Healthy Tahoe: Mental health systems of care

Tracy Protell, MD

As regularly identified, mental health and access to care are top concerns impacting our region’s health and well-being. Across the nation, care providers, health systems, and local agencies are grappling with the same issue.

Locally, we continue to work on addressing these needs through strategic partnerships, population health initiatives, educational campaigns, and multifaceted care teams, but the work is ongoing and can always be improved.

Accessing mental health care can be overwhelming, especially when you or a loved one is struggling with mental health. And depending on your insurance, where/ how you access mental health care may be different.

Mental health concerns are categorized as either severe, meaning it considerably interferes or limits major life activities, or mild to moderate, when a person has a small number of symptoms that have a modest effect on their daily life. Mental health professionals receive specialized education and training to address a variety of mental health issues, including:

  • Psychiatrist — medical doctors who diagnose, plan treatment, and dispense psychiatric medications. While trained in psychotherapy, psychiatrists are not usually a primary therapist for patients.
  • Nurse Practitioner — advanced practice providers who train in psychiatric care and can diagnose mental illness, create a treatment plan, and prescribe medications.
  • Psychologist — doctorates (PhD or PsychD) who diagnose, provide testing, and psychotherapy (often called talk therapy).
  • Licensed Clinical Social Worker — a licensed professional who can diagnose mental health conditions and are usually well trained in a variety of psychotherapies. Patients may or may not also have a psychiatrist.
  • Marriage and Family Therapists — licensed to diagnose and treat mental health and substance abuse problems through therapy techniques. Treatment often involves family systems. Patients may or may not also have a psychiatrist.

These mental health professionals may see patients as part of a health system, a group practice, or private practice.

For mild to moderate mental health issues:

  • If you have private insurance (not Medicare, Medi-Cal, or Medicaid), you should contact your insurance provider for a list of in-network mental health providers. Plan to contact several therapists to find availability and a good match. Not all patient-therapist relationships click and that is OK.
  • If you have public insurance like Medicare, Medi-Cal or Medicaid, you will need to obtain a referral for mental health services through your primary care provider or clinic, or contact your county mental health services for available resources.
  • If you are “private pay” (paying out of pocket through cash, sliding scale fees, HSA, credit card, or check), you should contact therapists directly. Again, plan to contact several therapists before finding an appropriate appointment and visit for additional information.

For severe mental health issues:

  • If you have private insurance (not Medicare, Medi-Cal, or Medicaid), obtain a referral from your primary care provider to a psychiatrist.
  • If you have public insurance like Medicare, Medi-Cal or Medicaid, contact your county mental health department.
  • If you or your loved one is experiencing a severe mental health crisis and needs support now, visit a nearby emergency department or call 911.
  • The Suicide Lifeline is a confidential and free resource — call/ text 988 anytime. 

Like your physical health, taking care of your mental health is important and can have a meaningful impact on your overall well-being. Knowing where and from whom to seek help will give you a head start toward better health and stability in time of need.

Dr. Tracy Protell is a child and adolescent psychiatrist with Barton psychiatry and mental health. For more information about taking care of your mental health, or for a list of area resources and crisis lines, visit

Tracy Protell

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