What teen mental health care costs in Dallas, and the help that costs nothing

The short answer on cost

There is no single price for a teenager's mental health care, because the cost depends on who provides it, whether they take your insurance, how often your teen is seen and what level of care is needed. Weekly outpatient therapy with an in-network counselor costs a family very differently than an intensive program or a hospital stay. Several important pieces cost nothing: the Here For Texas Mental Health Navigation Line at 972-525-8181, the HereForTexas.com provider search, our Coffee Days support groups for moms and female caregivers, and the 988 Suicide and Crisis Lifeline.

At Grant Halliburton Foundation we do not quote treatment prices, because we are not a treatment provider and fees vary from one practice to the next. What we can do is explain what moves the number, show you how to find options that fit your coverage, and point you to the help that is free. Families across Dallas tell us that the money question is often what keeps them from making the first call. It should not be.

Six things that move the price of care

When parents compare what different families paid, the numbers rarely match, and that is because the situations rarely match. These are the factors that make the biggest difference to what a family actually spends.

Keep in mind that the cheapest option is not always the least expensive one over time. A provider who is a good fit for a teenager, and whom your teen will actually keep seeing, usually costs less in the long run than a series of first appointments with people who are not. When you compare options, compare fit and availability alongside the fee.

• Type of professional. A licensed counselor, social worker or marriage and family therapist, a psychologist and a psychiatrist each train differently and usually bill differently. Psychiatrists can prescribe medication; most therapists cannot.
• Insurance network. An in-network provider bills your plan at a negotiated rate. An out-of-network provider may leave you paying the full fee and filing for partial reimbursement yourself.
• Level of care. Weekly outpatient sessions sit at one end. Intensive outpatient programs, partial hospitalization and inpatient care involve many more hours each week and cost more.
• Frequency and length. A teen seen weekly for three months costs less than one seen twice a week for a year. Ask the provider what they expect, and revisit it as things improve.
• Evaluation and testing. A full psychological evaluation is often billed separately from therapy and can be one of the larger single costs.
• Sliding scale and format. Some practices lower fees based on income, and telehealth can widen your choice of providers without adding travel time.

Reading your insurance before the first appointment

Most families learn the details of their mental health coverage only after a bill arrives. A short call to the member services number on your card, before the first appointment, avoids that. Ask whether outpatient mental health visits are covered, what your copay or coinsurance is, how much of your deductible remains this year, whether you need a referral or prior authorization, and whether the specific provider you are considering is in network for your exact plan, not just for the insurance company.

Write down the date, the name of the person you spoke with and what they told you. If a claim is denied later, those notes matter. If your coverage comes through a small employer and you are trying to understand what the plan does and does not include for behavioral health, a licensed health insurance agent such as Rex Slover can walk you through it. We can help you find providers; we cannot interpret your policy.

If you do not have insurance, or your plan has a high deductible, say so up front when you contact a provider. Many will tell you plainly whether they offer reduced fees or know a colleague who does.

Help in North Texas that is free to use

Some of the most useful support a family can get does not require a copay. These are the free resources we run or point families to every day, along with what each one is for.

• The Here For Texas Mental Health Navigation Line, 972-525-8181, Monday through Friday from 10 a.m. to 6 p.m. A trained volunteer navigator gathers what you need and an experienced mental health professional helps identify resources. The call is free and Spanish is spoken.
• HereForTexas.com, a free searchable database of Texas mental health providers and resources. You can filter by provider type, issue, age, language, location and payment options.
• Coffee Days, a free monthly peer support group for moms and female caregivers of children and teens with mental health challenges, with a Spanish-language group, Charlas con un Cafecito.
• The 988 Suicide and Crisis Lifeline, which the Lifeline describes as free, confidential and available 24/7 by call, text or chat.
• Your teen's school counselor, who can often connect you to campus and community resources.

How the Navigation Line narrows the search to what you can afford

The single most expensive mistake we see is spending weeks calling providers who turn out to be full, out of network or the wrong fit for a teenager. The Navigation Line exists to shorten that search. When you call, tell the navigator your insurance plan, your budget limits, your teen's age and the concern you are seeing. Our Navigation Line page lists in-network providers and sliding-scale options among the things navigators help callers find, along with therapists and treatment centers.

You do not have to be sure what kind of care your teen needs before you call. Parents, grandparents, siblings, teachers and mental health professionals all call to say, in effect, here is what is going on, what do I do. The line is a starting point, not a diagnosis, and it does not replace a licensed provider. If you would rather search on your own first, HereForTexas.com lets you filter by payment options at any hour.

It helps to have a few facts ready before you dial: your plan name and member number, the zip code where you want care, whether you prefer in-person or telehealth, any language needs, and the days and times your teen can realistically attend. The more specific you are, the more specific the options you get back will be.

Ways families stretch a limited budget

Cost should shape the plan, not stop it. These are approaches families have used to get consistent care for a teen without taking on more than they can carry. None of them are medical advice; talk through any change in treatment with your teen's provider.

Start by asking every provider the same three questions: do you take my plan, do you offer a sliding scale, and is there a waitlist. Ask whether sessions can be spaced out once your teen is stable, and whether a group program might help alongside individual therapy. Use telehealth if it lets you reach an in-network provider you could not otherwise get to. And make sure you, as a parent, have support too. A mom who is running on empty makes harder decisions, and a free support group like Coffee Days costs nothing but the time it takes to come.

• Confirm network status for your exact plan before booking.
• Ask about sliding-scale fees and reduced-fee slots.
• Ask whether a group program could complement individual therapy.
• Use free tools first: the Navigation Line, HereForTexas.com and school counselors.
• Keep every bill and explanation of benefits in one folder.

When cost should not slow you down

Some situations cannot wait for an insurance call. If your teen talks about suicide or self-harm, has a plan, or you believe they are in immediate danger, call 911 or go to the nearest emergency room. You can also call or text 988 or chat at 988lifeline.org; the Lifeline says its conversations are free and confidential. Our Navigation Line is not a crisis line, and we say that clearly every time.

For everything short of an emergency, the urgency is still real. The CDC lists suicide as the second leading cause of death for people ages 10 to 34. That is not a reason to panic about your own child. It is a reason to get a professional opinion sooner rather than later, and to let cost questions run alongside the search instead of in front of it.

If you are not sure whether what you are seeing is serious, our guide on what to do when your teenager has changed walks through how to tell, and our guide on helping a stressed, anxious child at home covers what you can do while you look for care.

Who pays for the free part

Nothing is truly free; someone covers it. At Grant Halliburton Foundation, the Navigation Line, HereForTexas.com and our support groups are paid for by donors, event sponsors and partners. That is the reason a parent in Dallas or anywhere in North Texas can pick up the phone without first checking a balance. Since 2006 the Foundation has provided mental health education, training and support to more than 375,000 students, educators, parents and professionals.

If you are a parent, the next step is simple: call 972-525-8181 during its hours, or search HereForTexas.com tonight. If you are a mom carrying this alone, come to a Coffee Days support group meeting. And if you are a business owner or donor who wants to keep these services free for the next family, I would be glad to talk with you about how to help.

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