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Washington, D.C. Mental Health Services Guide

Many people don't realize that publicly-funded mental health services are available where they live. People looking for free or low-cost counseling often think their only options are counselors in private practice and don't know that publicly-funded providers in their communities may also offer counseling services. 


While public programs are not for everyone, they're often a great place to start for people who face geographic, clinical, or financial barriers to therapy. Intake specialists at community mental health programs can help people learn whether they qualify for publicly-funded services and can refer people who don't qualify to other low-cost programs that may be able to meet their needs.


When Should You Go to a State Mental Health Program?


Few private mental health providers are able to immediately serve people in crisis, while most public mental health programs, including the District's, have crisis response systems that help people get mental health care quickly in an emergency. This usually makes public mental health programs the best option if you're having a mental health crisis and need help right away. The people who answer crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it's inpatient treatment or an appointment with a counselor.


The DC Department of Behavioral Health (DBH) contracts with nonprofit mental health agencies to provide publicly-funded outpatient mental health services. In addition to affordable therapy, public mental health clinics provide specialized and intensive services that aren't available anywhere else or that are hard to find in private clinics, like case management and day treatment. Consider seeking services at a public program if you need intensive treatment or can't access mental health care in the private sector due to your diagnosis or financial situation.

Who Is Eligible for Public Mental Health Services in Washington, D.C.?


The District of Columbia's public mental health system includes two different types of outpatient mental health providers: Core Service Agencies (CSAs) and free-standing mental health clinics (FSMHCs). The main difference between CSAs and FSMHCs is that CSAs are part of the DBH's Mental Health Rehabilitation Services (MHRS) program, while FSMHCs are independent of the MHRS program. There are different eligibility criteria to qualify for services at CSAs and FSMHCs.


To be eligible for MHRS services, you must be a District resident and have a severe mental illness (SMI). This means you must have a mental health condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that significantly disrupts your daily life and limits your ability to function independently. Examples include a psychotic disorder that requires you to live in supportive housing or a severe depressive disorder that has made it impossible for you to maintain employment and that has isolated you socially.


The eligibility criteria for FSMHCs are less strict. Programs that qualify as FSMHCs are freer to determine their own eligibility criteria and typically don't limit services to people with SMI. However, criteria vary from program to program, and it's not always easy to tell which DBH-certified programs are CSAs and which are FSMHCs. Some DBH-certified programs operate as both. The best way to find out whether you're eligible is to call a program you're interested in or call the Access HelpLine (888-793-4357). Even if you don't qualify, the counselor you speak with will usually be able to give you referrals to affordable nonprofit providers.

How Can You Find Out More About Local Programs in Washington, D.C.?


The best way to find out about public mental health services in Washington, DC, is to contact the program you're interested in directly or call the Access HelpLine at (888) 7WE-HELP or 888-793-4357. The Access HelpLine serves as a central information and referral hub as well as a crisis line for people who need immediate care. Any people seeking information about mental health care for themselves or loved ones can use the Access HelpLine whether they are in crisis or not.


For general information about the public mental health system in the District, you can call the DBH general information line at (202) 673-2200. You can walk in for a same-day assessment at the DBH clinic at 35 K Street NE and can reach the K Street clinic by phone at (202) 442-4202. The direct number for the adult mobile crisis team is (202) 673-9300. The next section of this article includes contact information for certified public adult mental health providers in Washington, DC. Some providers have stricter eligibility criteria than others. We recommend contacting them directly to find out whether you're eligible to receive counseling or other services there.


Washington, D.C.'s Mental Health Clinics and Access Numbers



Federally qualified health centers (FQHCs) are another option for public mental health care in the District. These federally-funded programs provide medical and mental health services to people in underserved communities. Their goal is to deliver high-quality coordinated care to people with complex needs and to link behavioral healthcare with primary medical care. Each FQHC accepts Medicaid and Medicare and offers sliding-scale fees to people without insurance. You can search for FQHCs using the online search tool on the U.S. Department of Health and Human Services website. 


How Does Washington, D.C.'s Public Mental Health System Work?

In the 1960s, Americans started thinking differently about how to treat mental health conditions. New laws required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. Many states' public mental health programs trace their origins back to this period.


The District of Columbia is a unique case. The densely populated "city-state" needed a mental health system but lacked the same government and funding structures as states that started building their mental health systems in the 1960s and 1970s. This delayed its transition to a community-based system. In 1974, people committed to Saint Elizabeths, the District's public psychiatric hospital, sued the District, arguing that the lack of community-based mental health services violated their civil rights. The judge ruled in their favor. In response to the ruling in the Dixon v. Weinberger lawsuit, the federal and District governments started building a community-based public mental health system in the District of Columbia in 1980.


Like the public mental health systems in most states, the District's system has changed over the decades since its founding. Currently, the main role of the DC Department of Behavioral Health is to fund and oversee the independent nonprofit programs they license to operate as Core Service Agencies and free-standing mental health clinics. However, DBH continues to directly operate the following programs: Saint Elizabeths Hospital, forensic mental health programs, the Comprehensive Psychiatric Emergency Program, Mobile Crisis Services, the Access HelpLine, and the mental health urgent care clinic at 35 K Street N.


According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 42 percent of people in the District of Columbia who have mental health conditions get treatment for them. One reason for the care gap is that people aren't aware of their options for affordable mental health care, including services offered by Core Service Agencies, free-standing mental health clinics, and other public programs. You can help change these statistics by reaching out and using local mental health resources to get the care you need.

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