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For the estimated 2.4 million adults living with schizophrenia in the U.S., and the people who love and care for them, it takes courage, compassion, and a commitment to stand and face this serious condition together — always looking ahead with hope.

Whether you’re living with this disease or caring for someone who is, we hope that our site can help provide some resources you need to face schizophrenia head on. Remember, we’re in this together.It takes strong support from the people that care, too.

Interactive Conversation Tool

Whether you live with schizophrenia or care for someone who does, our Interactive Conversation Tool may help you talk with your treatment team and loved ones about schizophrenia management, including treatment options. We’re building the tool based on input from people like you. So register today, and we’ll let you know when it’s ready to use.

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Schizophrenia Is a Lifelong Condition

Most people out there don’t understand what schizophrenia is. But the reality is, schizophrenia is a lifelong medical condition that affects 1 out of 100 adults in the U.S.

Because each person is unique, the symptoms of schizophrenia can be very different from one person to the next. And because schizophrenia is a lifelong condition, symptoms can also change, or come and go in phases.

Schizophrenia is nobody’s fault.
Schizophrenia affects the brain. This can change how people think, feel, act, and live. It’s important to remember that no one chooses to have schizophrenia or its symptoms.
Some commonly reported symptoms include: Hallucinations: sensing things that others don’t, like hearing or seeing things
Delusions: strongly believing something is true even when there’s no evidence of it
Altered emotions: having feelings that don’t seem to fit what’s going on, or having no feelings at all
Withdrawal: no drive or desire to do the things you used to enjoy
Lack of motivation: difficulty staying focused and doing tasks
Disorganization: having disorganized thinking, speaking, or behavior
Cognitive: such as attention and memory problems

A common symptom of schizophrenia is not realizing there’s anything wrong.

Accepting help or treatment
It’s really important to know that a lot of people with schizophrenia may not see there’s anything wrong, because of a clinical symptom called “lack of insight.” The symptom can make people think there’s no need for treatment or medication, which may make it hard for them to accept help from family and caregivers.

Help us develop a support tool that may make a difference. By registering, you’ll receive information about schizophrenia management, including treatment options.

Schizophrenia treatment:
understanding your options

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Psychosocial treatments, including one-on-one therapy, family therapy, cognitive behavior therapy, and others, may help manage the symptoms of schizophrenia. Antipsychotic medication is also an important part of a treatment plan to help improve and maintain control of symptoms. Antipsychotic medicines include what are called “typicals” and “atypicals.” Pills and liquid are taken daily, while some injections are given twice a month and others given once monthly.*

The Maintenance Phase is following a treatment plan including taking your medication to help control symptoms and try to prevent acute episodes from coming back quickly. With appropriate medication and support, many people with schizophrenia can aim to lead productive lives. But even in a Maintenance Phase, there is a risk that acute episodes may come back. So, it’s especially important to remember to stay on treatment—even when symptoms improve.

An Acute Phase of schizophrenia is when symptoms are typically severe and may lead to hospitalization. Acute episodes can keep happening, and for some may get worse over time.

Maintenance Treatment*

Daily

Oral Medication

Pills or liquid taken daily by the individual.

Twice a Month

Long-Acting Medication

Injections given by healthcare professionals twice a month.

Monthly
Long-Acting Medication

Once-monthly injection given by healthcare professionals.

*After Initial Dosing

Find out more about a treatment option

Stay informed. And help others.

Reach out to any of the people on your Treatment Team for help and support.

Caregiving:
It Takes Working Together

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Schizophrenia can be a lonely condition. The world outside often misunderstands schizophrenia, and doesn’t know how much courage and compassion it takes to live with the condition. That’s why it’s so important for family, caregivers, and loved ones to stand together.
How family members can help:
•They can be “advocates,” and help loved ones work with the complicated healthcare system.
•They can remind their loved ones to take their medication, which may help prevent acute episodes from coming back quickly.
•They can partner with their loved one and the rest of the Treatment Team to find an appropriate treatment plan.
•They can be the first to notice warning signs of an acute episode or side effects of medicine.

Some things can make it hard for family and caregivers to offer help. Like when they feel “shut out” because doctor-patient confidentiality doesn’t let them get information about their loved one’s health. Even then, family and caregivers may still offer important information to the Treatment Team.

A Treatment Team can be made up of one or more healthcare professionals — and is the best source of information about your loved one’s condition. Here’s a brief description of who might be on a Treatment Team.
Psychiatrists: The psychiatrist is a medical doctor who specializes in mental health, and prescribes and manages medication.
Psychologists, psychiatric social workers, or counselors: These are the professionals who help patients with what’s called psychosocial treatments, such as cognitive behavior therapy (CBT) or family therapy.
Nurse practitioners and physician assistants: Many psychiatrists will rely on these healthcare professionals to help manage day-to-day treatment.
Nurses: Are in regular contact with patients, and often work closely with caregivers, case workers, and social workers to discuss a patient’s treatment and needs.
Social workers: Many are trained as therapists and offer counseling and social skills training. Others can help arrange for various social services.
Case Managers: Can help find services and programs that help patients with daily living. They can also help apply for benefits and arrange for training.
Occupational therapists or employment counselors: Once a patient is sticking to treatment and in a Maintenance Phase, these professionals can help them find the skills needed for work or school.

Get involved.

With your input, we may develop additional resources for those caring for someone with schizophrenia

Support Resources
Additional Resources

National Alliance on Mental Illness (NAMI)
The nation’s largest grassroots mental health organization
1-800-950-6264

Mental Health America
Network of resources for living a mentally healthy life
1-800-969-6642

SAMHSA Mental Health Services
Resource for substance abuse and mental health

Bring Change 2 Mind
Medical advisory panel as well as information on schizophrenia and other mental illnesses

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)
Find out more and apply for disability benefits

http://www.bipolarsupportpack.com/g/1/?gclid=CLHZ7NSS07wCFXNo7AodpGwAzQ

http://www.bipolar4lifesupport.co

Identification
Bipolar disorder is a mental illness in which a person’s mood changes dramatically. Specifically, people with bipolar disorder experience manic periods, in which they have an excess of energy and may become irritable, impulsive and unable to concentrate, and depressive periods, which are characterized by sadness and lack of energy. There are different types of bipolar disorder, which vary in the number of manic episodes experienced and in severity.

Mood Stabilizers

Mood stabilizers help even out the highs and lows experienced by people with bipolar disorder. Lithium, a type of chemical salt, is the most commonly used mood stabilizer. Valproic acid, more commonly known as Depakote, can also be used to stop mood cycling. Anticonvulsants like lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax) are sometimes prescribed to treat bipolar disorder. While these drugs were originally designed to stop epileptic seizures, they can also act as mood stabilizers. Mood stabilizing drugs have a variety of side effects, depending on what type of drug is used.

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Antipsychotic Medications
Atypical antipsychotic medications can help people with bipolar disorder who suffer from severe bouts of mania. Olanzapine (Zyprexa), aripiprazole (Abilify), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon) are all used for this purpose. They can also help maintain a steady mood balance. These drugs are often used to supplement other types of medication for bipolar disorder. Atypical antipsychotic medications can cause weight gain and can raise a patient’s risk of developing type 2 diabetes.

Antidepressants

Antidepressants may be commonly used to treat the depressive episodes of bipolar disorder, but it’s uncertain whether they have any actual positive effect on the condition. They’re usually prescribed along with a mood stabilizer, but a large-scale study funded by the National Institute of Mental Health found that bipolar disorder patients who took both an antidepressant and a mood stabilizer were no less depressed than patients who took a mood stabilizer alone.

Therapy

Psychotherapy can help a person with bipolar disorder deal with the everyday problems of living with the condition. Cognitive-behavioral therapy can help patients deal with negative thought patterns they may have created, while interpersonal and social rhythm therapy teaches patients how to deal with others and how to manage bipolar illness. Family therapy is also a good option. During family therapy, the whole family will learn how to deal with their loved one’s bipolar disorder.

Other Treatments

Electroshock therapy (ECT) may be used in very severe cases of depression or mania, or when medication cannot be used (for example, when a bipolar patient is pregnant and the medication would harm the developing fetus). Sedatives can help with the poor sleep patterns that are a symptom of bipolar disorder.

http://www.bipolar4lifesupport.co

Bipolar disorder is a lifelong condition that can affect both how you feel and how you act. It is a mood disorder thought to be caused by chemical imbalances in the brain that can result in extreme swings in mood—from manic highs to depressive lows.

To be diagnosed with bipolar disorder, you must have experienced a high period (mania). Bipolar mania is described as an “extreme high,” or feeling unusually great. Most people with bipolar disorder, when ill or when symptomatic, experience more lows than highs.

These lows are known as bipolar depression. The good news is that there are clinically proven bipolar disorder treatment options available that may help. Your doctor can help you find a treatment plan that works for you. To help prepare for your next doctor visit, download questions to ask your doctor.

Bipolar disorder treatment

If you’re still living with symptoms of bipolar disorder, you should know that many people with the condition are able to manage their symptoms. Feeling better often involves a combination of education, medication, and therapy, including psychotherapy, or “talk therapy.” There are
a number of different medications, including SEROQUEL XR, that have been shown to be effective in people with bipolar disorder.

Some of the goals of bipolar disorder treatment
Reduce symptoms of depressive episodes
Reduce symptoms of manic episodes
Reduce the likelihood of future episodes/relapse
Reduce the severity of the disease
Provide assistance and support to patients and family

Bipolar disorder medication

Many types of medications are used to treat bipolar disorder. One medication approved to treat bipolar disorder is SEROQUEL XR. Learn more about SEROQUEL XR.

Your doctor can tell you what kind of improvements and potential side effects you may expect with SEROQUEL XR. It may take some time before you start to feel better, but by finding a treatment that works for you, and taking it as prescribed, you can work toward getting back to the things you once enjoyed.

Your health care professional will depend on you to let him or her know exactly how you are feeling, so your treatment can be adjusted, if needed. Use these questions to ask your doctor to help prepare for your next appointment.

Psychotherapy (talk therapy) for bipolar disorder

Psychotherapy (also called talk therapy) can make it easier for patients and families to better cope with disturbing thoughts, feelings, and behaviors associated with bipolar disorder. Talk therapy focuses on several important aspects of bipolar disorder management, including:
Recognition of and treatment for recurrent mood episodes
Management of stress, interpersonal/family issues, and regularity of daily activities
Development of problem-solving skills

Psychotherapy can be used in combination with medication and other treatment approaches.

http://www.bipolar4lifesupport.co

Metabolic syndrome in bipolar disorder: A review with a focus on bipolar depression
The Journal of Clinical Psychiatry, 02/10/2014  Review Article

McElroy SL, et al. – The study aims to perform a detailed, qualitative review of existing literature on the co–occurrence of bipolar disorder and metabolic syndrome, the impact of metabolic dysregulation on patients with bipolar disorder, and treatment considerations, with a focus on bipolar depression. Adequate management of metabolic syndrome may improve clinical outcomes in patients with bipolar disorder, as well as prevent adverse cardiovascular events and the development of diabetes.

Methods
•Searches of the PubMed database (October 23, 2012) and Cochrane Library (September 20, 2013) were conducted for English-language articles published from January 1980 onward containing the keywords bipolar AND metabolic, weight, obesity, diabetes, dyslipidemia, OR hypertension in the title or abstract.
• The searches yielded 1,817 citations from which case reports, conference abstracts, and pediatric studies were excluded.
• Abstracts and titles were evaluated for relevance to the stated objectives.
• Full texts of 176 articles were obtained for further evaluation; additional articles were identified from reference lists.

Results
• Metabolic risk factors are highly prevalent yet undertreated in patients with bipolar disorder.
• Putative factors accounting for the link between bipolar disorder and metabolic syndrome include behavioral/phenomenological features, shared neurobiologic abnormalities, and adverse effects of psychotropic medications.
• A comprehensive assessment of metabolic risk and regular monitoring of body mass index, waist circumference, lipid profile, and plasma glucose are important for patients with bipolar disorder.
• Management strategies for the bipolar patient with metabolic risk factors include use of bipolar disorder medications with better metabolic profiles, lifestyle interventions, and adjunctive pharmacotherapy for dyslipidemia, hypertension, and/or hyperglycemia.

http://www.bipolar4lifesupport.co

Understanding Bipolar I Disorder

People experience different moods throughout their lives. Happiness, anger, and depression are moods most people experience at one time or another. There is a difference between the various moods most people experience and the episodes of severe mood swings experienced by people with bipolar I disorder.

It is estimated that over 2.4 million adults in the U.S. have bipolar I disorder. Patients with bipolar I disorder can experience extreme mood swings. These changes in mood aren’t as simple as transitioning from happy to sad. With bipolar I disorder, symptoms can include both a lowering of mood (depression) and an exaggerated elevation of mood (mania). These changes occur in cycles and are referred to as episodes, which can take three different forms: manic, depressive, and mixed.

Bipolar I disorder is a disease thought to be caused by changes in the chemistry of the brain. The symptoms and severity of the condition can vary, but with treatment, bipolar I disorder symptoms can be managed.

There have been recent changes in the definition of symptoms for bipolar I disorder. Please see your healthcare provider for more information about these changes.

Paying for Care

Receiving the proper care for your mental health condition is essential to your recovery. The best treatments are the ones prescribed by a doctor or mental health practitioner, and that may include counseling, medication, support, diet and exercise, and alternative therapy among others. Unfortunately, visiting mental health providers and paying for many of these treatments can be expensive. Not all people have access to affordable insurance.
Whether you’re insured or not, and whether that insurance coverage is adequate, there are ways that you can find help paying for your care.
Obtaining Coverage
Shopping for Insurance
Finding Care
Finding Supportive Services
Help Paying for Medication
Paying for Mental Health Care with Insurance

Paying for Care – Without Health Coverage
Much of the health care system in our country depends on health care coverage, which is usually provided by a form of insurance. If you don’t have insurance, it can be difficult to pay for treatment unless you are independently wealthy. Consider the options below to obtain coverage; in the meantime see Finding Care to get immediate help.

Obtaining Coverage
You may be able to obtain insurance if you are not currently insured. Here are some options:
Medicaid
Medicaid is health care coverage offered in combination by the federal government and your state government. It helps low-income individuals in certain groups pay for medical care and prescriptions. Medicaid is not a typical insurance program with monthly payments and deductibles; Medicaid pays providers directly for your care. Low-income beneficiaries aren’t the only group to receive Medicaid, as there are several other qualified groups that are covered (although some of this will change in upcoming healthcare reform).
In addition to covering those who are low income, Medicaid covers:
•Pregnant women
•Women with children under 6
•Children between the ages of 6-19
•Supplemental Security Income recipients
•Young adults up to age 21 living alone
•People over the age of 65
•Those who are blind or deaf
Many states also have a “medically needy” clause, which means you can receive Medicaid without falling under any of those categories if your state determines that you need the medical treatment and you are under the threshold of the Federal Poverty Level.
Many people with mental illness become eligible for Medicaid by qualifying as disabled, either as children or as adults after age 19. Adults determined to be disabled receive Supplemental Security Income (SSI) from the Social Security Administration. SSI provides a small amount of monthly income To find out if you qualify for SSI, visit http://connections.govbenefits.gov/ssa_en.portal.
Many children can receive Medicaid even if they are not otherwise eligible through their State’s Children’s Health Insurance Program (SCHIP). SCHIP requirements tend to be broader.
If you believe that you meet the income and eligibility requirements, you can apply for Medicaid. For specific questions about eligibility for Medicaid in your state, you should call your state office. For more information on Medicaid, click here – https://www.cms.gov/MedicaidEligibility/downloads/ListStateMedicaidWebsites.pdf
Medicare
Medicare, like Medicaid, is a health coverage plan run by the federal government. Medicare operates more like traditionally funded health insurance than Medicaid. Unlike Medicaid, Medicare is a federal program (without state differences) and is geared toward people based on age or disability status and not income. To enroll for Medicare, you must have received social security disability benefits (SSDI) for at least two years. [Add link on qualifying for SSDI]
Medicare mimics a private insurance plan and has deductibles and co-pays. Medicare is structured into four parts, and you may be eligible for one or more of the parts.
•Part A – Medicare Part A deals with hospitalization and inpatient services.
•Part B – Medicare Part B deals with outpatient services and routine medical care.
•Part C – Medicare Part C or Medicare Advantage is a way to extend benefits of A,B, and D
•Part D – Medicare Part D deals with drugs. People with very low income get extra help paying for the prescription costs and deductibles in Part D.
Coverage under Family Insurance
You may be eligible for coverage under your parents’ insurance plan if you are under the age of 26 due to new changes in the healthcare reform law. If you had previously been removed from coverage upon reaching age 22, you can re-enter the plan until you reach 26.
Employer Coverage
If you are employed, your company may offer health insurance as a benefit package. Employers may pay some or all of the monthly payments or premiums for your package. Employer plans tend to be more expensive and comprehensive than those on the individual market and frequently do not discriminate on the basis of pre-existing conditions. Often, employers who do not pay any part of your health insurance may still have a company plan that you can opt to enroll in.
COBRA
If you have recently lost your job, you may be eligible to keep your health insurance at a cost to you through the Consolidated Omnibus Business Reconciliation Act (COBRA). COBRA allows you to keep your health insurance for a specified period of time as long as you continue to pay the premiums.
School
If you are attending a state university as an undergraduate student, your state may offer a healthcare plan for you. Large schools and universities may have their own clinics or teaching hospitals. Some schools may offer programs for graduate students.
Private Insurance
If you are not able to obtain insurance coverage through family, work or school and you are not eligible for government insurance, you can consider buying insurance on the private market. Private insurance can be expensive, and you will need to evaluate your plan very closely.

Shopping for Insurance
There are several terms you will need to know before shopping for insurance:
Primary Care Physician – In many managed care plans or health maintenance organizations, you will have to choose a primary care physician, also sometimes called a general practitioner. Primary care physicians typically specialize in Internal Medicine or Pediatrics. Your primary care physician is the main doctor you will see for most of your ailments that don’t require urgent care. If you want to see a specialist, you may need a referral from a primary care physician.
Specialist – A specialist is a doctor such as an allergist, a gynecologist, or a podiatrist who specializes in treating one or more similar conditions or specializes in a specific age or gender group. Specialists may be able to run more tests and diagnose more problems than a primary care physician.
Referral – A referral is an authorization from your primary care physician to see a specialist or another doctor. It does not mean your insurance company will cover the cost.
Pre-approval – A pre-approval is when your insurance company “OKs” paying for a treatment before you take it.
Network – Insurance companies will typically list doctors or facilities as “in network” or “out of network.” Anyone who is “in network” has a pre-existing arrangement with your insurance company for how much can be billed and paid by the company. Out-of-network practitioners do not have a relationship with your insurance company; they may cost you more.
You will have to pick what kind of plan you want when you are shopping for insurance. There are several different structures of plans:
•A managed care plan, though often the most affordable, is the strictest when it comes to choosing your doctors. In a managed care plan, you may receive all of your services from pre-determined doctors or facilities. You might always have to go to Facility A to see your primary care physician and receive a referral before you can see a specialist chosen by your plan who also works in Facility A, and you may have to get all of your prescriptions at the same facility.
•A health maintenance organization is similar to a managed care plan, but instead of your doctors being chosen for you, you will have a choice as long as you remain “in network.”
•A point of service plan is similar to a health maintenance organization, but you may not need to visit a primary care physician for referrals to specialists as long as you stay within the network.
•A preferred provider organization (PPO) plan is the broadest type of plan, where you never need to see a specialist. You can go both in and out of network, but in-network care is cheapest.
There are several kinds of expenses involved when you are shopping for insurance.
•A premium is a monthly payment that you make to buy into the insurance,.
•A co-pay is any payment you make out of pocket when you visit a doctor or buy medication. For example, you may have to pay $20 when you visit your primary care physician and $40 when you visit a specialist.
•A deductible is the total amount you will have to pay out of pocket before your insurance coverage activates (although routine visits for general health may be excluded from this deductible). For example, you may have a deductible of $5,000. So if you are hospitalized and it costs $10,000, you will have to pay $5,000 before your insurance company will make payments on your behalf.
•A cap is the final amount that an insurance company will pay on your behalf either per year or over your lifetime, although this is going away. For example, you might have an annual cap of $100,000 and a lifetime cap of $1,000,000.
Generally, the higher the premiums are, the lower the deductible. Private insurance may also be more discriminatory than employer plans based on pre-existing conditions (although this is going away) and other statuses that affect your health (such as smoking or age). You may be able to find cheaper private insurance if you look for incentive-based plans that charge lower premiums for people who actively work to eliminate health risks such as smoking and obesity.
There are also some other things to watch out for: A pre-existing condition is a health condition you have before you applied for insurance, such as major depression. Before the passage of the health care reform law, insurance companies could deny you based on a pre-existing condition, give you a very high premium and/or deductible because of your condition, or agree to cover any illnesses except those related to your pre-existing condition. This will change as health care reform goes into effect.
Your insurance will have a list of covered conditions and procedures. You should always read this to make sure your plan is comprehensive. Insurance companies can refuse to cover certain diagnoses and treatments not on the list.

Finding Care
If you are applying for insurance or you can’t find affordable health coverage, there are a number of ways that you can still get care. You should never be turned away from a hospital if you are having a medical emergency, regardless of your ability to pay.
Free Clinics are non-profit organizations that perform medical safety net services for free or at a highly reduced cost. You can find free clinics in your area by visiting http://www.freeclinics.us/.
Free Clinics provide safety net services, which are intended to help people who are ineligible for Medicaid and Medicare but can’t find affordable health insurance. They are often found in hospitals or as stand-alone facilities in densely populated areas of poverty. Some, but not all, free clinics provide mental health services in addition to preventative general health and maintenance.
Generally, free clinics will perform services for free, charge a nominal fee ($15/visit, for example), or initiate a sliding scale fee based on your income. , When visiting a free clinic, you may need to take your identification, as well as proof of income, such as a prior year’s W2 form. Some clinics may take walk-in clients on a daily basis; others are more like doctor’s offices that you will have to join.
Community Mental Health Centers offer low-cost or free care on a sliding scale to the public. Typical services include emergency services, therapy and psychiatric care for adults and for children. You can expect to go through an intake interview that determines the kind of care you will receive. Mental health centers also may offer a variety of services on a long-term basis for clients with persistent mental health conditions. Find your local mental health center by contacting your local government.

Local Nonprofits that aren’t specifically designated as health clinics may still have therapists, psychologists, or psychiatrists who donate their time and agree to see patients for free or at a reduced cost. Many groups will organize professionals who will donate some time each week or month to see patients. These professionals will often meet at drop-in centers or other clinics.
Even if community mental health centers or local nonprofits don’t have a pro bono program, they may know of other resources available to you in your community.
Medical Schools may provide another way of finding help. Students and interns may meet with clients at a highly reduced rate, if you are comfortable seeing them. These students will be under the supervision of a licensed professional.

Finding Supportive Services
If you are interested in finding supportive services in addition to professional counseling look for these options in your community:
Hotlines and Warmlines provide immediate support by telephone for people in emotional crisis and people with mental health conditions. Where hotlines provide emergency support and crisis intervention, warmlines provide assistance, comfort and referral services. Hotlines and warmlines can be lifesaving, they provide referral to help and care, and they are comforting because they are anonymous and easily accessible by telephone.
Drop-in Centers are organizations that are generally run by people with mental health conditions for their peers. A safe, accepting place to go for company and support. Drop-in centers may organize activities such as support groups or trainings, but they may also be more informal gathering sites.
Support Groups may meet at various places in your community such as churches, schools or government buildings. You can find information about support groups on the Internet, on bulletin boards at local mental health centers and restaurants, or by asking other people with similar conditions. Some support groups also meet anonymously on the Internet, posting on forums or using e-mail to stay in touch. Support groups should either be free or should have a very low cost to cover food or activities ($5 a meeting).
You can find more information about support groups by visiting http://www.mentalhealthamerica.net/go/find_support_group.
The American Self-Help Clearinghouse (http://www.mentalhelp.net/selfhelp/) and the National Mental Health Consumers’ Self-Help Clearinghouse (http://www.mhselfhelp.org/) maintain listings of support groups on a broad range of mental health topics. The National Mental Health Consumers’ Self-Help Group Clearinghouse also maintains a Directory of Consumer-Driven Services (http://www.cdsdirectory.org/) that includes peer-run organizations throughout the United States that offer a variety of supportive services and activities.

Help Paying for Medication
The ongoing cost of prescription medications can be a challenge, especially if you are taking more than one prescribed medication.
Some pharmaceutical companies offer prescription assistance programs to individuals and families with financial needs. These programs typically require a doctor’s consent and proof of your financial status. They may also require that you have either no health insurance or no prescription drug benefit through your health insurance.
In addition, there are county, state, and national prescription programs for which you may qualify and special drug discount cards offered by some pharmaceutical companies.
The Partnership for Prescription Assistance can help qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many will get their medications free or nearly free. For more information, visit http://www.pparx.org/ or call 1-888-477-2669.
Cutting Costs
Discuss with your doctor if switching to generic drugs or less expensive brand-name prescription drugs is a safe option for you. It is important to let your doctor know if you cannot afford your prescriptions. He or she may be able to give you free samples of your medications.
Compare the prices of your prescription drugs at different retail pharmacies. Many retail pharmacies list their prices for commonly prescribed drugs online, or you can call local pharmacies to request prices for your medications.
Want to try out a comparison tool? Check out Destination Rx at http://www.destinationrx.com/ to compare pricing of your prescription medications.
Medicare Part D
Medicare prescription drug coverage, also referred to as Part D, is a program that helps individuals who receive Medicare benefits pay for prescription drugs. This program covers both brand name and generic prescription drugs at participating pharmacies in your area. Everyone on Medicare is eligible, regardless of income, health status, or current prescription expenses.
There are two types of insurance plans that vary in cost and drugs covered:
1.Medicare Prescription Drug Plans, sometimes called “PDPs” only offer the Medicare drug benefit.
2.Medicare Advantage Plans, sometimes called “MA-PDs,” are managed care plans (like HMOs and PPOs) that offer more comprehensive health care coverage, to which the drug benefit will be added.
Extra Help is a program that helps eligible people with Medicare pay for some or most of their prescription drug costs. To learn more about Extra Help, visit http://www.mentalhealthpartd.org/consumers/04_Extra_Help.php.
For more information on Medicare Part D visit http://www.mentalhealthpartd.org/, and click on “Consumers and their Families.”
Want to find and compare Medicare drug plans or enroll? Visit http://www.medicare.gov/Default.aspx.

Paying for Mental Health Care – With Health Coverage
Dealing with insurance plans can be challenging, especially when you are already stressed and worried about mental health issues you or a loved one are experiencing. For this reason, it is best to understand your benefits before you need to use them, if at all possible. The following are steps you can take to make sure you understand your benefits so that you can do whatever is within your control to have your treatment covered.

Reviewing Your Insurance Policy
The first thing to find out is what mental health benefits your insurance policy offers. Review your insurance policy so that you are clear about whether your policy includes coverage for mental health services, types of services that are covered and the amount paid for these services, and any steps you must take to have treatment covered. You should have received a copy of your insurance policy when you enrolled in the program, whether at work or independently. If you did not receive a copy of the policy or have lost yours, you can call your insurance company and ask for another one to be sent to you.
Even if you have a copy of the plan, it is always helpful to speak to someone else and clarify questions. This way you can identify any possible points of confusion before you receive a bill. You should have a number on your card or on the website that will tell you whom to contact.
The following are some questions you will want to ask your insurance company, if possible, before starting treatment:
1) Do I need a referral from my primary care physician to a mental health professional?
Many insurance companies, especially Health Maintenance Organizations (HMOs) require referrals from a primary care physician to visit any specialist, including mental health professionals. If you do not receive a referral before visiting a mental health professional, your insurance company may deny your claims. If you think you require a referral, you should always get it in advance.
2) Do I need any pre-approval from the insurance company before I see a mental health professional?
A referral is an authorization from a doctor saying that the treatment is medically necessary; pre-approval or pre-authorization­ requires that your insurance company agrees to make the payment. You should call your insurance company to see if you need pre-approval, but you should also keep other questions in mind-how many visits are you approved for? Do you need a new approval for each visit? If you are going to be hospitalized or in inpatient care, how many days are you allowed to stay?
3) Do I need to see a mental health professional who is on a list provided by my insurance company (in a “network”) or am I free to choose any qualified professional?
If you need an “in network” provider, you can usually find a directory online or ask your primary care physician to help pick someone out.
4) Does the amount paid by my insurance company depend on whether I see a professional who is “in their network or preferred provider list” or “outside the network”? If so, what is the difference in the amount paid or percent reimbursement for “in network” vs. “out of network” providers?
“In network” providers are almost always cheaper than “out of network” providers, although whether you want to save money or visit a doctor you prefer is a choice you will have to make. Bear in mind that your insurance company may not always have a flat difference. For some companies, seeing an “in network” provider may cost you a $20 co-pay, and an “out of network” provider will cost you $30; in others, “in network” may cost you $20 and an “out of network” may cost you 20% – which could be significantly higher than $30.
5) Are there dollar limits, visit limits or other coverage limits for my mental health benefits? Is there a difference in what is paid for outpatient vs. inpatient treatment? If so, what are my benefits for each of these?
It is not uncommon, based on your state and your plan, to have limits on psychiatric visits or medication management visits. Your plan may limit you to something like 25 sessions with a psychiatrist each year, up to 7 days of inpatient treatment a year, and 12 medication management visits a year. If you exceed these services, you will have to pay out of pocket.
6) Is there a specific list of diagnoses for which services are covered? If so, is my diagnosis one of those covered by my policy?
Insurance companies often have the option to not include certain diagnoses in all policies. If you applied with your condition as a pre-existing condition, they may not cover anything related to that. Your insurance company will provide you with a list of covered and uncovered diagnoses.
7) What prescription benefit does my policy offer? What are the co-pays for medications? Are there different levels of prescription coverage depending on the specific medication? Do co-payments vary depending on whether the medication is generic or name brand?
Not all health insurance plans offer a prescription benefit plan in addition to a treatment plan. Even if you have a prescription plan, not all medications are covered. Many prescription plans have “formularies” that determine how much you pay for different classes or brands of drugs. Covered medications fall into three categories:
•Generic: These drugs are copies of brand-name drugs that have been on the market for a number of years and are often offered at very cheap prices.
•Preferred: These drugs are name brand but are available to you at a price below the retail price.
•Non-Preferred: These drugs are name brand but are not offered at a very large discount.
Insurance companies regularly update their formularies to classify drugs under certain payment categories. It’s best to ask your doctor to help you find out what payment category your drug is in before you go to the pharmacy to avoid an unpleasant surprise when the bill arrives.
However, many prescription medications for mental health conditions are very expensive and even with health insurance, you can find yourself paying a lot for a prescription.
Mail Order Pharmacy – Some insurance plans will allow you to order a three- month supply of maintenance drugs through the mail for a reduced, standard price.
Seek Outside Assistance – Go here to find out other ways to help pay for your prescription medication.

Seeking Help in Understanding Your Policy
If you have trouble understanding the policy, see if someone from your doctor’s office, your employer, or a trusted friend, can help explain the information.
If you receive health insurance through your employer, you may be able to go to your Human Resources department. If your company is large, you may have a dedicated Benefits Specialist who will be able to help you navigate health care. If you work for a smaller business, you will want to talk to the person who arranged the health care. They may not be able to help and their knowledge may be administrative, but they may help put you in touch with an advocate who can put you on the right track. You may be hesitant to admit to your employer that you need help with a mental health condition, but it is not legal for your employer to fire you over a disability.
If you have private insurance, you can contact your state Insurance Department (http://www.naic.org/state_web_map.htm) or state Insurance Commissioner’s office (http://www.naic.org/documents/consumer_hipaareps.pdf (their consumer hotline may be the most helpful) for help in understanding your insurance policy. They can also help you find out whether your company benefits follow the state mental health parity laws (laws that guarantee equal coverage for mental health conditions as for other health conditions), and can assist you in dealing with your insurance company if you are having a problem.

Education and Recovery
An important aspect of recovery involves not only getting better, but also achieving a full and satisfying life. Education can accelerate your recovery process in that it broadens your intellectual, social and emotional horizons. When you go to classes, you not only have an opportunity to expand your knowledge on a wide variety of topics that interest you, but you also have a chance to meet new people. Completing tasks and graduating from courses can give you a sense of pride in your accomplishments. Education can also further your goals in other areas of your life as well – it can help you get a job, and it can help you understand more about things that impact your life such as finances or health.
Education and Mental Illness
Seeking Accommodations
Learning and Career Choices
College and Mental Illness
Education-Related Issues

Education and Mental Illness
Having a mental illness can impact and affect the trajectory of your education in many ways. However, there are alternate academic opportunities at every stage of education that can enable you to continue to learn when you are well enough to do so:
•Special education and alternative secondary schools
•GED and high school equivalency
•Supported education

Special Education and Alternative Schools
If you are still in high school and have had a problem with traditional public schools, alternative schools offer another option. Alternative schools differ from public schools in a variety of ways, depending on the institution. There may be shorter or longer classes or more flexibility on assignments. You may be able to work and go to school at the same time. One type of alternative school is a continuation school. Continuation schools are non-traditional high schools that offer programs to students who have been expelled, are on probation, or have disciplinary or attendance problems.

General Equivalency Degree (GED)
If you haven’t received a high school diploma, you can take a test to receive your GED, which is the same as a high school diploma. The cost for this test may be up to $100, but the tests are frequently less. GED tests are administered at local community colleges or adult education centers. You don’t have to take any coursework to take the test and receive your GED; however, there are limits as to who can take it, and most test takers have completed at least through the 10th grade. If you don’t feel prepared to take your GED, you can take a GED preparation course.

Certificate of Attendance
If you do not meet all the requirements to graduate, such as hours taken or passing grades, you may still receive a Certificate of Attendance from a secondary school. Many schools will offer a plan of action to finish your coursework within a period of time after receiving a Certificate of Attendance.

Supported Education
Supported education is generally geared toward post-secondary college education. You will work with either a supported education specialist or a supported education team, although they may have different titles. Supported education services can include placement services, which help you find a learning path that fits your needs, assistance with admissions, and assistance finding financial aid. You might also receive help with problem-solving skills, test-taking skills, or studying tactics. A supported education specialist may, at your request, serve as an advocate for you and intervene on your behalf in school settings.

Seeking Accommodations
Teachers and professors vary in how accommodating they are to student problems – some may be willing to give you extra time if you ask, and some may tie up your request or deny it. Your academic advisor or student-counseling center may be able to help you if you run into problems.
Like employers, educators are required by law to make school a place that is open to people with and without disability. You may have a disability if your mental health condition prevents you from doing one or more major life activities. Many people with mental health conditions have disabilities. There are a number of federal government acts that cover education issues. Many private schools willingly comply with these.
Primary and secondary education, K-12, are required to provide free and appropriate education by law. Post-secondary educational institutions are not required to provide free and appropriate education, but they are required to take other actions. Schools may not stop your enrollment because of your disability; they must make reasonable accommodations or academic adjustments to your learning; if housing is available to non-disabled students, you must receive housing.
Academic adjustments can vary by the nature and severity of your disability and the school. Common examples include asking for longer time to take tests or asking for help with a student note-taker. You may be able to ask for a reduced course load or for oral tests instead of written ones; however, the more your request changes the class, the less likely it is covered by law. Still, some schools and teachers are voluntarily compliant and may even exceed the legal requirements. If you know other people with mental health conditions who have flourished in a school environment, you should ask them how their schools and teachers helped them.
You should never have to pay more to receive academic adjustments. Each school will have a process for handling academic adjustments; you can usually find this on the website, and if you can’t, you can ask any admissions counselor for assistance.
You will often have to provide documentation to schools about your disability. The burden of proof may be different for a post-secondary school than for a secondary school or an employer. You may need a detailed note from a doctor or a new evaluation.
If you think you have been unfairly discriminated against, you should follow your school’s reporting and grievance procedure. They should have a staff member who is required to ensure compliance with disability and education.

Consider your Learning and Career Choices
You have many choices in higher education beyond high school. Different careers will require very different paths of learning. If you want to be a doctor, you will need an undergraduate degree, you’ll need to pass a test to get into medical school, and you’ll need to spend another several years in medical school, internships and residencies. If you love fixing cars and want to be a mechanic, you’ll have to take a different path; a four-year degree may not be a good investment in time and money. If you want to be a bartender, you might not want to go to school at all; you will want to wait tables and tend bar during a day shift to get more experience to work at night.

Vocational School
Where a community college is more likely to offer courses that are academic in nature, vocational schools focus on specific occupations. Sometimes, community colleges will offer vocational tracks in addition to academic ones. Technical or vocational schools may be very broadly oriented – a large technical school, for example, might offer several degree programs for web design, graphic design, mechanical engineering and auto repair. Some technical or vocational schools, however, are highly specialized. Such schools may only offer training in a single field such as cosmetics for hairdressers and make-up artists, or the culinary arts for future chefs. When you graduate from a technical or vocational school, you will have a two-year degree or a certification.

Going to College with a Mental Illness
Having a mental health condition can affect your ability to study and learn. Because mental illnesses often manifest themselves during teenage years or early adulthood, it is not uncommon for symptoms to appear during the college years. If you become acutely ill while in college, you might need to take time out to seek treatment and stability. Chances are you will be able to continue your education once the condition is well controlled. While the onset of a mental illness can be dismaying, don’t feel ashamed; seek help. Mental illnesses are treatable and recovery is the norm.
You may want to seek a college or university that offers supportive services for students with mental or physical disabilities. Another way to get help is to team up with a mentor or fellow consumer for extra support. You may also find or start a support group for people with mental health problems on your campus.
If you feel that your mental health condition will affect your performance, you may need to reduce your schedule or ask for a reasonable accommodation. Work with an enrollment specialist to make sure that you aren’t jeopardizing your status as a full-time student.
Another option to consider if a mental health condition has prevented you from starting college or caused you to leave college is starting slowly as a non-degree student to figure out how much of a course load you can handle.

Community College
A community college is a public school that offers some college courses and certain certificates, diplomas or 2-year degrees. Students may attend community college to pursue a 2-year degree or a specific certificate to go straight to work afterwards. They may also attend to complete initial coursework before transitioning to another (usually more expensive) school, or take remedial coursework or specific courses as part of joint program. Typically a public community college has lower tuition than four-year colleges, lacks on-campus housing, is accessible by public transportation and offers a variety of enrollment options, from a few hours a semester to night school. Community colleges may be called junior colleges; however, a junior college can be a private institution (not a public one) and therefore typically is more expensive.

Four-Year Colleges and Universities
College most frequently refers to a liberal arts college that offers a four-year undergraduate degree such as a Bachelor of Arts or a Bachelor of Science. A university is generally a school that has an undergraduate college as well as graduate schools that offer advanced degrees like a Masters or PhD. While colleges and universities can be expensive, you can apply for financial aid and outside scholarships.

Distance Education
Correspondence schools allow you to get a degree through the mail. Correspondence schools may offer high school or college-level courses. While there is usually a set finish date, work in correspondence schools can usually be done at your own pace. It is very important for you to understand, however, that if you are someone who needs external structure and discipline to excel, correspondence schools may not provide that structure. You also may not have an instructor that you work closely with; however, instructors will frequently be available by e-mail or telephone. A correspondence school is usually highly affordable.
Telecourse learning might be sponsored by your local college or university. Instead of attending classes in a classroom, you receive your education manual and watch either a live television feed or prerecorded video of a lecture. The instructor is available by e-mail or phone. Like correspondence school, telecourse learning can be done more at your own pace than a traditional school. However, you may have to go to your campus or a pre-designated satellite site to take tests, turn in assignments or study for exams with a group. Telecourses may be more expensive than correspondence courses because they typically have the same cost per credit hour as the university that sponsors them. You will likely need access to a television with a video player, a computer with Internet access, or both.
E-learning or online degree programs have made distance learning more popular and accessible than ever. Many traditional colleges and universities have offered some courses or degree programs online, but recently, schools that specialize in all distance learning have sprung up. In fact, an online college has the highest enrollment of any U.S. university. E-learning can take a variety of forms. In some programs, you may work entirely on your own, reading your textbook and watching lectures online but working largely at your own pace as long as you finish by the end of your semester. Other online degree programs will be highly involved, requiring you to attend regularly scheduled meetings with classmates through technology that lets you see and talk to each other and submit paperwork. You should pick a style of learning that best fits your schedule. You will need a computer and regular Internet access to attend online degree courses.

Other Types of Learning
Tests and Certifications
Depending on your job, a specific certification may be the most reputable thing you can have. You can achieve certifications by taking tests or performing jobs. Some tests will require that you have existing working experience; others do not. For example, human resources professionals may want to have the Professional of Human Resources (PHR) title. To take the test to get PHR certified, you need to prove you have a combination of a degree and certain years of experience. If you want to repair computers, you may need certifications in some computer courses. These certifications may not require experience in the field; you can be self-taught.
Short Courses
Some employment fields have short courses or on-the-job training that can prepare you for what to do. These on-the-job courses, such as ones that train you to work at a crisis hotline, for example, may be sponsored by your employer.
Continuing Education
Even if you already have a degree, the world is constantly changing and it requires you to stay on top. Social workers and other professionals in human services frequently need to keep continuing education ongoing in their careers. Many conferences or seminars may be certified to offer “continuing education” credits if you need this more formally; otherwise, you will want to keep abreast of current topics.
Adult Education
Many community centers or community colleges will offer adult education. These courses are not specific to degree programs or paths of learning but may offer valuable information, such as courses in running a small business or speaking Spanish. These are usually held at night or on the weekends.
Internships
When most people think of internships, they think of college students working without pay in order to earn academic credit. Internships aren’t actually student specific; they are a blend of education and work. An internship usually involves a close relationship with other staff at a business working on specific projects and tasks to refine old skills or learn new ones. Where a volunteer might answer phones or bring food to homeless people, an intern might help a program staff member develop strategies to bring the food to the homeless. Sometimes the line between intern and volunteer can be blurred. Some internships offer an hourly wage or a paid stipend. If you are interested in an internship, make sure you talk to your employer at the interview. Ask about the specific tasks and projects you will work on. You should expect to spend some of your time doing administrative work like filing, but you should also get a sense of a real opportunity to learn on the job.

Common Education-Related Issues
While managing your mental illness and pursuing your education may be difficult at times, making you feel isolated, you are not alone. Many people, including some highly successful people, have found themselves in similar circumstances. Read on to learn more about questions frequently asked by students and prospective students just like you.
What if I’m uncomfortable in school?
Despite efforts to educate the public about mental health and mental health conditions, you may still encounter stigma from people who don’t know or understand what you are going through. If you think that any school official has illegally discriminated against you or violated your privacy rights because of your mental health condition, you should report your concerns to the Office of Civil Rights.
However, you might feel uncomfortable in school even if your teachers and the staff haven’t done anything illegal. Maybe your fellow students are judgmental; maybe your school doesn’t offer enough academic adjustments. Remember, switching schools may be a lot easier than switching work. You should always ask in advance what kind of accommodations a school is willing to make for someone with disabilities.
When would I need an advocate?
Despite efforts to educate people about mental illness, some people still harbor prejudices. Your teachers may not understand your condition, or believe that no one needs adjustments or accommodations. If you encounter problems asking for adjustments like longer test times or student note-takers, it may be helpful to involve an advocate to speak to your educator on your behalf.
How will going to school affect government benefits?
While government benefits such as SSI, SSDI or Food Stamps are generally impacted by wages and employment, attending school may have little or no impact on government benefits you receive. In fact, full-time students often have more benefits available to them. If your campus is large enough, you may have access to a health center or a teaching hospital. You can read more about attending school at http://www.disability.gov/education/.
What are some things to watch out for?
You should always make sure that your school is accredited by proper authorities. Regional and national organizations accredit institutions of learning to make sure they adhere to certain standards. Accreditation validates your degree. If you get a law degree, but your school isn’t accredited, you will not be able to practice law in most areas. It gets tricky because there are both recognized accreditation and unrecognized accreditation organizations. The Department of Education runs a database on accredited postsecondary institutions that can be found at http://ope.ed.gov/accreditation/.

Additionally, you should be aware of the fact that some schools or courses may be run by organizations or persons that have their own agenda and interests other than your education. You should always research the mission of any school you pick.
What are some other things I might need while attending school?
A permanent address – If you’re moving around frequently or staying with friends, you will still want a permanent address so you can receive important school documents. If you visit family and friends and trust them, ask if you can use their address temporarily. Otherwise, you might want to consider getting a P.O. Box from a local post office.
Important Documents – When you apply to a formal school, you may need to have proof of legal U.S. residency. Resident ID cards, passports, birth certificates, social security cards and driver’s licenses may help you with this. Schools are generally less strict about verifying legal status than employers. If you are pursuing adult education, you may need to have proof of address, as many locations offer discounts or require that you live in a certain area. Additionally, you may want to have something that verifies a diagnosis of a mental health condition in the event you need to request accommodations. Schools may ask for an updated diagnosis if you request an adjustment.
Transportation – If you do not have a car, research the schools you are interested in attending to see if they are accessible by public transportation. Generally, most schools and education centers are accessible by public transportation in areas where transportation is readily available. If not, your school might have its own bus system or a way to transport someone with a disability.