Why is it so hard to get mental health help

The Doctor is Out | NAMI: National Alliance on Mental Illness

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Each year millions of Americans with mental illness struggle to find mental health care. Nearly half of the 60 million adults and children living with mental health conditions in the United States go without any treatment. People who seek treatment must navigate a fragmented and costly system full of obstacles. As a result, many people cannot access mental health care when they need it most.

Despite the passage of the Mental Health Parity and Addictions Equity Act of 2008, significant barriers remain which keep many Americans from accessing mental health treatment and support.

Americans are finding it difficult to access care for several reasons. People lack the same access to mental health providers as they have for other medical providers. And when they can find a mental health professional, many are forced to go out-of-network to do so. This leads to higher out-of-pocket costs for mental health care compared to other types of primary or specialty care.

To assess whether federal and state parity laws were truly leading to equity in accessing mental health and substance use disorder care, NAMI has conducted a series of three surveys. Following the first survey in 2014, NAMI issued a report in April 2015, A Long Road Ahead: Achieving True Parity in Mental Health and Substance Use Care. The survey revealed that, despite the requirements of the federal parity law, people encountered significant barriers to receiving services.

View 2015 Report

As a follow-up to the findings published in early 2015, NAMI released Out-Of-Network, Out-Of-Pocket, Out-Of-Options: The Unfulfilled Promise of Parity in 2016. The report sought to answer the question, “What do insurance beneficiaries experience when they seek mental health care?” The report revealed that people with insurance had more difficulty locating in-network providers and facilities for mental health care compared to general or specialty medical care, whether for inpatient or outpatient services.

View 2016 Report

Unfortunately, the most recent survey conducted in late 2016 revealed continued barriers for people to obtain mental health care. In the nationwide online survey, 3,177 individuals participated. These were individuals with mental health conditions or a relative who could provide reliable information. Participants in the survey could have coverage from either private health insurance or public health coverage such as Medicaid or Medicare.

The Doctor is…Out-of-Network

In The Doctor is Out, respondents indicated that they struggle to find a mental health therapist or prescriber. More than half of respondents who looked for a new mental health provider in the last year contacted psychiatrists who were not accepting new patients (55%) or who did not accept their insurance (56%). A third of respondents (33%) reported difficulty finding any mental health prescriber who would accept their insurance, either in- or out-of-network. This far exceeded the number who had difficulty finding a medical specialist who would accept their insurance (13%) or a primary care provider (9%).

When people cannot find a provider, many have to go out-of-network and pay high out-of-pocket costs, including co-pays. This happened at much higher rates than when seeking primary or even specialty medical care. Over 1 in 4 people (28%) receiving mental health therapy used an out-of-network therapist, compared to only 7% needing to use an out-of-network medical specialist.

When people face higher out-of-pocket costs, it may lead to them seeking less care—or going without any care at all. Out-of-pocket costs exceeding $200 were more frequent for people visiting a mental health prescriber (16%) compared with visits to medical specialists (9%) or a primary care provider (6%).

Survey respondents also reported difficulty finding in-network, inpatient mental health care. Of those who received psychiatric hospital care, over twice as many used an out-of-network hospital (12%) compared to those who used an out-of-network medical hospital for other types of medical care (5%). And, twice as many respondents (20%) had issues locating any inpatient psychiatric hospital compared to those who reported difficulty finding similar medical care (10%).

Private insurance continues to be lagging. Medicaid recipients were far more likely to use in-network services than were people with private insurance. While more than two-thirds of the respondents enrolled in Medicaid reported no out-of-pocket costs for outpatient care, those who did incur out-of-pocket costs reported these expenses as more of an impediment to accessing mental health care compared to other medical or specialty care.

Pursuing Equity

Because of the substantial disparity in access to in-network mental health care and out-of-pocket costs compared to other types of medical care, NAMI believes it is crucial that state and federal regulators routinely conduct market audits of all commercial health insurers and Medicaid managed care organizations for compliance with federal parity law. These audits would help level the playing field for insurers who are doing the right thing—and ensure that individuals with mental illness can access the care they desperately need.

NAMI also recommends the following steps health insurers and Medicaid managed care organizations should take to improve coverage under federal parity law:

Increase reimbursement rates and other incentives for psychiatrists and other mental health clinicians
Increase reimbursement and reduce barriers for tele-mental health services
Expand reimbursement models that integrate health, mental health and substance use disorder care, such as the Collaborative Care Model
Recruit and contract with a wider range of providers, including mental health and substance use disorder residential and inpatient facilities and allied mental health workers, such as peer support and family support specialists
Promote use of advance practice nurses and other health care professionals with appropriate training to prescribe mental health medications

Despite federal parity law, the promise of parity remains out of reach for people with mental illness. Overly narrow provider networks and high out-of-pocket costs are substantial barriers to individuals accessing mental health treatment. NAMI calls on health plans, regulators and lawmakers to take the necessary steps to address these disparities and ensure access to mental health care for millions of Americans.

Study Reveals Lack of Access as Root Cause for Mental Health Crisis in America

Mental health services in the U.S. are insufficient despite more than half of Americans (56%) seeking help. Limited options and long waits are the norm, but there are some bright spots, with 76% of Americans now seeing mental health as important as physical health.

Washington, D.C.

Today, Cohen Veterans Network (CVN), a national not-for-profit philanthropic organization, and National Council for Mental Wellbeing, the unifying voice of America’s health care organizations that delivers mental health and addiction treatment and services, issued the inaugural America’s Mental Health 2018, a comprehensive study of access to mental health care, at the 2018 Cohen Veterans Care Summit in Washington D. C. The study, which assesses Americans’ current access to and attitudes towards mental health services, revealed American mental health services are insufficient, and despite high demand, the root of the problem is lack of access – or the ability to find care.

The study offers a comprehensive analysis of the state of mental health care in the U.S. It is comprised of a two-pronged research project that includes an online survey of 5,000 American adults, and a robust analysis of third-party data measuring patients’ access to mental health services in terms of four pillars – providers, facilities, funding and perceived satisfaction among patients.

“There is a mental health crisis in America. My experience establishing mental health clinics across the country, coupled with this study, shows that more needs to be done to give Americans much needed access to mental health services,” said Cohen Veterans Network President and Chief Executive Officer Dr. Anthony Hassan. “If we want to save lives, save families and save futures we must reimagine our behavioral health system and take concrete steps to improving consumers’ ability to find the care they need, when they need it, and on their terms. ”

Despite Strong Demand for Mental Health Services, Common Barriers Remain

The demand for mental health services is stronger than ever, with nearly six in 10 (56%) Americans seeking or wanting to seek mental health services either for themselves or for a loved one. These individuals are skewing younger and are more likely to be of lower income and have a military background. The large majority of Americans (76%) also believe mental health is just as important as physical health.

“This study confirmed what we hear from our members every day, that individuals and families continue to struggle to find the help they desperately need,” said Linda Rosenberg, President and CEO of National Council for Mental Wellbeing. “Mental health and addiction providers need adequate funding to hire skilled staff, employ evidence-based practices and adopt innovative technologies – all of which will help us meet demand.”

Despite this strong demand and growing societal awareness of the importance of mental health in the U. S., the study revealed that the overwhelming majority of Americans (74%) do not believe such services are accessible for everyone, and about half (47%) believe options are limited.

These beliefs are driven by several perceived barriers in Americans’ ability to seek mental health treatment, including:

High Cost and Insufficient Insurance Coverage: Forty-two percent of the population saw cost and poor insurance coverage as the top barriers for accessing mental health care. One in four (25%) Americans reported having to choose between getting mental health treatment and paying for daily necessities.

Several individuals blamed the U.S. government and insurers for not providing enough funding and support for access. Nearly one in five of Americans, or 17%, noted they have had to choose between getting treatment for a physical health condition and a mental health condition due to their insurance policy. The majority (64%) of Americans who have sought treatment believe the U. S. government needs to do more to improve mental health services.

Limited Options and Long Waits: Access to face-to-face services is a higher priority for Americans seeking mental health treatment than access to medication. Ninety-six million Americans, or 38%, have had to wait longer than one week for mental health treatments. And nearly half of Americans, or 46%, have had to or know someone who has had to drive more than an hour roundtrip to seek treatment.

While most Americans have heard of telehealth as an option for treating mental health issues, only 7% have reported using it. When asked if they would be open to using it, almost half, or 45%, of Americans who have not already tried telehealth services said they would be open to the idea of trying a service to address a current or future mental health need.

Lack of Awareness: While most Americans do try to seek out treatment, there also is a large portion of the population who have wanted to but did not seek treatment for themselves or loved ones (29%)– in part due to not knowing where to go if they needed this service. What’s more, fifty-three million American adults (21%) have wanted to see a professional but were unable to for reasons outside of their control.

Furthermore, younger Americans (i.e., Gen Z and Millennials) are less sure about resources for mental health services, compared to older generations. This younger generation was also more likely to find it too hard to figure out legitimate resources online. Instead, many turned to unreliable resources for information, including Facebook, YouTube and Twitter.

Social Stigma: Nearly one-third of Americans, or 31%, have worried about others judging them when they told them they have sought mental health services, and over a fifth of the population, or 21%, have even lied to avoid telling people they were seeking mental health services. This stigma is particularly true for younger Americans, who are more likely to have worried about others judging them when they say they have sought mental health services (i. e. 49% Gen Z vs. 40% Millennials vs. 30% Gen X vs. 20% Boomers).

Stark Disparities in Accessibility at State and Income Levels

Based on the analysis of third-party data, states are struggling to keep up with demand due to lack of funding and facilities, and, to a lesser extent, providers. Texas, Wisconsin and Georgia ranked among the lowest in terms of lacking adequate number of providers, facilities and funding to support the states’ populations. Pennsylvania, New York and Minnesota ranked among the top.

There is also a large disparity in access to mental health care based on level of income and location. Individuals located in rural areas and of lower-income are less likely to say that mental health services are extremely accessible to them.

Compared to middle- and high-income households, low-income Americans are less likely to know where to go for treatment and more likely to use a community center verses a qualified mental health center. Of the Americans that have not sought mental health treatment, more than half, or 53%, were in low-income households.

In addition, compared to Americans living in urban and suburban areas, individuals living in rural areas are less likely to proactively seek mental health specialists they need, and instead go to their primary care doctor or community center for treatment. Rural Americans are also less accepting of mental health services and care.

The Path Forward

The Cohen Veterans Network and National Council for Mental Wellbeing believe that more must be done to improve access to care for everyday Americans. Specifically, younger Americans need more information on how and where to access care. There must also be a better understanding of the real cost of delivering mental health care and related reimbursement rates, which typically cover only a small portion of care. This is critical to help attract new providers into the field and more must be done to train and retain providers to help ensure people can get help when they need it. Finally, we must ensure standards of care are consistent through continued adoption of evidence-based practices.

For more information on the comprehensive study results and how CVN and National Council are working to address mental wellness and accessibly across the country, please visit www.cohenveteransnetwork.org/AmericasMentalHealth or www.TheNationalCouncil.org.

About America’s Mental Health 2018

Cohen Veterans Network and National Council for Mental Wellbeing partnered with Ketchum Analytics who conducted an online survey among 5,000 Americans, representative of the U.S. population based on age, gender, region, household income and race/ethnicity. The survey was conducted between July 31 – August 12, 2018, with a margin of error of +/- 1.38 at the 95% confidence level. Through the survey, the following groups were identified: veterans, active duty military and those with a secondary relationship with a veteran as well as those who have sought mental health treatment (Mental Health Treatment Seekers). A custom index was developed, ranking each state according to its mental health service access. Third-party data was gathered to determine access based on four pillars: providers, facilities, funding and satisfaction. Data was aggregated and averaged to each state, resulting in a score between 0 and 100, where 100 indicates the greatest access.

About Cohen Veterans Network

The Cohen Veterans Network (CVN) is a 501(c)(3) national not-for-profit philanthropic organization for post-9/11 veterans and their families. CVN focuses on improving mental health outcomes, with a goal to build a network of outpatient mental health clinics for veterans and their families in high-need communities, in which trained clinicians deliver holistic evidence-based care to treat mental health conditions. There are currently 10 Steven A. Cohen Military Family Clinics nationwide.

About The National Council

Founded in 1969, the National Council for Mental Wellbeing is a membership organization that drives policy and social change on behalf of over 3,100 mental health and substance use treatment organizations and the more than 10 million children, adults and families they serve. We advocate for policies to ensure equitable access to high-quality services. We build the capacity of mental health and substance use treatment organizations. And we promote greater understanding of mental wellbeing as a core component of comprehensive health and health care. Through our Mental Health First Aid (MHFA) program, we have trained more than 2.6 million people in the U.S. to identify, understand and respond to signs and symptoms of mental health and substance use challenges.

Media Contact

Sophia Majlessi
[email protected] 202-621-1631

"Yes, it's hard to be a psychologist"

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MIA Rossiya Segodnya hosted a round table on the topic “Ensuring the psychological well-being of the population”

Author:

Irina Larina

The round table discussed what should be mandatory in the upcoming law “On psychological help”, how modern psychologists are trained, how to prevent the appearance of scammers in this industry and how to deal with thought-scrolling.

©Aida Asadullina / Journalist Online

Psychological anxiety

Oleg Olegovich Salagay, Deputy Minister of Health of the Russian Federation, spoke about how the problem of psychological anxiety of the population in Russia is being solved. “ I must say that for the Ministry of Health, an approach that is related to the health and well-being of the person himself is fundamentally important” , - says Oleg Olegovich. He also added that it is very important that the patient receives all the help he needs, including in the field of mental health.

Now a trend is being recorded all over the world, which is associated with an increase in diseases affecting the mental health of a person, so at the moment it is especially important that there be a constant increase in professional assistance. Today, such assistance is provided by psychiatrists, psychotherapists and medical psychologists.

However, as Oleg Olegovich noted, psychiatric care is currently well regulated from a legislative point of view. In the field of psychological assistance, in turn, there are no such clear regulations. Who can provide psychological assistance, how, how a person is admitted to medical practice - these are, at the moment, questions that remain unanswered. That is why legislative regulation is necessary so that the patient can receive professional help at any time.

In Russia, the position of a psychologist appeared only in 1943. Then the training of professional psychologists began at Moscow and Leningrad Universities. In 1966, the first faculties of psychology appeared there. However, there were about 50 graduates in both universities. And when in 1989 the position of a school psychologist was introduced in every school, there was a large shortage of personnel. In 1992, the law of the Russian Federation "On psychiatric care and guarantees of the rights of citizens in its provision" appeared. Psychologists were also next in line, but the legislative settlement was postponed. And only now the draft law “On psychological assistance to the population” has begun to be developed.

Yuri Petrovich spoke about the key points that should be in the upcoming Federal Law. First, in the first paragraph there should be a clear definition of what professional psychological assistance is. Now, and especially during the pandemic, a large number of pseudo-psychologists have divorced. Yuri Petrovich showed the audience several slides with screenshots from sites that offer psychological education in three months, a week, three days, etc. There are also a large number of chatbots that offer psychological help. “Who will be responsible for what the bot recommends?” - commented Yuri Petrovich.

The rights of the recipient of psychological assistance should also be specified in the law in order to reduce the cases of quackery and thus the deterioration of the patient's psychological health. It is also necessary to give a definition of the position of a psychologist, since there are many specialties in this industry. The psychologist needs to understand from what moment he can start private activities and to whom he can transfer the information revealed during the conversation, if the patient's situation threatens his health.

No less important is the question of at what age a person has the right to visit a psychologist on an individual basis. Whether the parent should be present at the reception with the child, if he is not yet 18 years old, or not, it must be prescribed at the legislative level.

In addition, it is very important to consolidate the role of the state in the regulation of psychological care and the budget that will be allocated to free clinics. It is also necessary to introduce the concept of the minimum set of knowledge that a person must have in order to work as a psychologist. Yuri Petrovich noted that it is also necessary to introduce periodic confirmation of qualifications by a psychologist, because science is constantly developing, but not all psychologists follow this development.

The law should create good conditions for psychologists themselves. It is important to prepare an environment that will attract new professionals and require ongoing professional development from existing psychologists. To reduce the incidence of quackery, the best solution would be to create a registry that would display only those psychologists who are admitted to work professionally with patients.

When asked how fast the development of the law is going, Yury Petrovich answered: “ The most important thing is not speed, but quality ... We need to draw up a document that will help, not harm ". Education for psychologists conditions for the training of psychologists we have now and what else needs to be created, said the head of the department of pedagogy and medical psychology of the First Moscow State Medical University named after I.M. Sechenov, Maria Georgievna Kiseleva. At the beginning of her speech, she answered the question: why do medical psychologists need to take mathematics upon admission? " Psychology is a science that studies a person deeply, with the help of statistical processing and mathematical modeling .

There are two lines in education for psychologists, as noted by Maria Kiseleva. The first of them is theoretical, which you can study all your life. The second is the practical, the most difficult, but the most necessary part. " Even doctors find it easier to learn ", says Maria Georgievna. The fact is that doctors during practice have the opportunity to use simulators, while psychologists need to practice with living people and not cause them any harm. Maria Kiseleva also noted that a medical psychologist can work in a medical institution only after completing six years of training. Courses from the Internet will not help here.

Maria Georgievna supported Yury Petrovich Zinchenko's assertion that it is necessary to introduce mandatory accreditation. At the moment, medical psychologists are required to obtain primary accreditation, consisting of 80 test questions and a practical component. If a medical psychologist after training decides to engage in private practice, he does not need accreditation. “ However, I would make it mandatory ,” says Maria Georgievna.

It is also necessary to introduce mandatory personal therapy for psychologists themselves into the law, Maria Kiseleva believes. At the moment, there is a certain percentage of people who come into this area with psychological problems. In addition, a psychologist can simply “burn out”, because the more the doctor works, the better he understands all the responsibility that falls on him.

“ Yes, it's hard to be a psychologist ,” says Maria Grigorievna. But on the other hand, after six years of training, such a specialist can really guarantee high-quality treatment to the patient.

Nina Alekseevna Petrochenko, director of the State Budgetary Institution "Moscow Service for Psychological Assistance to the Population", also spoke about the specifics of preparing students to work as a psychologist. At the moment, the speaker noted, there is a shortage of personnel. Many people, having received a bachelor's degree in another specialty, go to a psychologist for a master's degree. At the moment, people get education as a psychologist along with any prefix at the end. Nina Alekseevna told how one day she stumbled upon the position of a psychologist-animator in her resume.

“ Our population should know that a person who received a psychological education in three days cannot be in demand as a psychologist ,” Nina Alekseevna said.

Nina Petrochenko also noted that it is necessary to introduce an internship in the field of psychology. New specialists are well trained, I have work experience, but it is small. At the moment, internships, introduction to the specialty and protection of the psychologist himself are needed, because at the moment he is not protected. Nina Alekseevna proposed to include the stages of its implementation, responsible executor and terms in the forthcoming law. Otherwise, when the law is passed, it will not work. In addition, it is necessary to understand that what will be prescribed in the law, the budget may simply not be able to withstand, so you need to think about insurance coverage that will be beneficial to everyone.

©Aida Asadullina / Journalist Online

The need for a psychologist

Nina Alekseevna Petrochenko spoke about the need for psychologists. Today, the need for psychological help is only growing. During the pandemic, many psychologists went to the red zones and provided more than 56,000 services. Doctors and the military understood how important the presence of a psychologist is for a person, because during any illness he needs to speak out, experience his feelings, and for someone to understand them. Therefore, when a person understands that he has come to a professional, his treatment immediately becomes more productive.

Georgy Petrovich Kostyuk, Chief Physician of the N.A. Alekseev Psychiatric Clinical Hospital No. 1 of the Moscow City Health Department, spoke about the specifics of the law “On Psychiatric Care for the Population”. “There is a law , quite clear, but it introduced some restrictions at the time, which today leads to the fact that many people find themselves without this help . ” That is why psychiatrists are looking forward to working with clinical and medical psychologists, since, as Georgy Petrovich said, turning to these specialists is not as painful as turning to a psychiatrist. At the moment, contacting a psychiatrist is a rather difficult step that requires overcoming many fears. And one way to overcome this fear is the window of psychological help.

Pavel Nikolayevich Ermakov, Dean of the Faculty of Psychology of the Southern Federal University, also spoke at the round table. « Who do we convince that qualified psychological help is really needed? Are we saying this for the average layman or are we convincing ourselves that this help is needed? ,” said Pavel Nikolayevich. If a person has mental problems in life, he, first of all, will turn to his close circle and only then go to a psychologist.

It is important to understand, said Pavel Nikolaevich, that psychological assistance is qualified, professional assistance. Therefore, such a specialist should be in the foreground. However, psychologists also have their own specialties: some work in extreme conditions, some work with children, some work with patients in a hospital. That is why qualified regulation of psychological assistance is necessary.

“ The professional community is the regulator that helps people get the right, high-quality assistance” , - added Pavel Nikolaevich. Therefore, the training of a professional psychologist is an important task for higher institutions.

Yuriy Zinchenko after Pavel Nikolayevich's speech noticed that many people go to psychology departments to improve their knowledge and apply it at the everyday level. Therefore, it is impossible to deprive them of the possibility of education, but it is necessary to clearly spell out in the law the opportunity to start a professional activity.

©Aida Asadullina / Journalist Online

The specifics of psychological education

Alla Vadimovna Shaboltas, Dean of the Faculty of Psychology of St. Petersburg State University, spoke about the pros and cons in the field of psychological education. According to her, many people get confused with the concept of vocational education. Courses on the Internet are not regulated in any way, and any private structure now has the right to issue a diploma in psychological education. There are a lot of such specialists at the moment.

However, as Anna Vadimovna noted, there is such an item in the ethical code of a doctor as professionalism. It is very important for psychologists. That is why it is very important for a specialist to stay in a professional environment for some time in order to improve his level. Since 2016, the possibility of distance learning as a psychologist has been excluded, which, according to Anna Vadimovna, has a positive effect on the situation, as it will allow future specialists to grow and develop even better.

Elvira Evaldovna Symanyuk, Head of the Department of General and Social Psychology, Department of Psychology, Ural Federal University named after the First President of Russia B. N. Yeltsin. At the moment, people who do not have a basic bachelor's degree can enter the Ural University for a master's degree in psychology. As Elvira Symanyuk said, the bill should understand that people should be able to enter a master's program without a bachelor's degree if they do it for themselves. Many try in this way to overcome their crises and overcome some problems in the psyche. However, in the working industry, a specialist must have both a bachelor's and a master's degree.

It is also very important to answer the questions of people from the regions about what psychological assistance is, because many people confuse a psychiatrist and a psychologist. This is also explained by the fact that the position of a psychologist was introduced recently - a little over 30 years ago. In addition, in the law "On Psychological Assistance" it is important to thoroughly prescribe the position of a psychologist, as such, so that the population is able to distinguish a professional from a non-professional. Elvira Evaldovna supported the idea that Russia needs a registry that would include those psychologists that people can turn to without risking their mental health.

Olga Alexandrovna Dmitrieva, director of the Shuvalov School No. 1448 in Moscow, finished the round table by talking about the specifics of the work of school psychologists. If earlier a school psychologist was mainly engaged in psychological diagnostics, now he is also engaged in psychological correction, therapy, counseling and much more. It also needs to be legally regulated. It is very important, says Olga Alexandrovna, that parents do not seek help from strange, suspicious offices that provide psychological assistance. At the moment, school psychologists can give advice not only to children, but also to teachers and parents.

Olga Alexandrovna added that it is necessary that psychologists have a sufficient number of electives, hours, psychological assistance lessons, because children often lack someone to talk to them and suggest something. “ With the adoption of the law, the level of work of school psychological services will be better than ,” Olga Alexandrovna said.

At the end of the round table, the speakers answered journalists' questions and shared their method of combating doomscrolling. Nina Petrochenko said that you should not let the news feed guide you. The best way to combat this phenomenon is to limit the time you spend on the news. It is necessary to allocate an hour during which the reader would look through the news feed, but no more. This will allow you to control the amount of incoming information. It is also very important to devote the same amount of time to other activities. For example, count the number of steps taken per day. If you walked one thousand steps more, then this is also news, but already good. In addition, we must not forget that in our life there are moments during which there is no desire to look at the news feed. These periods should also be lengthened and do as much as possible of what pleases a person, and not what brings him suffering.

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Stop Tolerating This: 7 Steps to Psychological Help

Together with the authors of the book Stop Tolerating This. How to choose a psychotherapist and learn how to work with him ”by practicing psychologists Anton Votrin and Nastasya Solomina, as well as psychotherapist Alexei Demin, we figure out which of the specialists to contact for mental disorders.

1. What is psychotherapy?

Scientifically, psychotherapy is “the treatment of mental and emotional disorders and related bodily illnesses by psychological methods.” It is used for depression, anxiety, chronic pain, eating disorders. In general, a person seeks psychological help if he wants to change something in his life, learn new things and solve a specific problem. Sometimes there is a need to work through childhood traumas, come to terms with the past, explore and understand yourself, your values, find the meaning of life.

Psychotherapy helps:

increase self-esteem,
change thoughts,
improve mood,
feel happier,
learn to manage your emotions,
reduce anxiety,
get rid of obsessive thoughts and impulses,
learn to control your behavior,
understand yourself,
learn to communicate with people,
gain independence from something or someone,
learn to enjoy life,
improve some ability (work more, remember, concentrate),
increase productivity.

2. How is a psychologist different from a psychotherapist and a psychiatrist?

For example, a psychologist, a psychotherapist and a psychiatrist work on a depressive state. Most often, a psychologist is consulted for mild depression, and for a more severe course, a psychotherapist and a psychiatrist. All specialists work with mental disorders.

Psychologist is a person whose diploma of higher education indicates the specialty "Psychologist", "Teacher of Psychology" or "Psychologist-Educator". By law, a psychologist has the right to engage only in "psychological counseling" and not "psychotherapy." Some psychologists work only with depression and OCD, some with couples, others with loss. A psychologist can either refer clients with psychiatric diagnoses to a doctor or connect the latter to work together.

Psychiatrist is a medical professional with an internship or residency in psychiatry. This is a doctor who can prescribe medical examinations and prescribe antidepressants. A psychiatrist treats, for example, bipolar disorder, psychosis, dementia, schizophrenia.

Psychotherapist - a person with a higher medical education, retrained in the specialty "Psychotherapy". If it is important for you that the psychotherapist is a doctor, it is better to clarify this with a specialist in advance. Separately, you need to find out if a psychotherapist can write prescriptions for drugs, because some doctors do not have permission to do this.

Crisis psychologist is a psychologist who works with grief, loss, acute conditions. They turn to him if someone has experienced the death or suicide of a loved one, an emergency.

Sexologist is a doctor who deals with human sexual health. They turn to him if the sexual life does not bring pleasure or is completely absent.

There are also specialists such as cognitive behavioral therapist, psychoanalyst, gestalt therapist, schema therapist - as psychologists and psychotherapists call themselves in accordance with the method in which they practice.

It is difficult to determine on your own who to go to in the first place. Therefore, the advice is to go to at least someone, and he will already determine the further route.

3. How to find a good psychologist (if you decide that you want to start the path to psychotherapy with him)?

There are several important criteria:

Education and diploma. Higher public education is a base that is approximately the same for everyone. Each specialist has his own additional education: training in psychotherapeutic areas, methods of working with a specific problem, developing skills. Professionalism is made up of building blocks, which each psychologist selects for himself, depending on his interests and needs.
Comfort. Psychotherapy should not complicate life. If live meetings are important, then look for a psychologist in your hometown. If you are ready to communicate via video link, contact a specialist online. It makes no sense to wait six months for a consultation with an eminent psychologist if the problem is urgent. Feel free to take into account the gender and age of the specialist. There are no ethical or unethical questions and criteria here. You need a person you can trust.
Cost of consultations. It should be accessible to you and not create a situation in which you have to borrow money from friends or take out a loan. The principle "the more expensive the better" does not work here. There will most likely be no difference between a consultation for ₽1,000 from a psychologist from the region and for ₽10,000 from a popular psychotherapist. The high cost is associated with the workload of a specialist or his popularity. There are also many free forms of psychological help: helplines, crisis centers, support groups for drug addicts, and so on.
Working method . If you do not know anything about the directions and your condition, look at the method in which the specialist you are interested in works. The main thing is to find out whether this method is generally recognized and evidence-based.

4. Is it possible to convince a person that he needs psychological help?

Impossible to convince! One of the main principles of psychotherapy is voluntariness. Forcibly forcing a person to go to a psychotherapist is harmful. You can help, explain, provide examples of how counseling has a positive effect on later life. Influencing the beliefs and values of another person is a rather complicated process and it is difficult to do it in one conversation. It is important to motivate a person, but he must make the decision himself.

5. Where can I find a therapist?

Professional associations are associations of psychologists based on the method in which they work. There are associations of psychoanalysts, sexologists, cognitive behavioral therapists, and they, in turn, have websites with a list of members and useful materials on psychotherapy.

social networks are a great way to find a psychologist and find out how much you like him/her. Many psychologists maintain their blogs and/or channels on Instagram, YouTube, Telegram and other social networks. Through them, you can understand whether the psychologist adheres to the principles of evidence-based therapy or likes to treat the aura with nettle decoction, as well as learn useful information about mental health.

Free psychological assistance on the basis of state organizations, such as neuropsychiatric dispensaries and social services. It is focused on those categories of people who are in a vulnerable position. The quality of services in such places is unpredictable, so this type of assistance is best sought if there are no other options.

Mobile applications or aggregators - there is a large selection of specialists. But the formalization of questionnaires, as a rule, does not imply their deep study. To learn more about a person's views and values, you still have to find and study his blog, while the names are usually hidden on the platform.

6. How long should therapy with a psychologist last?

In short, from one meeting to several years. There are specialists who adhere to the idea of short-term therapy. Someone believes that each consultation should be as effective as the last one. How much time a particular person needs to solve his problem can only be understood in the process of work. There are protocols for dealing with disorders, but they differ depending on the condition of the person who applied. Everything is very individual. Here it is important to focus not on numbers, but on the result: one meeting will be enough for someone, and ten will not be enough for some.

It is not the goal of psychotherapy to keep the client as long as possible. The principle of modern evidence-based psychotherapy is to make the client feel good in the shortest possible time.

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