Getting Help & Talking to your Mental Healthcare Provider

Do you think you suffer from a mental illness?

While being diagnosed with a mental illness can be frightening, many people say that being able to put a name to the symptoms you are feeling can be comforting. Understanding your illness will help you and your care providers to take the steps required for recovery. But if a television personality is the only therapist you have ever heard of, sorting out who to talk to and how to get help can be very confusing and overwhelming. Here are some tips to help you get started on your road to recovery.

There are as many different types of care providers as there are types of problems. Talk to your family doctor, they may be able to refer you to an appropriate care provider.
Remember that your care providers are actually working for you. Before you begin make sure that you know what it is that you want. If you’re not sure, then ask your primary care provider for information, education and their recommendations.
There are lots of people who provide treatment, counseling and therapy. Some have formal training and credentials, and others do not. It can be client beware so it’s important you know the differences to make the best choices for yourself. When you are making your first phone calls to a provider, consider these questions for them.

•What's your education and professional/clinical training?
•Have you got experience in treating your particular condition or disorder?
•Are you a member of a professional association or college?
•How long have you been practicing?
•Do you have experience with my specific problem?
•Did someone you trust and respect refer you?

Your 'gut' feelings about the person on the other end of the phone shouldn't be ignored. If a provider refuses to provide any information, try to find someone else to talk to. Most conditions have recommended evidence based treatments that have been shown to help. Ask your mental health provider if they are aware of these and able to provide the recommended treatment. You may be able to do your own research and find out what the recommended treatments are from a treatment guideline, professional association, university, government public health agency or consumer association.
How to talk to your health care provider

There are several different ways to communicate with your care provider. Here are three styles of interacting and communicating with your provider. Each style offers quality based care. It is important that you choose a style that you are comfortable with.

Active-Passive Style
• When your care provider actively makes most care decisions for you. Some people find this comforting.
Guidance-Cooperation Style
• When your care provider guides you through your options, points outs the pro’s and con’s of each, advises you of what they think is best for you, and you often go along with the advice and recommendations as you trust their judgment.
Mutual Decision Making Style
• You are an equal partner in all decisions. You may decide differently from your providers recommendations and you accept a great deal of responsibility and accountability for your care decisions. Your provider is comfortable in working with you and your decisions, even if it’s not their first choice. Your provider may still refuse to go along with care decisions they feel are harmful or inappropriate.

In identifying your preferred style of interaction it is important that you try to develop a good fit between your style and your provider’s. Be aware that any one provider will also have their own preferred style or styles of how they deliver care. And you can’t tell them what style of care to practice. That’s their choice and out of your control.

Tell your provider your preferred style and way of participating and discuss it with them so that they know how to best meet your care needs. All styles of care can be of high or low quality despite your personal style preference and perceived level of satisfaction.

In an emergency safety comes first. You might not obtain your preferred style of care and may benefit from tolerating a variety of styles. There may be emergency situations when it’s in your interest for care providers to take over, and for you to take their advice and direction. In emergency situations there are laws and legislation that guide and oversee the provider’s action, intended to protect your civil rights and freedoms balanced with the need for emergency care.

Before your care visit

•Write down the most important things you want to discuss or ask so you don’t forget
•Educate yourself about your condition using quality evidence based information
•Ask your provider what you can expect at your care visit (e.g. time, cost, insurance coverage)
•Ask a trusted friend/family member to go with you
•Send your questions or concerns to your provider ahead of your visit so they have a chance to review and be clear about your concerns.

During your care visit
•Ask if it’s ok for a trusted friend/family to accompany you -they can help remind you what was discussed or speak for you. It’s easy to forget or misinterpret when you’re feeling unwell.
•Write things down if needed or ask the provider to write things down for you
•Ask for take away information or recommended information sources
•Communicate using the first person “I” statements in sentences - e.g. “I feel unclear about” it’s more effective than “you didn’t tell me” and more likely to get you a better response

After and between care visits
•Review your notes
•If accompanied by a friend or family then discuss what was said to clarify and synthesize your understanding and concerns.
•Educate yourself with quality information
•Write down and prepare the next most important things you want to discuss
•If something doesn’t seem right, contact a professional regulatory authority to inquire about standards of care and report any inappropriate behavior

Questions to ask yourself after the first few sessions:
•Am I beginning to trust this care provider?
•Does the provider seem to understand me?
•Do I feel at ease with the therapist even though it's a difficult situation?
•Are the fees okay and in keeping with the standard or appropriate range?
•Is the location as good as possible?
•Do I feel comfortable in the care provider’s office?
•Can the therapist accommodate my schedule needs as much as possible?
•Do I feel that we make a good team?
•Do I feel heard?
•Do I feel supported?
•Do I need a second opinion?
•How long will I need treatment? What’s the end point?

Make sure that you feel comfortable. Remember, this is an important and courageous step that you have taken and you need to be on the journey with someone that you know you can count on and feel is appropriately knowledgeable and skilled to help you.
The goal of treatment is recovery if possible. Ideally therapy and care will make you more able to function independently and at some point no longer need treatment. Therapies and treatments that make you more and more dependent should be questioned and need a clear and convincing reason. Sometimes mental health conditions are chronic and may require ongoing monitoring and treatment to help you maintain your best possible health, ease suffering and help functioning.
If you don't feel that you and the provider are a good fit, let them know. Some problems can be resolved but sometimes it's just a matter of 'mismatched or poor fit between you and the care provider. This is no one's fault but will require you to find a different provider if possible and available.

If you need to find a new provider ask your current one to help you by providing some recommended names. They should be able to accommodate this request. You can also check with your local professional organizations, health care centers, or speak to your primary care physician or provider. Getting a name of a provider by word of mouth from someone who’s had a positive experience is another good approach.
Mental health care providers are dedicated, caring, concerned and understanding people. They’ve chosen helping others as their career and life’s work. Most of them will be helpful or at least steer you in the right direction. And they know you may be uncomfortable or ashamed at first. They’re used to that, and will work to help put you at east. They’ll explain and remind you that mental health conditions are not your fault. Their knowledge, skills and training will help you understand your condition and experiences, and help you work towards recovery.

The most important step is that you seek out help and talk to someone. It can be life saving.

Suggested resources include:

http://www.ccmhi.ca/
http://www.nnmh.ca/
http://www.cmha.ca/bins/index.asp
http://www.mooddisorders.on.ca/therapist.html