Mental Healthcare Resources

In crisis? This Crisis Resources Guide can help you figure out if you are navigating a crisis, and provides contact information for relevant crisis and warm lines.

Getting started with health insurance

Some health insurance options cover mental health care (sometimes called behavioural health). Depending on your employment status, your best option may be Medicaid/Apple Health.

Don’t have health insurance? Find a walkthrough in the Apple Health section. Looking for regular doctors? Check the medical section.

Apple Health

Medicaid in Washington State is called Apple Health and covers some mental healthcare. For example, if you can find a therapist that takes Medicaid, weekly sessions are typically free. Learn more here: https://www.hca.wa.gov/free-or-low-cost-health-care

Some options for finding healthcare navigators who are queer and trans-knowledgeable:

• LGBTQ+ Center: https://gaycity.as.me/schedule.php?appointmentType=category%3AHIV%2FSTI+Testing
• The Mapu Maia Clinic, for folks from queer and trans Pacific Islander communities: https://utopiawa.org/mapu-maia-clinic/

Therapists vs Psychiatrists

If you are looking for general mental health support, a therapist is usually your best option. If you specifically need prescription medication, you’ll likely need to see a psychiatrist, as therapists cannot prescribe. (Not sure? Maybe see a therapist first, they can usually refer or point you to psychiatrists if it’d be useful!)
You might also consider talking to your primary care provider / a regular doctor about medications; some may require a psychiatrist, but others like hormones or some renewals may be able to be done by a PCP.

Finding Therapists / Psychiatrists with Insurance

It can be difficult to find therapists who take insurance, and it is often confusing which therapists are in network and submit bills to the insurance company for you, versus those who offer what is called a “superbill” (a receipt that you can submit to your insurance, which they may or may not reimburse you for). As you look for a therapist, make sure you ask which they mean when they say they “take” a specific insurance.

• Sound Mental Health is a big clinic with lots of services that takes Medicaid, including Psychiatry. They only do consults for therapy, but after a while of therapy your therapist will likely refer you to a psychiatrist/prescriber.
• Seattle Roots also takes Medicaid + has an objective-based help program, as well as Psychiatrists on staff!
• Other recommendations for queer therapists: HeartFelt is good (they also have an intensive outpatient program!)
• You can also use Psychology Today, InclusiveTherapists, or TherapyDen to find specific therapists – email a bunch of them. You can filter for insurance.

Many therapists will offer a free 15-20 minute introduction call, where you can “vibe check” and ask them questions about their practice. As part of that, if it isn’t clear from their profile text, you might ask what their familiarity and comfort is with trans issues. If the therapist doesn’t seem to be a good fit for you for whatever reason, you can ask if they are willing to ask their referral network for names of people who take your insurance, are trans affirming, and are familiar with the specific issue you’re wanting to work on.

If you want to use out of network benefits but don’t want to deal with the insurance company, there are a few companies that will manage bill submissions for you while taking a fee from what the insurance company pays. Some companies that do this type of work are Mentaya, Thizer, and Reimbursify.

ADHD

For folks needing ADHD treatment / stimulants, Mindful Therapy Group is a large prescriber in the city, and accepts all Apple Health other than CHP. Please be careful with stimulant medications if you don’t have experience with them!

Therapy without insurance

If you do not have insurance, if you cannot find an in-network provider, or your insurance does not cover mental health services, there are still places you can find support.

Open Path Collective

Open Path Collective (https://openpathcollective.org/) is a nonprofit network of therapists who offer discounted services to members. Rates are offered at a significant discount to prevailing local prices for mental health services ($40-$70 per session, as of this writing).

Membership is for people who make less than $100,000 per year and cannot find providers through their insurance plan. Members are asked to self certify that they are financially eligible and cannot find appropriate care through their insurance and pay a one-time fee of $65 to become a life member.

Affinity Groups

Some identities have groups that work to provide free or low-cost therapy for their members. Different groups may have different levels of understanding and support for trans issues, so be aware that you may need to do additional self-advocacy at the matching stage. Some groups doing this work include:

• A Home Within: Offers free once-weekly therapy for current and former foster youth.
• Loveland Therapy Fund: Partners with the Queer and Trans Therapy Network and others to offer vouchers to Black women and Girls seeking therapy.

Sliding Scale Spots

Many therapists consider it an ethical imperative to offer sliding scale spots and may do so through Open Path Collective or directly on their own. When contacting a therapist, it is always okay to inquire if they have a sliding spot available. If demand for therapy is high, it may feel hard to find a sliding scale spot. If you connect with a therapist but they don’t have any available, ask them to ask their therapist referral group for someone who has sliding scale spots open and is trans-supportive.

Peer support groups

Peer support groups exist for topics such as addiction recovery, mental health, living with HIV, and more. They typically are no or low cost, with an email address you can contact for more information. Some are online while others are in person:

• Ingersoll Gender Center - Online, no-cost group run by trained peer facilitators
• Peer Seattle - A local peer support group
• Sonder Recovery - An online-only LGBTQIA+ peer-to-peer recovery group with daily meetings. The groups are non-religious and support a variety of goals beyond abstinence only.

Peer Coaching

Coaching is not the same as therapy, but can be a good option if you have a specific goal you need support. Note that coaching doesn’t have the same legal protections around confidentiality that therapy does in Washington state.

Peer Seattle offers peer coaching services for folks working with

• Addiction recovery (chemical/behavioral)
• Mental Health Challenges (short/long term diagnosis, grief & loss)
• Chronic Illness (HIV/Hep C – Newly Dealing/Newly Diagnosed)

These are all no cost, and are for one hour a week for 26 weeks.

Usually when we think about mental health support we think of therapists and psychiatrists, but there are many other options depending on what your needs are, how much time you have, what you can afford, and so forth. This blog post walks you through the options:
https://www.selfwittecounseling.com/blog/post-3/

Warm Lines and Crisis Lines

Crisis lines are text or phone lines you can contact when you feel in crisis and need immediate help. Warm lines are a service that provides emotional support and conversation for individuals experiencing mental health challenges. Warm lines are appropriate for non-urgent situations where you need support for everyday concerns and to prevent crises. Both are staffed by trained peers who have lived experience.

• This Crisis Resources Guide can help you figure out if you are navigating a crisis, and provides contact information for relevant crisis and warm lines.
• The national crisis line is available by calling 988 or going to 988lifeline.org. It is available 24/7.
• The Trans Lifeline provides trans peer support and is available 10am-6pm.
• The WA warm line is available 9am-10pm daily.
• If you are concerned about potential police involvement, search “crisis lines that do not call police” or use resources on not911.me (primarily for the greater Seattle area).

Inpatient Care

Mileage varies greatly in terms of how good or trans-inclusive inpatient psychiatric stay locations are. Anecdotally, I’ve heard good things about Smokey Point Behavioral Hospital in Marysville.

Finding Psychiatric Medication Support

If you’re taking prescription medication to support your mental health, you’ll want to make sure you get refills before you run out. Some classes of psychiatric medication can only be prescribed by psychiatrists, which may be different than the state you’re coming from. (Some states, for example, allow psychologists to prescribe. Washington State does not.)
However, many commonly used medicines such as SSRIs can be prescribed by a primary care doctor or nurse practitioner.

Your best bet for getting the prescriptions you need as fast as possible is to find a primary care provider. There’s information in the healthcare resources section on how to do that.