Mass General expert Steven Schlozman, MD, offers advice on preparing your child for his or her first visit with a mental health clinician.

The understandable stress of worrying about your child is compounded by a clumsy system that at times seems to conspire against readily available help. Ironically, most of us don’t discover just how hard it can be until we’re in the thick of the storm. When we need help for our children, we need it immediately, and yet, it’s precisely at this moment that we instead spend an inordinate and unacceptable amount of time on hold with various service providers. Dr. Schlozman provides suggestions to help you and your child prepare for that initial visit.

There are some concrete inquiries you should make when scheduling a mental health appointment for your child right off the bat. Many of these might seem basic, but it’s the basic stuff that often gets overlooked.

Steve Schlozman, MD, who practices child and adult psychiatry at Mass General, has plenty of firsthand experience dealing with snow days as a parent.
Steve Schlozman, MD

Plan for Payment

Make sure the practitioner still accepts the form of payment you plan to utilize. If you plan to use insurance, make sure that he or she accepts your particular insurance. If you plan to pay out-of-pocket, make sure that you agree on a fee. We’re well aware that this feels more like buying a car than securing a doctor, but the current system has led to multiple models of practice. Some clinicians find some third-party (insurance) payments inadequate to maintain their clinical practice. This isn’t greed; this is economics. Multiple studies have shown that mental health reimbursements sit squarely at or near the bottom of clinical payments. Add to this the necessary paperwork and phone calls to insurers, and many clinicians have determined that it makes more sense for them and their patients to work directly with one another—even when it comes to finances.

Who Can Prescribe?

While there are plenty of psychiatrists who continue to practice both psychotherapy and psychopharmacology, there are some who prefer to specialize in one aspect or the other. Some psychiatrists do primarily short medication visits; some do lengthy visits. Some do monthly visits, and some do weekly visits. The same can be said of psychiatric nurse practioners, psychologists, social workers and licensed mental health counselors. However, remember that only nurse practioners and physicians can write prescriptions. If you believe your child might need medication and you’ve been referred to someone who can’t prescribe, find out whether that clinician has contacts in the prescribing community with whom you can also work.

What if It’s Urgent?

Some clinicians are available via an answering service or pager. Some will provide you their cell phone number. Though it’s to some extent frowned upon in the medical community, some clinicians will tell you to call the emergency room for urgent issues, and have no other means of reaching them outside of the appointed time. Find out which of these methods your clinician employs, and decide whether you’re comfortable with the form of emergency contact.

Consider the Commute

Weekly visits make little sense if the clinician is a two-hour drive from your home. Alternatively, the clinician might be available only during certain hours. Don’t assume availability before you know both when and where your clinician is located. Also, be prepared to change your schedule if needed. Recall that almost all clinicians are seeing many, many patients. You can inform clinicians when you would most like to see them, but know as well that there may be some schedule horse-trading before you settle on a time.

To read the full article, click here. Steve Schlozman, MD, is a contributor to The MGH Clay Center for Young Healthy Minds and an assistant professor of psychiatry at Harvard Medical School.