Frequently Asked Questions

The Basics

What is mental illness?

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Who does mental illness affect?

Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. The National Institute of Mental Health reports that one in four adults—approximately 57.7 million Americans—experience a mental health disorder in a given year.

Are mental illnesses real?

Mental illnesses are serious medical illnesses. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.

Is treatment important?

Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives; the economic cost of untreated mental illness is more than 100 billion dollars each year in the United States.

Will I have my mental illness for the rest of my life? Is recovery possible?

The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination treatments and supports.

With appropriate, effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.

What causes mental illness?

Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of biological factors (ie, mental illness runs in the family), psychological factors (trauma, neglect, extreme stress), or environmental factors (poverty, death or divorce in the family).

When should I seek help?

Mental illness can keep you from relating to your family and friends. It can also keep you from taking care of other people in your life. It can make it hard to do your work and even put your life at risk. Know signs of trouble and ask for help.

Everyone has some of these feelings from time to time. But you should get help if they last for two weeks or more, or if they keep you from your relationships, your work or your life:

• You gain or lose a lot of weight
• You lose your appetite or eat a lot more
• You feel sad or cry a lot and it doesn't go away
• You feel guilty for no reason, like I you're no good, or you lose your confidence
• Life seems meaningless or like nothing good is going to happen again. You have a bad attitude often, or it seems like you have no feelings.
• You don't feel like doing things you used to enjoy, and you want to be left alone most of the time
• You do dangerous things for no good reason
• Your not as good at school or work as you used to be
• It's hard to make up your mind. You forget a lot of things and it's hard to pay attention
• Little things make you mad and you over-react
• You start sleeping a lot more or you have trouble falling asleep at night. Or you wake up really early most mornings and you can't get back to sleep.
• You feel restless or tired most of the time.
• You think about death or feel like I you're dying. You think about killing yourself
• You hear voices in your head

Coverage

How are mental health services covered?

The MN DHS can provide information on how services are covered if:

• You have no insurance coverage and I cannot pay for services.
• You have insurance coverage, but I don't think it would cover these services.
• You have insurance coverage.
• You will pay on my own for services.
• You are an American Indian.

I cannot afford my medication/doctor's fees. Where can I go for financial assistance?

Some pharmaceutical companies offer prescription assistance programs for low-income individuals and families. These programs typically require a doctor's consent and proof of financial status. They may also require that you have either no health insurance, or no prescription drug benefit through your health insurance. Click here to view the list of pharmaceutical companies and their contact information.

Also, you may wish to visit the Free & Low Cost Health Care Service Locator that the United States Department of Health & Human Services has available for a list of local services.

You can also connect with your local NAMI chapter for more information (www.NAMI.org).

Treatment

If I think I have a problem, what is the first step?

A first step may be to see your doctor or go to a health clinic and talk about how you are feeling. They can usually make a referral for you to get an assessment by a professional to determine if treatment is something you need.

If you want to arrange for an assessment, the process may vary, depending on the type of health insurance you have, if any. But even if you do not have insurance, you can still get an assessment.

What is the difference between mental health professionals?

There are many types of mental health professionals – psychologists, psychiatrists, social workers, counselors, just to name a few. The variety of providers and their services may be confusing. Each have various levels of education, training, and may have different areas of expertise. Finding the professional who best fits your needs may require some research.

Psychiatrist

Psychiatrists are medical doctors (M.D.) or doctors of osteopathy (O.D.) who specialize in the diagnosis, treatment, and prevention of mental illnesses. After medical school, they complete at least another four years of residency training. A psychiatrist who passes certain exams can be certified by the American Board of Psychiatry and Neurology. Some psychiatrists seek further training to specialize in certain areas, such as children and adolescent, geriatric, or addiction psychiatry.

Because they're medical doctors, psychiatrists can prescribe medications. They also offer psychotherapy. They may work with you on everyday problems like stress or more complex issues like schizophrenia. Psychiatrists work in private practice, hospitals, medical centers, schools, and other settings.

Psychologist

Psychologists are specialists in psychology, a science that deals with the mind, mental processes, and behaviors. There are many types. Those who treat mental illnesses are generally clinical or counseling psychologists. The title "psychologist" is usually used for those who have a doctoral degree (Psy.D. or Ph.D.), advanced training, and certain licensing and certification. However, it is sometimes used for someone who has only a master's degree.

Psychologists provide psychotherapy for a range of issues, from marriage problems to personality disorders. They work in private practice, hospitals, schools, community agencies, and other settings. Psychologists can't prescribe medications except in New Mexico and Louisiana, the only states with privileges for specially trained psychologists.

Psychotherapists

Psychotherapist is a general term for a mental health provider. Psychotherapists may be psychologists, social workers, psychiatric nurses, marriage and family therapists, pastoral counselors, or others who provide psychotherapy.

Be aware that some people who set up shop as therapists have no formal training and aren't subject to any state laws or regulations.

Social Workers

Social work is a broad profession. In general, social workers help people overcome social and health problems. Most have a master's degree in social work (M.S.W.), but training and education vary widely. To provide mental health services, they must have advanced training and be licensed by their states.

Licensed clinical social workers (L.C.S.W.) may provide therapy in private practice, psychiatric facilities, hospitals, and community agencies. Others may work in employee assistance programs or as case managers who coordinate psychiatric, medical, and other services. They may specialize in certain areas, such as domestic violence or chronic illness. They can't prescribe medications or order medical tests.

Psychiatric Nurses

Psychiatric nurses are licensed registered nurses (R.N.) who have extra training in mental health. They may have an associate degree or a bachelor's, master's, or doctoral degree. Their level of training and experience determine what services they can offer. Under supervision of medical doctors, they may offer mental health assessments and psychotherapy, and they may be able to help you manage your medications.

Advanced practice registered nurses (A.P.R.N.) have at least a master's degree in psychiatric-mental health nursing. In general, they can diagnose and treat mental illnesses, and in many states they're authorized to prescribe medications. They also may be qualified to practice independently, without the supervision of a doctor.

Marriage and Family Therapists

Marriage and family therapists evaluate and treat disorders within the context of the family. They typically have a master's or doctoral degree. After additional experience under supervision, they may go on to take an exam to become licensed or certified. Not all states require licensing or certification, however.

Marriage and family therapy is usually brief, averaging about 12 sessions. It focuses on specific problems and solutions. You may meet with a therapist one-on-one, with a partner or with your whole family. These therapists provide help with a range of problems, such as depression, parent-child conflicts, and eating disorders.

How do I choose a mental health professional?

SAMHSA, the Substance Abuse and Mental Health Services Administration (SAMHSA), issued the following guidelines:

1. See your primary care physician to rule out a medical cause of your problems. If your thyroid is "sluggish," for example, your symptoms (such as loss of appetite and fatigue) could be mistaken for depression.
2. After you know your problems are not caused by a medical condition, find out what the mental health coverage is under your insurance policy or through Medicaid/Medicare.
3. Get two or three referrals before making an appointment. Specify age, sex, race, or religious background if those characteristics are important to you.
4. Call to find out about appointment availability, location, and fees. Ask the receptionist:
   • Does the mental health professional offer a sliding-scale fee based on income?
   • Does he/she accept your health insurance or Medicaid/Medicare?
5. Make sure the therapist has experience helping people whose problems are similar to yours. You may want to ask the receptionist about the therapist's expertise, education, and number of years in practice.
6. If you are satisfied with the answers, make an appointment.
7. During your first visit, describe those feelings and problems that led you to seek help. Find out:
   • What kind of therapy/treatment program he or she recommends;
   • Whether it has proven effective for dealing with problems such as yours;
   • What the benefits and side effects are;
   • How much therapy the mental health professional recommends; and
   • Whether he or she is willing to coordinate your care with another practitioner if you are personally interested in exploring credible alternative therapies, such as acupuncture.
8. Be sure the psychotherapist does not take a "cookie cutter" approach to your treatment. What works for one person does not necessarily work for another. Different psychotherapies and medications are tailored to meet specific needs.
9. Although the role of a therapist is not to be a friend, rapport is a critical element of successful therapy. After your initial visit, take some time to explore how you felt about the therapist.
10. If the answers to these questions and others you come up with are "yes," schedule another appointment to begin the process of working together to understand and overcome your problems. If the answers to most of these questions are "no," call another mental health professional from your referral list and schedule another appointment.

Where do I find a provider/Where do I go for help?

Where you go for help will depend on the nature of the problem and/or symptoms and what best fits you. Often, the best place to start is by talking with someone you trust about your concerns. Ask for referrals and recommendations. These may come through friends, family, clergy, health care providers, or other professionals whom you know and trust.

For additional information and resources please visit our I Need Help or Resource/Provider Search section of the website.

How do I find a local support group?

Many people find peer support a helpful tool that can aid in their recovery. There are a variety of organizations that offer support groups for consumers, their family members, and friends. Some support groups are peer led while others may be led by a mental health professional. Many support groups are listed on our calendar. You can also look for support groups on our Resource/Provider Search.

My friend/family member won't follow recommended treatment. What can I do to make him follow through?

In the United States, noncompliance is not a crime and therefore medication or therapy is not enforceable except in the case of minors, and those who are a danger to themselves or others.

In extreme cases where a consumer may be a danger to themselves or others, a friend or family member can petition the courts to have the person committed to assisted treatment. You may contact the Treatment Advocacy Center for information and guidance through the process.

My loved one is not him/herself, I think they need some help but they refused to talk about it or see someone. How can I persuade them to get help?

It may be a good idea to make a list of reasons why you think your loved needs help. A good first step may be to make an appointment with your family doctor and go with to the appointment to help describe the problems. A book that many family members and friends have found helpful is "I Am Not Sick, I Don't Need Help" by Xavier Amador, Ph.D.

What should I do if I know someone who appears to have all of the symptoms of a serious mental disorder?

If you know someone who is having problems, don't just think that they will snap out of it. Let them know that you care about them, and there are ways this can be treated. Notify a family member, a mental health professional, a counselor or someone if you think you have symptoms or if a friend has symptoms. The more you or your friends realize how many people care about them, the more likely it will be that treatment will be sought.

If I become involved in treatment what do I need to know?

Beginning treatment is a big step for individuals and families and can be very overwhelming. It is important to continue involvement in the treatment process as much as possible. Some questions you will need to have answered include:

• What is known about the cause of this particular illness?
• Are there other diagnoses where these symptoms are common?
• Do you normally include a physical or neurological examination?
• Are there any additional tests or exams that you would recommend at this point?
• Would you advise an independent opinion from another psychiatrist at this point?
• What program of treatment is the most helpful with this diagnosis?
• Will this program involve services by other specialists? If so, who will be responsible for coordinating these services?
• What do you see as the family's role in this program of treatment?
• How much access will the family have to the individuals who are providing the treatment?
• What medications are generally used with this diagnosis? What is the biological effect of this medication, and what do you expect it to accomplish? What are the risks
• associated with the medication? How soon will we be able to tell if the medication is effective, and how will we know?
• How much experience do you have in treating individuals with this illness?
• What can I do to help you in the treatment?

Medication

What do I need to know about medications?

The best source of information regarding medications is the physician prescribing them. He or she should be able to answer questions such as:

• What is the medication supposed to do and when should it begin to take effect?
• How is the medication taken and for how long?
• What food, drinks, other medicines, and activities should be avoided while taking this medication?
• What are the side effects and what should be done if they occur?
• What do I do if a dose is missed?
• Is there any written information available about this medication?
• Are there other medications that might be appropriate? If so, why do you prefer the one you have chosen?
• How do you monitor medications and what symptoms indicate that they should be raised, lowered, or changed?
• Why do I need Laboratory tests?

All medications should be taken as directed. Most medications for mental illnesses do not work when taken irregularly, and extra doses can cause severe, sometimes dangerous side effects. Many psychiatric medications begin to have a beneficial effect only after they have been taken for several weeks.

If a medication is prescribed to me and I begin to feel better after taking it is it okay to stop taking it?

It is not uncommon for people to stop taking their medication when they feel their symptoms have become controlled. Others may choose to stop their medication because of side effects. A person may not realize that most side effects can be effectively managed. While it may seem reasonable to stop taking the medication, the problem is that at least 50% of the time the symptoms come back. If you or your child are taking medication, it is very important that you work together with your doctor before making decisions about any changes in your treatment.

Another problem with stopping medication, especially if you stop it abruptly, is that you may develop withdrawal symptoms that can be very unpleasant. If you and your doctor feel a trial off your medicine is a good idea, it is necessary to slowly decrease the dosage of medications so that these symptoms don't occur.

It is important that your doctor and pharmacist work together to make sure your medications are working safely and effectively. You should talk with them about how you are doing and whenever there are side effects that might make you want to stop your treatment.

How can I get help paying for my prescriptions?

Some pharmaceutical companies offer prescription assistance programs to individuals and families with financial needs. These programs typically require a doctor's consent and proof of your financial status. They may also require that you have either no health insurance or no prescription drug benefit through your health insurance. In addition, there are county, state, and national prescription programs for which you may qualify and special drug discount cards offered by some pharmaceutical companies.

Partnership for Prescription Assistance is an interactive site designed to help you find patient prescription drug assistance programs for which you may qualify.

Information on this page was taken from the SAMHSA.gov, womenshealth.gov and NAMI.org websites.