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Q: Mental health care for the uninsured ( Answered,   1 Comment )
Question  
Subject: Mental health care for the uninsured
Category: Health
Asked by: jahv22-ga
List Price: $35.00
Posted: 28 Jul 2006 14:05 PDT
Expires: 27 Aug 2006 14:05 PDT
Question ID: 750493
I have a friend who I believe is suffering from long-term depression. 
I believe he either needs to see a therapist or go on medication or
both. I have offered to pay for this because he does not have health
insurance and is barely scraping by. I am by no means wealthy,
however, so I need to save wherever I can. Ideally I could pay for
just some of it and he could cover the rest on his own. My specific
questions are:

1. What resources are available for obtaining mental health care for
people without health insurance? (I?d like to see things like
payment-assistance options or reduced-cost counseling.)

2. Going the medication route, what anti-depressants are least
expensive if you need to pay cash? (I am guessing something either
available as a generic or maybe one that has been around for a while,
where the manufacture has offered subsequent extended-release
variations.)

I will tip for especially thorough answers, thank you.
Answer  
Subject: Re: Mental health care for the uninsured
Answered By: boquinha-ga on 28 Jul 2006 20:13 PDT
 
Hello jahv22-ga!

It seems that there are a lot of people in your friend?s situation,
and it is sobering to realize how difficult it can be to find services
for people suffering from depression. Your friend is blessed to have
someone like you who is willing to help him get the services that he
needs. I?ve been able to find some resources and organizations that
should be able to help. This answer is not intended to substitute for
the opinion of a qualified health professional that you trust. If you
have any specific concerns or questions you should discuss them with
him or her. Here is the information that I?ve compiled.

- - - - - - - - - - - - - - - - - - - -

RESOURCES FOR THE UNINSURED

Something that is easy and accessible from his home is the counseling
services readily available on Kasamba.com. It is a service where
people can post questions to experts in a variety of areas, including
mental health counseling. There is also an option to talk to a
therapist online through a live chat feature. Clients pay by the
minute/hour for live chat and negotiate a fee for other services (such
as email therapy). You can rank therapists by many criteria, including
price. Here is a link to the Professional Counseling section.
http://www.kasamba.com/experts/professional-counseling

= = = = = = = = = = =

The U.S. Department of Health and Human Services has a page describing
various types of assistance available for those needing mental health
care.

* Community-based resources?may require patients to be on public assistance
* Pastoral counseling?many church-based services include counselors
with professional counseling experience
* Self-help/Support groups?many people find these groups to be quite
helpful, and most communities have these support groups
* Public assistance?depending upon the extent of the mental illness,
patients may be eligible for one of several forms of assistance
http://www.mentalhealth.samhsa.gov/publications/allpubs/ken98-0050/default.asp

= = = = = = = = = = =

The American Association of Pastoral Counselors has a service for
people looking for qualified pastoral counselors in their areas.
http://www.aapc.org

Here is a link to their directory of providers.
http://www.aapc.org/directory.cfm

= = = = = = = = = = =

The American Self-Help Clearinghouse is an organization dedicated to
helping people find strength in numbers. They have local
clearinghouses that help connect people with support groups and other
resources in their communities.
http://www.mentalhelp.net/selfhelp/

This is their directory of local clearinghouses.
http://www.mentalhelp.net/selfhelp/selfhelp.php?id=859

= = = = = = = = = = =

Another organization that can help people find mental health resources
is the National Alliance for the Mentally Ill. There are many local
chapters that can help people with specific needs.
http://www.nami.org

You can use this interactive map to find local NAMI chapters to assist you.
http://www.nami.org/Template.cfm?section=your_local_NAMI

= = = = = = = = = = =

The National Empowerment Center is dedicated to putting information
about mental health into the hands of those who need it. Local
organizations can help with specific community needs.
http://www.power2u.org

There are a number of ?consumer-run? organizations that can help
people with needs find resources in their communities. Here is a list
of state organizations.
http://www.power2u.org/consumerrun-statewide.html

- - - - - - - - - - - - - - - - - - - - 

COST OF ANTIDEPRESSANTS

Consumer Reports has a detailed document about anti-depressant
medications, including costs. Most of the drugs highlighted are the
commonly used selective serotonin reuptake inhibitors (SSRIs) and
similar, newer medications. They also list what they believe to be the
?best buy.? Here is a list of common anti-depressants with their
average monthly costs. Higher doses of the same medication will, of
course, cost a bit more. Generic names are given first, with brand
names in parentheses. This information is accurate as of February
2005.

$32 Fluoxetine 20mg capsule (Generic)   
$35 Fluoxetine 10mg capsule (Generic) 
$35 Fluoxetine 10mg tablet (Generic) 
$37 Fluoxetine 20mg tablet (Generic)   
$50 Citalopram 20mg tablet (Generic)  
$52 Citalopram 40mg tablet (Generic)  
$56 Mirtazapine 15mg tablet (Generic)   
$57 Mirtazapine 30mg tablet (Generic)   
$60 Bupropion 75mg tablet (Generic)   
$61 Mirtazapine 45mg tablet (Generic)   
$66 Paroxetine 10mg tablet (Generic)   
$67 Fluvoxamine 50mg tablet (Generic)   
$67 Paroxetine 20mg tablet (Generic)   
$71 Bupropion 100mg tablet (Generic)   
$72 Paroxetine 30mg tablet (Generic)   
$74 Paroxetine 40mg tablet (Generic)   
$77 Paroxetine 10mg tablet (Pexeva)   
$80 Paroxetine 20mg tablet (Pexeva)   
$81 Mirtazapine 15mg sublingual tablet (Generic)   
$82 Mirtazapine 30mg sublingual tablet (Generic)   
$83 Paroxetine 30mg tablet (Pexeva)   
$86 Bupropion 100mg sustained release tablet (Generic)   
$86 Escitalopram 10mg tablet (Lexapro)   
$86 Fluoxetine 40mg capsule (Generic)   
$86 Paroxetine 40mg tablet (Pexeva)   
$87 Escitalopram 5mg tablet (Lexapro)   
$91 Escitalopram 20mg tablet (Lexapro)   
$94 Citalopram 20mg tablet (Celexa)   
$96 Bupropion 150mg sustained release tablet (Generic)   
$96 Mirtazapine 45mg sublingual tablet (Generic)   
$98 Citalopram 40mg tablet (Celexa) 
$98 Sertraline 100mg tablet (Zoloft)   
$98 Sertraline 50mg tablet (Zoloft)   
$99 Mirtazapine 15mg sublingual tablet (Remeron)   
$99 Mirtazapine 30mg sublingual tablet (Remeron)   
$100 Sertraline 25mg tablet (Zoloft)   
$102 Paroxetine 10mg tablet (Paxil)   
$103 Paroxetine 12.5mg sustained release tablet (Paxil CR)   
$105 Bupropion 100mg sustained release tablet (Budeprion SR)   
$105 Paroxetine 20mg tablet (Paxil)   
$106 Mirtazapine 45mg sublingual tablet (Remeron)   
$106 Paroxetine 25mg sustained release tablet (Paxil CR)   
$108 Paroxetine 30mg tablet (Paxil)   
$109 Mirtazapine 15mg tablet (Remeron)   
$111 Paroxetine 37.5mg sustained release tablet (Paxil CR)   
$111 Venlafaxine 37.5mg sustained release capsule (Effexor XR)   
$113 Mirtazapine 30mg tablet (Remeron)   
$114 Bupropion 150mg sustained release tablet (Budeprion SR)   
$114 Fluvoxamine 100mg tablet (Generic)   
$116 Paroxetine 40mg tablet (Paxil)   
$118 Mirtazapine 45mg tablet (Remeron)   
$121 Venlafaxine 75mg sustained release capsule (Effexor XR)   
$126 Fluoxetine 90mg enteric coated capsule (Prozac Weekly) 
$129 Duloxetine 60mg enteric coated capsule (Cymbalta)   
$131 Venlafaxine 150mg sustained release capsule (Effexor XR)   
$136 Venlafaxine 25mg tablet (Effexor)   
$138 Fluoxetine 20mg capsule (Prozac)   
$138 Venlafaxine 37.5mg tablet (Effexor)   
$140 Fluoxetine 10mg capsule (Prozac) 
$143 Fluoxetine 10mg tablet (Prozac) 
$143 Venlafaxine 50mg tablet (Effexor)   
$144 Bupropion 300mg sustained release tablet (Wellbutrin XL)   
$146 Venlafaxine 75mg tablet (Effexor)   
$147 Fluoxetine 10mg capsule (Sarafem) 
$148 Bupropion 75mg tablet (Wellbutrin)   
$150 Fluoxetine 20mg capsule (Sarafem) 
$154 Bupropion 100mg sustained release tablet (Wellbutrin SR)   
$155 Venlafaxine 100mg tablet (Effexor)  
$157 Bupropion 150mg sustained release tablet (Wellbutrin SR)   
$194 Bupropion 100mg tablet (Wellbutrin)   
$223 Bupropion 150mg sustained release tablet (Wellbutrin XL)   
$237 Duloxetine 20mg enteric coated capsule (Cymbalta)   
$269 Duloxetine 30mg enteric coated capsule (Cymbalta)   
$293 Fluoxetine 40mg capsule (Prozac)   
http://www.crbestbuydrugs.org/PDFs/Antidepressants_update.pdf


Tricyclic antidepressants (TCAs) are older antidepressant medications
that have fallen out of favor in recent years. They are still used,
but usually as a second- or third-line drug in patients where SSRIs
have failed. Here is a list of some TCAs with approximate monthly
costs. All names are the generic names of the medication. This article
is from 2004.

$8 Amitriptyline
$10 Doxepine 
$22 Desipramine 
$22 Nortriptyline
$30 Imipramine 
$39 Clomipramine 
$62 Maprotiline 
$72 Amoxapine 
$84 Trimipramine 
$99 Protriptyline 
http://acpmedicine.com/dxrx/dxrx1302.htm

- - - - - - - - - - - - - - - - - - - -

As one who has dealt with debilitating depression, I sincerely wish
you and your friend well. I really do. Depression is a monster. I
think it?s great that your friend has you?a good support system is so
important in overcoming that monster. I really do wish you and your
friend well.

I hope that you find this information useful! Again, if you have
specific concerns or questions, be sure to discuss them with a
qualified health practitioner that you trust. I wish you and your
friend good luck and hope that you are able to find the help that he
needs. If you have any need of further clarification, please let me
know how I can help.

Sincerely,
Boquinha-ga


Search terms:

Uninsured mental health
cost antidepressant
cost tricyclic
Comments  
Subject: Re: Mental health care for the uninsured
From: voila-ga on 29 Jul 2006 09:21 PDT
 
Most cities with a sizeable population have community mental health
centers.  Clinicians see patients there on a sliding fee scale
according to income and family size.

CMHC Locater
http://www.mentalhealth.samhsa.gov/databases
http://healthlibrary.epnet.com/getcontent.aspx?token=d291a9f5-2226-447d-88bf-2cb7e6905ec3&docid=/healthy/mind/2003/mentalhealth_services

Another option would be to call your local United Way organization
since they would have knowledge of resources available within your
community.
http://national.unitedway.org/myuw

If your friend decides to forgo the talk therapy route and just opts
for medication intervention, antidepressants can be prescribed by any
primary care physician who should also be familiar with any free or
discount prescription assistance programs.  Here are a few you can
review as well:
http://www.ncsl.org/programs/health/pharmlinks.htm#free
https://www.indicare.com/defaultsecure.aspx

Best of luck to both of you,
V

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