Free/Cheap psychiatric care in the Boston area?
January 27, 2011 7:38 AM   Subscribe

TL;DR My boyfriend has asked for psychiatric help, but he is unemployed and uninsured. I don't know where to look or where to start.

Allow me to introduce myself: I am the girlfriend of a wonderful, caring, funny, genuine, incredible human being. He also suffers from crippling depression and anxiety.

Some background: He was physically and verbally abused as a child. He has gone to (psychologists/psychiatrists) before, but I'm not sure for how long and how many separate occassions. (I'm also not sure which he's gone to.) He's tried medication several times, but to no avail. I'm not sure how frequently it happens (I just learned about it tonight), but he has also been hearing voices for a few years, too. He has attempted or seriously considered suicide in the past (years before I met him), and has also physically harmed himself. I think he still considers it on a regular basis. He is convinced that everyone (his friends, family, my roommates) hates him.

The problem: After a long, difficult night and morning, he told me tonight that he wants to try again. His exact words were that he wants to go to a hospital. I'm not sure exactly what he's looking for, but I think it's a bit more intense than going to therapy for an hour once a week. All of this is fine and great, except he is unemployed and has no insurance.

Which brings me to...

The question: How can I find help for him? What resources are available? What are the first/next steps? I've been googling all morning and I can't seem to figure out what to do. Everything seems to lead to a hotline, but I'm not sure that's the best way to start. Also, we are in Massachusetts, about 35 minutes from Boston.

I know I could probably figure this out on my own, but I'm beginning to feel overwhelmed. I don't know what his options are. Thank you in advance for any support, advice or information you can offer.
posted by lisawin to Health & Fitness (17 answers total)
If you're 35 minutes from Boston, call up some of the various medical school and ask them what resources they have.

Many teaching hospitals have psychiatrists on staff who work on a sliding scale.
posted by dfriedman at 7:53 AM on January 27, 2011

The very unfortunate fact is that low-cost help does exist, but it is very hard to find and requires jumping through hoops. It would be a great help if you could call around and then assist him with those hoops. Call crisis clinics first. A hotline will at least help you find some of these. Ask how much they cost.

Sometimes for depressed people this whole thing seems insurmountable, but lemme tell you the hotline thing is going to be a lot better in the long run. How much more depressed would he feel if he goes to a hospital and ends up with $8000 in debt? It's possible the hotline will direct you to a hospital depending on the situation, but at least you can ask them if there is one that is cheaper. If he ends up in the hospital he will probably need your help filling out the numerous financial add forms. I got a family member's bill written off that way, but he would never have been able to do it without my help.
posted by melissam at 7:53 AM on January 27, 2011

You might find the collection of mental health resources on the MetaFilter Wiki helpful.
posted by hapax_legomenon at 8:21 AM on January 27, 2011 [1 favorite]

If you decide to go the hospital route, the folks at the psych ER at Cambridge Hospital are really nice. I helped someone avail themselves of their services.

You might even try going down and talking to them (with or without your bf) - explain the insurance situation straight out and ask what they could recommend.

Good luck. I hope you can help him get the help he needs.
posted by rmd1023 at 8:28 AM on January 27, 2011

Tufts appears to have a psych clinic which could also be a good place to check, too.
posted by gracedissolved at 8:33 AM on January 27, 2011

Check and see if he's eligible for Commonwealth Care or MassHealth.
posted by Civil_Disobedient at 8:42 AM on January 27, 2011

Call McLean. RIGHT NOW.

If your boyfriend gets any worse --- if he starts talking of hurting himself or you, if he says he's hearing voices any more frequently or the voices are telling him to do or believe things, get him to an ER. Call an ambulance if you think you have to. But don't mess around with that.
posted by zizzle at 8:43 AM on January 27, 2011 [5 favorites]

Sometimes, going to the ER is a relief.

Sometimes, when a person is overwhelmed with life, feels like he's out of control and can't seem to find relief, having someone else take control is suddenly very comforting.

It is not a punishment. It is not because he's been bad. It is because he needs some help right now and this is the best way to help him.

I hope this helps. Thanks for being a good partner.
posted by Sophie1 at 8:45 AM on January 27, 2011 [2 favorites]

Assuming that you haven't done this, the first step should be contacting the Massachusetts Department of Health and Human Services. He may qualify for free/subsidized insurance and/or mental health programs. It sounds like a horrible situation, but you live in one of the better states to be faced with such a problem-- take advantage of it.
posted by Mayor Peace Love and Unity at 8:47 AM on January 27, 2011

You know, it might not be the time to try and wade through public mental health service bureaucracy. Call McLean right now. Explain the situation and see if they can help with the immediate issue and you can work on the rest later.
posted by elsietheeel at 8:51 AM on January 27, 2011 [1 favorite]

All of this is fine and great, except he is unemployed and has no insurance... Also, we are in Massachusetts, about 35 minutes from Boston.

Why doesn't he have insurance? Massachusetts is the one state in the country right now that provides subsidies for health insurance (all the way up to 100% of the cost of insurance for the very-low-income) and requires every insurance company to sell a policy to anyone who applies, regardless of health status. This sounds like a hard situation but the insurance part, at least, should be easier to straighten out and get help with than anywhere else in the country right now.

Your very first step is to visit this site: MA Health Connector

I'm betting that if he's unemployed his income is probably low enough (is it less than ~$1,350 per month?) to qualify for either MassHealth or for fully-subsidized private insurance through Commonwealth Care.

Good luck. If you feel he's in crisis or going to hurt himself and needs immediate help, go straight to a hospital; they should be able (and I would think willing) to help straighten out the insurance stuff and get him onto either MassHealth or CommCare while he's receiving help.
posted by iminurmefi at 9:26 AM on January 27, 2011 [1 favorite]

You and he both can try DBSA Boston - Depression Bipolar Support Alliance of Boston. If Boston is too far, Google "DBSA" and your or nearby towns. Groups are all over. The meeting attendees and facilitators, many in your same position, are a wealth of information. At least I've found that to be the case in my area. Good luck, and he's fortunate to have your help.
posted by dmvs at 9:34 AM on January 27, 2011

Call any psychiatrist's office or hospital, explain what's up, and ask them what his options are. They have no doubt encountered similar situations before, and will know where to direct you.

Nthing "go to the emergency room" if he is a danger to himself. Honestly, if there's any way he could swing the cost, even by paying $20/month, go to the emergency room with him now. If he says he's suicidal and hearing voices, *they* will find a place for him (probably short-term inpatient psych treatment followed by outpatient care) that takes low- or no-income patients.

I will keep you both in my prayers. Feel free to MeMail me if I can be of any more help.
posted by epj at 2:09 PM on January 27, 2011

I hope that you have already gotten him help by now but if you're still hesitating because of the potential cost then I'd like to point out that it's better to be alive with medical debt than dead with a spotless credit report!

If he is feeling suicidal then this is a life-or-death situation. You wouldn't hesitate to take him to the emergency room regardless of cost if he suffered a life-threatening physical injury, right? Please treat his suicidal ideation as seriously as you would any other life-threatening emergency because it is just as serious even if it isn't as physically obvious.

Be sure to take care of yourself, too. That is another good reason to get him into professional care ASAP -- you should not be under the stress of feeling like you have to watch over him 24/7 lest he kill himself. You will make yourself sick doing that and you won't be able to help him at all if you completely deplete your own mental and physical energy.

I really hope that everything works out for both of you.
posted by Jacqueline at 12:57 AM on January 28, 2011

Response by poster: I doubt anyone will read this and its much much later, but I just wanted to thank everyone for their advice. He ended up making an appointment with his previous psych, who prescribed him prozac and it's been extremely helpful (everything else he'd tried never worked, go figure the most cliche solution would be the best). After adjusting the dosage a bit, he feels like a new man. So, thank you again for all your support in a very emotionally trying time.
posted by lisawin at 10:14 PM on April 4, 2011

Glad to hear it.
posted by rmd1023 at 4:41 AM on April 5, 2011

Hooray! So glad to hear that things worked out.
posted by epj at 11:23 AM on April 6, 2011

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