2024 has provided me with a crash course in all different types of mental health resources. I admit, I didn’t know I was signing up for this education. And often, I’ve felt like a blindfolded trail hiker.
It turns out, the services and resources I’ve been steered toward – either for myself, my children, or my family as a whole – form a complex web of often-disjointed mental health support. There’s a landscape full of acronyms, providers who don’t always talk to one another, and confusing trail markers.
This blog post is my attempt to save you some of the groping around in the dark I’ve done over the past few years. It’s also a stake in the ground of destigmatizing mental and behavioral health challenges as HEALTH challenges. I suspect you wouldn’t tell someone with diabetes or high blood pressure, for example, to “tough it out” rather than taking their life-saving medications. You’d probably not tell a kid who’s hard-of-hearing or who has vision problems to simply “pay more attention” in class. And I suspect you know one or more people who would benefit from a higher level of mental health support but who are afraid of what people will think if they ask for it.
Let’s change that narrative. Just because our – or our kids’ – challenges are more invisible and less quantifiable than some other physical ailments doesn’t make them any less real. And let’s intervene early when we or our kids are struggling, so we don’t have to ignore problems or try to be cycle-breakers who are doing this all alone.
A Few Caveats: I’m not a mental health professional. All of the thoughts below are what I’ve learned from navigating the mental health system as an individual and as a parent. Also, for each option, the quality and experience of providers varies widely. It’s always a good idea to ask around and get the advice of people you trust about which providers to use.
A Mental Health Resource Map
I’m going to walk you through the mental health resources I’ve become aware of, in a rough order from less-intensive needs to more-intensive needs. This path need not be linear, though. You may wind up skipping around from one option to another. Or, as our family has done, you might put together a beautiful mosaic of support in different categories.
Here we go on our trek. I’ll name the scenario, provide a bit of information about the type of resource, and then share a personal anecdote:
MENTAL HEALTH RESOURCE #1
Scenario: You – or your child – are feeling really down, off, anxious, or struggling in some way with trying to do the so-called “normal” activities of daily life.
Resource #1: School + Workplace Supports You Already Have Access To (But May Not Know It!): A good first stop on the path is where you already are. What mental health resources do your kids’ schools already offer? What workplace support – perhaps an EAP program? – does your employer have in place? If you don’t know, call.
Personal Anecdote: I’m now self-employed, so I don’t have an employer option for myself. But the mental health supports at my kids’ public schools have been awesome. Spend some time getting to know your school’s social workers and counselors. Remember that they are humans who are probably helping tons of kids. But be persistent in your outreach, and they can be amazing advocates. I’ve found it’s possible to set up a plan with them to have them touch base with your little one a certain number of times per week, for example. One of them has even come to our house to help our kiddo get to school on a particularly tough day.
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MENTAL HEALTH RESOURCE #2
Scenario: It’s looking like you or your kiddo needs a bit more support than school or work can provide. (Or perhaps your EAP led you to outpatient resources.)
Resource #2: Outpatient / Community Therapists and Counselors for Individuals: We’re probably all aware of the idea of therapy. But as a refresher, this is the opportunity for you and/or your child to work 1:1 with a professional who can support you on this journey toward better mental health. Some options are virtual, some are in person. Some providers take insurance, some providers don’t. And different providers are trained in different so-called “modalities” or types of treatment.
Personal Anecdote: I’ve had a number of different therapists throughout my adult mental health journey. Sometimes, I’ve needed more intense support with weekly sessions. Other times, I’ve just done a check-in every few months. Even when I’m not in crisis mode, knowing there’s someone I can trust as a backstop, who already knows me, has been really reassuring. I’ve written about my experiences with EMDR therapy here, which can be incredibly helpful for trauma-related work. And when it comes to my kiddos, I’ve learned a ton about and have become a believer in the powers of DBT (dialectical behavioral therapy) as a modality.
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MENTAL HEALTH RESOURCE #3
Scenario: You find yourself wondering how the heck other people in the same or a similar boat as you navigate these rocky paths.
Resource #3: Support Groups: Struggling with a particular issue? Connecting with others who face that same challenge can be lifesaving. Some groups are led by a trained facilitator, and others are just a gathering of similarly situated people. Some cost money, some don’t. Postpartum Support International, for example, has 50+ free online support groups for different perinatal-related challenges. Working Parent and Caregiver ERGs and Affinity Groups can sometimes serve this purpose within a workplace. If you’re on Facebook, type in the name of a diagnosis or “Parents of kids with _______” and you’ll probably find groups with active discussions on whatever you’re facing. (Note that this is different from “Group Therapy” described below.)
Personal Anecdote: The first support group I ever attended was many years ago, when I went to some “Adult Children of Alcoholics” (ACOA) meetings. Gosh did I feel seen and less alone in my own experiences at that time. I’m now on a few Facebook groups related to my kids’ diagnoses that have given me some great ideas. These message boards can also scare me and become overwhelming, though, so I limit my interaction with them to a few minutes a week. Mindful Return – both our courses (for new parents and for “experienced” parents) and our monthly calls for all of our alumni – are also a type of support group for working parents. I got so much out of connecting with other working parents that it’s become my mission to create these supportive spaces for others.
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MENTAL HEALTH RESOURCE #4
Scenario: You like the idea of connecting with others in the same boat, and you want discussions to be led by someone who has expertise in the area in which you’re struggling. You also may see your child struggling alone and wish they could see they aren’t the only one facing the same challenges.
Resource #4: Group Therapy: In this model, you have a therapist who is treating a group of people all at once to achieve a common goal. You can do group therapy on an outpatient basis, usually once a week for an hour or two. Sometimes the therapist will take insurance, and sometimes they won’t. Group therapy will also likely be part of the program, if you or your child attend an IOP, PHP, inpatient, or residential program described below.
Personal Anecdote: What I’ve learned about group therapy is not only does every kid have a different preference, but their opinions of it can change over time. I have one kiddo who could spend all day talking about his feelings in a group if he were given the opportunity. Another was *much* more resistant to the idea. Yet even this kid has come to really enjoy the multi-family DBT skills group that we participate in together. An initial reaction to something can most certainly evolve.
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MENTAL HEALTH RESOURCE #5
Scenario: You’re thinking, “gosh, I wish we could just get everyone in our family into the same room at the same time to work on these challenges!” Or “wouldn’t it be nice if we had a mediator who helped everyone get equal airtime?”
Resource #5: Family Therapy & Couples Therapy: In the family therapy model, one therapist meets with the whole family at the same time, and you work on goals that are relevant to the whole family unit. It helps strengthen relationships within the family and can help families through difficult times. Similarly, in couples therapy, the therapist meets with both members of a couple at the same time.
Personal Anecdote: I don’t have personal experience with couples therapy, but family therapy has been helpful for us to problem-solve together as a group of four. We’ve met about twice a month for a few months, and the sessions are even more productive when we head out for ice cream together at the end.
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MENTAL HEALTH RESOURCE #6
Scenario: All the “usual” or “intuitive” parenting approaches you’ve taken just don’t seem to be working. The model your parents used to raise you doesn’t fit. And watching your peers and neighbors seem to know what they’re doing – or who have kids who seem to respond well to their approaches – makes you feel like you’re either doing it wrong or don’t have the right tools.
Resource #6: Parent Coaching: Parent coaches help parents strategize and improve the relationship with their children. They can be great sources of referrals to other resources, empathetic ears, and brainstorming partners. Just as you wouldn’t try to learn or play a sport without a coach, there’s no shame in getting a parent coach on board to help you with your parenting game.
Personal Anecdote: I’ve found Dr. Becky Kennedy’s online platform, Good Inside, to be a great place for gaining new strategies, insights, and education. Parent coaching is also part of the DBT program we’re involved with. We meet with our coach approximately once a week, sometimes virtually, and usually in person. She helps us address not only the COWS (crises of the week!) but also teaches us a DBT curriculum. I’ve learned to speak up and get what I need in terms of providers. It’s okay, for example, if you don’t want a parent coach who hasn’t been a parent themselves. (I certainly didn’t.)
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MENTAL HEALTH RESOURCE #7
Scenario: My child’s therapist recommended that we have our child evaluated for a few things like ADHD and autism. Who does this?
Resource #7: Neuropsychological Testing (or “Neuropsych Testing”): This testing is an evaluation of how your brain works, and it’s used to assess your cognitive and behavioral abilities. Sessions usually last a few days (or parts of days), and they include interviews with a neuropsychologist and/or a psychometrist, and a bunch of standardized tests.
Personal Anecdote: In the DC area, the waiting lists are long to get these evaluations, and they can be incredibly expensive. I’ve heard that if you have them done at a university or academic medical center, they can be less costly. While ours didn’t take insurance, we did submit the expense for out-of-network coverage and got a good chunk of it reimbursed. Also, we found that the individuals who conduct neuropsych tests can be helpful advocates at your kids’ schools. They can support you, for example, through 504 and IEP processes.
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MENTAL HEALTH RESOURCE #8
Scenario: Does it really have to be this hard? We’re doing ALL of the things, and I’m still struggling. My child just doesn’t even seem to be able to access therapy because of the challenges they’re facing.
Resource #8: Outpatient Psychiatrists: Psychiatrists are physicians (i.e. medical doctors) who can prescribe mental health related medications. They diagnose, treat, and work to prevent mental, emotional, and behavioral conditions.
Personal Anecdote: I REALLY wish psychiatrists were also therapists. But most of them aren’t. So I’ve learned not to expect them to act like therapists. What I’ve found most frustrating about psychiatry – and mental health in general – is that it often feels more like art than science. If you have diabetes, you can diagnose it with a specific test and then check your Hemoglobin A1C levels to determine if it’s being managed appropriately. There is nothing so blissfully straightforward in the field of mental health. Also note that your primary care provider (rather than a psychiatrist) may be able to prescribe some mental health medications – mine does.
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MENTAL HEALTH RESOURCE #9
Scenario: Once-a-week therapy just doesn’t seem to be enough. It provides some temporary support or relief. And then things keep crashing during the rest of the week.
Resource #9: Intensive Outpatient Program (IOP): An IOP is a program that lasts for a few hours a day, often a few days a week. (It’s a step down from the PHP, described below.) There are child and adolescent IOPs, some of which take place during school time and others of which are after school. There are adult IOPs, some of which are held after work in the evenings. And there are even mother-baby IOPs like the new one at MedStar Georgetown, which a mom-baby dyad can attend together. The programming is usually a mix of individual and group therapy, coordination with a psychiatrist, and other therapy modalities (sometimes art therapy, yoga, etc.).
Personal Anecdote: I’ve seen that IOPs can be useful for either a step up into more intensive treatment than 1:1 therapy, or a step down from an inpatient stay or a PHP. Before this year, I didn’t even know IOPs existed, and gosh am I glad they do. I’m also incredibly grateful that the one we’ve used for our kids takes insurance, because this more intensive treatment can be really expensive without it. I’ve also seen a number of parents who are Mindful Return alumni take leaves of absence from work to take part in an IOP program. (Here’s one in in the Philadelphia area, for example.) Caregiver burnout is real, and IOPs can be a great treatment option if you are suffering.
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MENTAL HEALTH RESOURCE #10
Scenario: You do an intake session for a local IOP, and the evaluation team determines you’re probably better suited for a full-day level of care. Or, your child needs a path back to school after an inpatient hospital or residential stay, and you’re not sure what’s next.
Resource #10: Partial Hospitalization Program (PHP): Basically see everything I wrote above about IOPs, but this is type of program is all day long, five days per week. In some cases, you can start in a PHP and then “step down” to an IOP run by the same provider. Once again, I’m grateful for the PHPs that take insurance.
Personal Anecdote: I sincerely wish every human could take a month and have the benefit of a PHP program. As a species, we’d all develop better coping and emotional regulation skills if we had this type of support and education. And we’d recover from the many ways both Covid lockdown and modern life have wreaked havoc on our nervous systems.
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MENTAL HEALTH RESOURCE #11
Scenario: Someone in your household is so dysregulated that the health and safety – of any member of the family – is in question.
Resource #11: Hotlines and Crisis Lines: These are all *free* services. In the United States, the universal emergency line is, of course, 911. 988 is another good number to know off the top of your head, as it’s the suicide and crisis lifeline. In the D.C. area, there’s a whole subsection of the police force that consists of officers who are trained in mental health. So, if you’re in DC and you’re calling 911 because someone is in a mental health crisis, ask for one of their “Crisis Intervention Officers.” (Find out what the equivalent name is wherever you live.) In DC, there’s also a crisis team for kids and adolescents called ChAMPS, which stands for Child & Adolescent Mobile Crisis Service, (202) 481-1440. They will come to your house to help out. You can also reach the National Maternal Mental Health Hotline at (833) 852-6262.
Personal Anecdote: I’ve felt a lot of anxiety and shame in needing to use these crisis lines – but I need not have. Our challenges are why these lines exist. Everyone I’ve spoken with in times of crisis has been VERY, supportive, helpful, and calm. Believe you me, they do not match your level of hysteria with hysteria. The people who have helped us through ChAMPS, for example, have been the most chill and calm people I’ve ever met.
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MENTAL HEALTH RESOURCE #12
Scenario: I called a crisis line, and they recommended I go – or I take my child – to a hospital emergency room. What’s going to happen once they evaluate me?
Resource #12: Inpatient Psychiatric Units: These are units of hospitals – or sometimes they are standalone hospitals in and of themselves – that provide stabilizing psychiatric treatment. Unlike with a PHP, a patient stays overnight often for a few days or weeks.
Personal Anecdote: My experience has been that whether you “meet clinical criteria” for being admitted to a psychiatric unit or a facility often depends on whether that unit or facility has a bed open to take you. There’s definitely a shortage of child and adolescent psych beds, for example, and they tend to be the fullest in September and May (beginning and end of school). Also, I’ve found that these units tend to be “stopovers” that are designed to keep you safe while you find a next option. They’re not going to fix a problem or cure you of anything. They’re just going to stabilize you until you can get outpatient care lined up. If you’re the parent of a child who has been admitted to an inpatient psych unit, start exploring your PHP and IOP options immediately, so you can work toward discharge.
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MENTAL HEALTH RESOURCE #13
Scenario: Life has become completely untenable. Everything else you’ve tried hasn’t worked, and things have become too much for the safety and health of the person with the mental health challenge and/or their whole family.
Resource #13: Residential Treatment Programs: Participants in these programs live outside of their homes, in a setting that’s monitored 24/7 but is not a hospital. Some are on campuses, and others take place in the wilderness. They’re usually focused on treating mental health and substance abuse challenges, and they may or may not take insurance.
Personal Anecdote: I don’t have any personal experience at this point with residential treatment. I’ve come to understand it as a “last resort” option, but one that can be incredibly helpful when everything else doesn’t work. The cost of these programs is a huge concern, of course, and many don’t take insurance. Others that do take insurance “time out” of insurance after a relatively short period of time. I’m also told that there are individual care navigators you can hire to help you understand the landscape of these facilities.
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MENTAL HEALTH RESOURCE #14
Scenario: I’ve seen how much comfort my kids seem to derive from spending time with other people’s pets. What about therapy or service dogs?
Resource #13: Therapy Dogs, Emotional Support Dogs, and Service Dogs: It turns out these are not one in the same. Therapy dogs provide comfort and affection, but they’re not service animals and don’t have the same access privileges as service dogs. Service dogs and their owners have protected legal rights. Here’s an article by the American Kennel Club that explains each of these three classifications.
Personal Anecdote: My boys are in LOVE with all dogs, everywhere. We haven’t yet taken the dog plunge, though. Feel free to take bets offline on whether this is in our future.
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That’s it for this very long resource roundup. What did I miss? What would you add to the list? And what have you found helpful? The mental health crisis is real for us as parents, and for our kiddos, and we absolutely cannot navigate it alone.
Want more practical tips on working parenthood? Check out my book, Back to Work After Baby: How to Plan and Navigate a Mindful Return from Maternity Leave
