Association in cooperation with the American Nurses Association.
Rehabilitation Counselor: A person trained to provide vocational and personal adjustment counseling to people with disabilities. A certified rehabilitation counselor (CRC) has a master’s degree in rehabilitation counseling (including one year of supervised experience) or a bachelor’s in counseling and five years of supervised experience and has passed an examination given by the Commission on Rehabilitation Counselor Certification.
Social Worker: A social worker helps people with the social, family, emotional and financial aspects of illness or disability. A Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW) has a master degree in social work and at least three years of full-time supervised clinical social work experience in mental health and has passed a licensing examination administered by the Association of Social Work Boards. Licensed social workers also offer counseling as private practitioners covered by insurance plans in NYS.
Therapist: A broad term to describe a person who provides a type of therapy but does not require any one degree. A psychotherapist is a mental health professional such as Psychologist, Social Worker or counselor who can help someone better understand and cope with their thoughts, feelings and behaviors. They offer what is called “talk therapy” and use theories of psychotherapy to guide their practice. They have varying degrees of experience and education. Other mental health professionals include a Clinical Mental Health Counselor (CMHC) or Certified Alcohol and Substance Abuse Counselor (CASAC).
Therapy Assistant/Therapy Aide: Referred to by a variety of different names, these individuals provide much of the daily hands-on care patients need when hospitalized. They assist in feeding, bathing, and dressing patients who cannot complete such tasks themselves. Most therapy aides have a high school education and some additional in-service training provided by the facility where they are working. In some institutions, they must also have some supervised experience before receiving permanent employment status.
If You Don’t Know – Check. New York State does not restrict anyone–no matter how unskilled–from practicing psychotherapy, hypnosis, psychoanalysis, or counseling. The law does restrict the use of titles such as physician, psychologist, registered nurse, and licensed social worker to those that have met the requirements of licensure in those fields, though a designation of “L” or “R” will usually indicate either “licensed” or “registered”. The Office of Mental Health is also required by law to establish and enforce standards of treatment in the agencies and facilities it certifies. If you are presented with a credential you do not know the meaning of, ask the provider what it means. We advise families to take advantage of these safeguards by seeking help only from licensed professionals or from certified mental health agencies. NYS licensing of mental health professionals can be verified through the NY State Dept. of Education at http://www.op.nysed.gov/opsearches.
Finding Non-Health-Related Resources
This section includes organizations that assist you in finding community services other than mental health treatment services. When someone has mental illness, other services may be needed related to Social Security Disability, housing, medical insurance, basic needs (food, clothing, utilities) and other non-medical services.
This list is not intended to be comprehensive. Many other nonprofit and community agencies offer assistance with obtaining these services. Please contact WNY 211 or http://www.211wny.org/ for additional resources.
45 Jewett Ave
Buffalo, NY 14214
292 High St
A health and wellness care coordination program
180 Washburn St
Lockport NY 14094
Neighborhood Center, Niagara Falls
64 19th St
Niagara Falls, NY 14301
Town of Tonawanda Coalition
160 Delaware Rd
Kenmore, NY 14217
NYS Office of Temporary and Disability Assistance
Local: 295 Main St., PO Box 5030, Buffalo, NY 14205
Administrative Hearings, or 800-342-3334
PO Box 1930, Albany, NY 12201-1930
Provide fair hearings relating to Temporary Assistance and Medicaid. State form required.
Maria M. Love Convalescent Fund
P.O. Box 293
Buffalo, NY 14213
11955 Liberia Rd, E. Aurora, NY 14052
Contact: Human service agency referral only