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Behavioral health

Your plan covers health for you as a whole person, not just your physical health. A lot of people have mental health conditions like depression or anxiety. Many others have substance use disorders. You deserve to be healthy in body and mind. And we can help.

Questions?

Just contact us. You can also check out your member handbook on our member materials and forms page.  

Help in a crisis

Help in a crisis

Call 911 or go to the nearest hospital if:

 

  • You have thoughts of harming yourself or someone else
  • You have an emergency and need help right now

You can use any hospital for emergency care, even if it isn’t in our network. Just show your member ID card.

 

The National Suicide Prevention Lifeline has counselors that will talk or chat with you. You can get help 24 hours a day, 7 days a week:

 

24-Hour Behavioral Health Crisis Hotline  

 

We’re here for you 24 hours a day, 7 days a week:

 

Then, choose the option for crisis. We’ll connect you with a mental health professional. 

Your partners in care

Your partners in care

Your care manager and your primary care provider (PCP) can help you stay as healthy as possible. Work closely with your whole health care team to meet your goals.

 

Your care manager

 

Talk with your care manager if you might need behavioral health services. They can help you make an appointment. 

 

Your PCP

 

If you think you might need behavioral health services, you can also contact your PCP. They can help you decide which next steps you should take.

 

Are you already seeing a behavioral health provider? If yes, tell your PCP. They can better help you with a complete picture of your health.

 

Your PCP also needs to know about all the medications you take. Why? Some medications shouldn’t be taken together. Knowing about your medications can help your PCP prevent problems with side effects.

 

Do you need help talking with your PCP about your behavioral health care? We can help. Just contact us.

We’ve got you covered

 

Behavioral health benefits cover treatment for mental health and substance use disorders. We want to help you feel better and support your recovery. So we cover many behavioral health services, like:

 

  • Counseling
  • Hospital care
  • Day treatment
  • Crisis services

 

You can get these services in your home or in the community. And you don’t need a PCP referral. You can get care from any provider in our network.

 

Not sure what services we cover? Just contact us. We can help coordinate the services you need.

Your new and improved mental health benefits

 

Your mental and behavioral health are key to your overall health and well-being. We want you to have access to quality services. You can now get these new benefits and services.

 

Questions? Just contact us. You can also ask to speak with your care manager about these enhanced benefits. Or check your member newsletter (PDF).

ACT takes a person-centered approach to your care — in the community where you live. ACT helps adults manage severe mental illness during recovery. Trained staff will work with you to create a plan for day-to-day life and build important life skills. They’ll help you manage your medicine. ACT services also help you coordinate your next health care visits. That way you get the follow-up care you need when you need it. ACT is for adults living with serious mental illness.

We offer MH-PHP services at least five days each week and four hours each day. It’s a structured program in a safe environment. It doesn’t require an overnight stay. Health care staff will work with you on how to handle a crisis and be safe. They’ll also work with you on your symptoms to help prevent a future setback. They use a variety of approaches in caring for you. This program is for adults and children.

MH-IOP takes place at least three days a week. It is a structured program in an outpatient setting. It includes therapy and help with building life skills. Treatment for substance use, care coordination and behavior change may also be part of the program. MH-IOP is more intense than traditional outpatient services. This can help support you so you stay out of the hospital. This program is for adults and children.

MST works with the family, school and community to aid at-risk youth. Its aim is to support those who need help with substance use, behavior or mood. The service helps youth stay in the home and in school. It helps keep them out of trouble, the hospital or other facilities. Positive behavior is modeled. This program empowers parents and guardians, as well as youth. It’s for adults and adolescents.

FFT helps at-risk youth. Trained staff work with the family. This is done to address the behavioral or emotional needs of their child. The focus is on strengthening family connections and creating positive behaviors. Its aim is to keep children in the home and school and out of the hospital or justice system. A community partner may refer a child they see as at risk. The program is short term, for adults and adolescents. 

A mobile crisis team comes to you during a crisis. They’ll help you work through the crisis and make sure you’re safe. They assist with trauma and can connect you to helpful resources where you live. This can help you stay out of the hospital. This program is for adults and children.

These services take place in the community. They only last a short time and are meant to stabilize someone after a mental health crisis. This program is for adults and children.

This is a walk-in program where you can go in for evaluation when you notice a big change in how you feel. It’s meant to help you before a crisis takes place. You can access this service 24 hours a day, 7 days a week. It takes place in a clinic-type setting where you can stay up to 23 hours. This program is for adults and children.

Trained staff will help you when you’re having a mental health or substance use crisis. The service takes place in your community at a residential crisis unit. It is meant to support you during this time and keep you out of the hospital. This service is offered 24 hours a day, 7 days a week for a short time. This program is for adults and children.

On December 1, 2021, the Department of Medical Assistance Services (DMAS) will change Behavioral Therapy to Applied Behavior Analysis (ABA).

 

What is ABA?

 

ABA is behavioral therapy for children. The goal of these services is to help the child:

 

  • Build social skills
  • Improve communication
  • Learn other new skills to use in their daily life

 

Avoid duplicate services

 

Duplicate services are services that you can’t combine with ABA. These include:

 

  • Intensive in-home care
  • Mental health skills building
  • Family functional therapy (FFT)
  • Partial hospitalization program
  • Assertive community treatment

 

Note for FFT: You can get approval for a 14-day authorization if you have an FFT admission or discharge.

Mental health services

You can also learn more about our standard mental health benefits and services. Here are a few that we want you to know about.

 

Addiction is a treatable mental illness. If you or someone you know has a substance abuse disorder, you’re not alone. Many people use substances at some time in their lives. There’s good news, though. Most people can benefit from treatment, no matter how bad the problem may seem. If you need treatment, we have ARTS to help.

 

We cover a range of treatments and we’re here to help. The first step? Talk with your PCP. Ask for more info about treating problems with substance use or alcohol.

 

Your doctor and health care team can work with you to find the best treatment. Some ARTS include:

 

  • Inpatient, outpatient, residential and community‑based treatment
  • Medication-assisted treatment for those dealing with prescription or non-prescription drug use
  • Peer support services (working with people who’ve had success in the recovery process)
  • Care management

You can find an ARTS provider in your provider directory. Or ask your care manager. They can talk with you about your care options. You can also contact us to learn how to get ARTS.

 

Some services need preapproval

 

Your provider needs to submit the ARTS Service Authorization Review Form for some services that need preapproval, like: 

 

  • Intensive outpatient services
  • Partial hospitalization services
  • Clinically managed low-intensity residential services
  • Clinically managed population-specific high-intensity residential services
  • Clinically managed high-intensity residential services
  • Medically monitored intensive inpatient services
  • Medically managed intensive inpatient services

Living with a mental health problem or recovering from substance abuse can be a long journey. You can help your chances for recovery with support. You don’t have to do it alone. It can help to talk with someone who knows what you’re going through. 

 

Peer providers

 

Peer providers are people who:

 

  • Have completed peer recovery training
  • Are trained to share how they achieved success
  • Support you on your journey to recovery, one step at a time
  • Help you build a circle of support you can count on

 

What are Peer Support Services?

 

We have two types of services:

 

Peer Support Services is for adults with mental health or substance use issues. Peer providers help you reach success by:

 

  • Supporting you as you find your path to recovery
  • Helping you understand what to focus on
  • Helping you understand how to work with your health care providers

These services can help you live a healthier life in your community.

 

Family Support Partners is for caregivers of children with mental health or substance use issues. Peer providers:

 

  • Have had real life experiences parenting a child with mental health or substance use issues
  • Have completed peer recovery specialist training

Parents with a child with these problems can get help from someone who understands the issues. They know how to get the help you need. They can also help find resources to support your family.

 

Can I get Peer Support Services?

 

Ask your provider if they offer these services. You can also learn more about how peer providers can help with substance use disorders. Just contact us.

 

MHSS is for youth under 21. These services are for those experiencing symptoms of a mental health problem, such as:

 

  • Major depressive disorder
  • Bipolar disorder
  • Schizophrenia
  • A similar mental health condition

Trained staff work with families to provide their child with support and goal directed training. The focus is to help them achieve independence and stability in the community.

 

These services include training in areas like:

 

  • Functional skills and behavior related to health and safety
  • Daily living skills and use of community resources
  • Managing health, nutrition, personal care and hygiene
  • Medication management

Questions about MHSS? Ask your care manager. They can talk with you about these services. You can also contact us to learn more.

IIH care provides highly supportive home-based services for youth who are at risk of removal from their home. The goal is to provide stability for the child and their family when the child is experiencing a mental health crisis. It aims to keep the child in the home with the family and out of the hospital, foster care or justice system.  

 

To qualify for these services, the child must fit into one of these groups:

 

  • At risk of out-of-home placement
  • Transitioning back into the home from an out-of-home placement

Ask your care manager if you’d like to learn more about IIH services. Or just contact us.

TDT provides services to youth in a school setting. Children and adolescents get two or more hours of services per day. The goal is to address mental and behavioral health issues that create a barrier to effective learning.

 

These services include:

 

  • Assessment
  • Help with medication management
  • Interventions to build daily living skills or enhance social skills
  • Individual, group and/or family counseling and care coordination

Need to learn more about TDT? Ask your care manager. Or just contact us.

PSR is a type of treatment designed to help improve the lives of those living with a mental health problem. These services take place in the community. Those who take part get coaching and education to help them develop emotional, cognitive and social skills. The goal is to help them live and work in their communities as independently as possible.

 

Questions about PSR? Ask your care manager. They can talk with you about these services. You can also contact us to learn more.

More about behavioral health

Learn to manage stress

 

Did you know that stress can affect your health? It can be hard to keep up with healthy habits during times of stress. 

 

You can read these articles to learn more about mental and emotional well-being:

 

Staying mentally healthy in tough times

 

Understanding depression

 

Healthy living resources

 

4 ways to take care of physical and mental well-being during unsettled times

 

Or learn more about depression from the National Institute of Mental Health.

Substance use disorders happen when people misuse drugs, alcohol or both, repeatedly. Often, substance use is related to mental health. 

 

More about substance use disorders

 

Or find more info from:

 

Alcoholics Anonymous®

 

Addiction resources

 

Talking about addiction is hard. It’s not easy knowing what to say or how to say it. There’s no right or wrong way to let a loved one know you care. Try these tips to start:

 

  • Offer your support with an open ear.
  • Be ready to listen.
  • Avoid judging or criticizing.
  • Offer to go with them to get help.

Keep in mind that your loved one’s addiction isn’t your fault. You can support them. But getting treatment is their decision.

 

You can also call the national helpline for the Substance Abuse and Mental Health Services Administration (SAMHSA). The number is 1-800-662-HELP. It’s:

 

  • For people and their families dealing with mental and substance use disorders
  • Confidential and free
  • Here for you 24 hours a day, 365 days a year

You can also visit the SAMHSA website.

Mental health disorders can be serious. They can change a person’s thinking, feeling, mood and daily functioning. And each year, they affect:

 

  • 1 in 4 adults  
  • 1 in 10 children  

Some examples of mental health disorders include:

 

  • Depression 
  • Schizophrenia 
  • Bipolar disorder 
  • Obsessive-compulsive disorder (OCD) 
  • Post-traumatic stress disorder (PTSD) 
  • Anxiety 
  • Borderline personality disorder 

 

For more info, visit the National Alliance on Mental Illness (NAMI) website.

 

There, you can learn about the different support programs NAMI offers, including:

 

Peer-to-peer

 

A no-cost course for anyone living with mental illness. Those who join can learn about coping skills and self-care.

 

Family-to-family

 

A no-cost course for family caregivers of adults living with mental illness. It teaches communication and problem-solving skills to help them deal with the impact on the family. 

 

StrengthOfUs.org

 

An online social community for teens and young adults living with mental illness. It’s a place for them to connect and learn about services.