Mental Health & Substance Abuse
In addition to taking your medication as directed, other steps you can follow to manage your health and decrease symptoms include:
- Talk therapy
- Good nutrition
If you find it difficult to take your medication, have any questions, or experience any side effects, please contact the doctor who prescribed the medication. Don't stop taking your medication. Some medications may have adverse effects if stopped without a doctor's guidance.
Sometimes, cost or transportation to the pharmacy can stand in the way of taking your medication.
If you have any financial concerns related to taking your medication, our Care Management Service may be able to help. There is no fee to talk to our Care Management team. We can share with you resources to help with the cost of medications and transportation to the pharmacy, and medical and therapy appointments.
- Depression Checklist
- How do I get help for depression?
- How do I help myself feel better?
- Depression Medicines
- My Depression Goals - What are they?
The Healthwise® Knowledgebase - provides information on a variety of mental health and substance use disorders, medications, and treatment options.
The American Psychiatric Association - offers information about mental illness and treatment.
Health Risk Assessments offer an opportunity for individuals to identify a variety of health concerns including depression and alcohol abuse. This tool is not designed to diagnose any illness. If you are concerned about any mental health symptoms that you or a loved one is experiencing, please see your primary care physician or a mental health professional.
Types of Behavioral Health Providers
Mental Health Providers - Private Practitioners
Psychiatrists (M.D., D.O.) are medical doctors who have specialized in psychiatry. Psychiatrists can prescribe medication and may also practice psycotherapy. Psychiatrists are licensed by the New York State Education Department and may be Board Certified in psychiatry and or child psychiatry. Some psychiatrists have extra training and certification in areas such as geriatrics, addiction medication, or forensic psychiatry.
Licensed Clinical Social Workers (LCSWR) have a master's degree in Social Work (MSW) and a minimum of six years of supervised clinical experience. Social Workers receive training in individual, family, and group therapy and are licensed by the New York State Education Department. Social Workers may have experience in treating adults and/or children/adolescents.
Psychologists (Ph.D., Psy.D.) are doctoral level practitioners trained in clinical psychology and licensed by the New York State Education Department (they are not medical doctors and do not prescribe medication). Psychologists receive training in individual, family, and/or group therapy and also in psychological research and have at least two years of clinical experience in a supervised setting. In addition to providing psychotherapy, some psychologists may also practice psychological or neuropsychological testing. Like psychiatrists and social workers, psychologists may specialize in treating adults or children/adolescents and may have received additional training in treating specific mental health conditions.
Licensed Mental Health Counselor (LMHC) have a master's degree and are required by the Health Plan to qualify six years of supervised clinical experience. Mental Health Counselors receive training to provide individual, family and group psychotherapy. LMHC's are licensed by the New York State Education Department and treat adults, children and/or adolescents.
Licensed Marriage & Family Therapist (LMFT) have a master's degree or higher and are required by the Health Plan to qualify six years of supervised clinical experience. Marriage and family therapists receive training to provide individual, family and group psychotherapy. LMFT's are licensed by the New York State Education Department and treat adults, children and/or adolescents.
Mental Health Providers - Facilities
Outpatient Mental Health facilities offer comprehensive outpatient treatment, including services provided by psychiatrists, social workers, and clinical psychologists. Outpatient facilities offer individual, family, and group treatment, as well as medication and psychological testing.
Inpatient Hospitalization (24-Hour inpatient treatment) is offered at many general hospitals and at private psychiatric hospitals for the diagnosis and treatment of patients with severe mental health symptoms. Patients admitted for inpatient hospitalization cannot be treated safely at a less restrictive level of care. Patients follow a treatment plan developed by a psychiatrist. The plan may involve the use of medication and treatment provided by nurses, social workers, clinical psychologists, and other medical and counseling staff. Most member contracts require the hospital to pre-authorize inpatient admissions.
Partial Hospitalization (also known as Day-Night Care in some member contracts) is offered in some Health Plan regions. These programs are designed for the diagnosis and treatment of serious mental disorders, and patients usually attend five to six days per week for several hours a day. Partial Hospitalization is used when it is necessary to maintain a patient's functional level and prevent relapse or inpatient hospitalization.
Substance Abuse Providers
Outpatient Treatment services provide assessment for and treatment to individuals with substance abuse or dependence or to significant others of a person who has a substance dependence or abuse condition. Outpatient treatment is designed for individuals who are able to participate and comply with treatment outside a more intensive treatment setting.
- Intensive Outpatient Treatment is available at some licensed treatment facilities and is designed to treat patients with a higher risk for relapse and to help the patient avoid a more restrictive inpatient admission.
Inpatient Detoxification services are designed to treat patients with moderate to severe substance withdrawal symptoms that pose an immediate health risk or interfre with the individual's ability to engage in outpatient treatment. Inpatient detoxification is available at general hospitals and at some private substance abuse treatment facilities.
Find a Behavioral Health or Substance Abuse Treatment Provider
Follow this link to Search our Online Provider Directories to find a participating health provider:
- Use "Find a Doctor" to search for a participating psychiatrist, psychologist or licensed clinical social worker.
- Use "Find Other Providers" to search for a participating outpatient or inpatient mental health facility or a substance abuse treatment provider.
Tips for Choosing an Outpatient Behavioral Health Provider
Mental Health professionals can be highly specialized. Some have general practices while others concentrate on a specific area of mental health, such as addiction or geriatrics. They may provide individual, group or couple/family therapy. Not all outpatient practitioners specialize in treating certain conditions or age groups, such as children or adolescents. Once you have some names of participating private practitioners or facilities, contact the providers to obtain more information about the services they provide.
You should consider the following before scheduling an appointment with the provider:
- Does the provider participate with my health insurance?
- Is the service a covered benefit?
- Does the provider have experience treating my mental health condition?
- Does the provider specialize in treating certain age groups, such as children, adolescents, or seniors?
- Is the provider accepting new patients?
- What hours is the provider available for appointments?
- What types of therapy does the provider offer?
After meeting with the provider, it's ok if you feel a little uncomfortable during the first few sessions. Sharing personal information can be difficult and it may take some time to build trust. However it's important to eventually feel comfortable with your provider. If you are still uncomfortable after several sessions, don't hesitate to try a different provider.
As a patient, you should expect:
- Sensitivity to issues such as race, culture, gender, and sexual orientation
- Involvement in your treatment plan
Follow this link for additional information on choosing a psychiatrist.
Court Ordered Treatment for Mental Health and Substance Use Disorder
When there is a court order for treatment; a preauthorization request must be submitted by the provider or facility if a preauthorization is required for the service being requested. The Court Ordered Certification Form must also be submitted with the preauthorization request for a medical necessity determination.Court Ordered Treatment: Certification Form for Mental Health and Substance Use Disorders
Behavioral Health Care Managers
Behavior health care managers are available to talk Monday through Friday, 8 a.m. to 5 p.m., at 1-800-277-2198 (TDD/TTY 1-800-421-1220). They can help you understand the signs and symptoms of depression, discuss treatment options, and help you navigate through your Medicare coverage.
Behavioral Health Specialty Programs
After Hospitalization Follow-up - Continuing in outpatient care after discharge from an inpatient admission can greatly help patients avoid a relapse of their mental health symptoms. While treated in an inpatient setting, patients work closely with hospital staff to prepare for their aftercare treatment and should have an aftercare appointment scheduled within 7 days following discharge. The Behavioral Health Department assists members in following their aftercare plan by contacting members by telephone to remind them of their first aftercare appointment. If members are unable to keep their outpatient appointment, Behavioral Health staff will assist members in scheduling another appointment and will work with members to eliminate barriers to adhering to their discharge plan.
Child and Adolescent Psychiatry Phone Consultation Service - It is estimated that more than 10% of children and adolescents have a psychiatric illness and that only a small portion of these children receive psychiatric services. This is partly due to a shortage of Child and Adolescent Psychiatrists both nationally and in ther Upstate New York region. These factors result in the demand for pediatricians and family practitioners to treat psychiatric illnesses in their offices often without adequate training or support.
In an effort to offer support to pediatricians and family practitioners, the Health Plan has implemented an initiative to offer two hours a week of phone consultation with a Board Certified Child and Adolescent Psychiatrist. The goal of the program is to increase the skill and knowledge of pediatricians and family practitioners in managing psychiatric illness for their patients.
Demand Treatment - With funding from the Robert Woods Johnson Foundation, the Health Plan has partnered with several community organizations in the Rochester area to train health care providers in the prevention of alcohol abuse, recognition of early signs of abuse, and screening for alcohol dependency.
First Episode Augmented Treatment (FEAT) - FEAT is a program targeting 18-25 year old patients who have recently been diagnosed with Schizophrenia (or Schizophreniform Disorders), or who are experiencing psychotic symptoms but have yet to be diagnosed. The program offers members and families who meet criteria access to Multi-Family Group Treatment at designated mental health facilities in their area. The group provides education on the disease, symptoms, family relationships, interpersonal and social issues, mood disorders, noncompliance issues, and problematic behaviors of the patient. Groups meet once a month. Coverage is for 18 months, subject to contractual benefits and necessary approvals. The program also eliminates the member's pharmacy co-payments on all/any of their anti-psychotic medications for the time they are in the program.