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Your (Unofficial) Guide to Publicly-Funded Therapy in Washington, DC

There’s a way to get affordable mental health care that you might not know about. That’s the public mental health system in Washington, DC.

If you qualify, you can get mental health care at a publicly-funded program for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services, your local program can usually still help you by giving you information, referrals to affordable local providers, and other essential help for free.

If you’re in a hurry and want to get the most important information about what’s available in the public mental health system and who it’s for, you can read our quick start guide below.

Quick Start Guide

Quick facts about the mental health system in Washington, DC:

  •     Washington, DC, has made several updates to its mental health crisis response system in the last few years, including launching the 988 crisis line.
  •     All public mental health programs in Washington, DC, accept Medicaid and many offer low sliding-scale fees to people without insurance coverage.

What services are available?

  •     Core Service Agencies in the District of Columbia’s mental health system offer specialty and intensive mental health services that can be hard to find anywhere else, like case management, day treatment, and community-based services.
  •     Outpatient mental health services including psychiatric evaluation, medication management, and group and individual therapy are also available in most publicly-funded mental health clinics.

Who’s eligible?

  •     Some services, such as crisis and information lines, are available to any Washington, DC, resident without exception.
  •     Some services are only available to people who have severe conditions like major depression or schizophrenia. However, more people have one of these conditions than realize it! In fact, 1 in 10 Americans experience major depression each year.

Where can you get started?

  •    You can connect with crisis and information services anywhere in the District of Columbia by dialing (888) 793-4357.
  •     You can find numbers for publicly-funded mental health agencies in Washington, DC, by scrolling to the directory below.

To learn more about public mental health services in Washington, DC, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if the District of Columbia’s mental health system might be right for you.

Who Is Eligible?

The public mental health system in Washington, DC, can serve a wide range of needs, but you should especially consider looking into it if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have Medicaid, or have a limited income.

Everyone in Washington, DC, can use the public mental health emergency response system. If you or someone you love is in crisis, you can call a crisis line to get the help you need, quickly.

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Use the Public Mental Health System When You're in Crisis

Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.

The public mental health system is required to provide crisis response services and is the fastest way to get care when you’re having a mental health emergency.

The people who answer national and local 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.

Even if you’re not in crisis, you can call the DC mental health hotline for information about mental health services in your area. When you call, you can find out whether you might qualify for public mental health services, schedule an assessment, or get free information about other affordable providers in the area.

Other parts of the system have stricter eligibility requirements. You need to have a serious mental health condition (a diagnosable condition that affects your daily functioning) to qualify for some types of public mental health care in Washington, DC. This includes many specialty and intensive services that you can find at Core Service Agencies.

However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!

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Check Out Publicly-Funded Programs If You Need Specialized Services

Public mental health programs in Washington, DC, are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.

The Washington, DC, public mental health system includes two different types of outpatient mental health providers: Core Service Agencies (CSAs) and free-standing mental health clinics (FSMHCs).

Both types of programs are licensed by the Department of Behavioral Health to provide outpatient mental health services. However, CSAs are more specialized and have stricter eligibility criteria.

Core Service Agencies are part of DBH’s Mental Health Rehabilitation Services (MHRS) program and provide specialty services for people with serious mental illness (SMI). In many cases, you have to have SMI to qualify. On the other hand, free-standing mental health clinics are not part of the MHRS program and don’t have to offer specialty services. Their eligibility criteria are not as strict.

MBI Health Services, an agency that offers both CORE and free-standing clinic services, puts it simply: “While our free-standing services are easily accessible by the public, CORE is not.”

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What Is Serious Mental Illness?

Most Core Service Agencies in Washington, DC, require you to have a diagnosis of a serious mental illness (SMI) to be eligible for services. Serious mental illness is usually defined as a condition that causes you severe distress, limits your ability to function, makes it hard for you to live independently without support, or puts you at risk of hospitalization. Conditions that can qualify as SMI include schizophrenia, bipolar disorder, and major depression.

Free-standing mental health clinics are usually a better option if you don’t have severe symptoms. However, it’s not always easy to tell which DBH-certified programs are CSAs and which are FSMHCs. Some programs even operate as both.

And even among similar types of programs, eligibility criteria can vary from program to program. So, the best way to find out whether a program might be right for you is to call the program you’re interested in directly. You can find contact information for publicly-funded mental health programs in the directory below.

Even if you’re not eligible, or if the program you call doesn’t offer the service you want, they can probably still help you. The people who work at these programs are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.

Where Do You Call to Get Started?

The easiest way to learn more about public mental health services in Washington, DC, is to call the Access Helpline at (888) 793-4357. You can call whether you’re in crisis or not, because it’s not just a crisis hotline—it’s an information and referral service for all of Washington, DC. The people who answer your call can help no matter what kind of mental health help you’re looking for.

You can find other helpful mental health hotlines for Washington, DC, in the information box below.

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Important Numbers in Washington, DC

The national and local mental health crisis line is 988.

The Crisis Text Line in Washington, DC, (and nationally) is 741741.

You can connect with emergency mental health services in Washington, DC, by calling (202) 673-9319.

You can get mental health information, referrals, and crisis support in Washington, DC, by calling the Access Helpline at (888) 793-4357.

You can reach the National Alliance on Mental Illness (NAMI) Helpline by calling 1-800-950-NAMI (6264).

You can get local support on weekdays from 9AM to 5PM by calling the NAMI DC Helpline at (202) 466-0972.

You can reach the Department of Behavioral Health, which oversees the public mental health system in Washington, DC, by calling (202) 673-2200.

Public mental health services in the District of Columbia are managed by the Department of Behavioral Health. For general information about the public mental health system, you can contact the main DBH office at (202) 673-2200.

The Department of Behavioral Health provides some direct services including information and crisis services.  You can walk in for a same-day assessment at the DBH urgent care clinic at 35 K Street NE and can reach the K Street clinic by phone at (202) 442-4202. The direct number for the mobile crisis team is (202) 673-6495.

However, the best place to start is usually the Access Helpline at (888) 793-4357. In addition to serving as a crisis hotline for Washington, DC, it also serves as a central information and referral helpline and is the main entry point for public outpatient mental health services in the District.

You can also try calling the program you’re interested in directly. You can find the numbers for publicly-funded outpatient mental health clinics in Washington, DC, in the directory below.

District of Columbia Mental Health Directory

There are two types of publicly-funded outpatient mental health providers in Washington, DC: Core Service Agencies (CSAs) and free-standing mental health clinics (FSMHCs). Core Service Agencies provide services to people with serious mental illness, while free-standing mental health clinics provide services to a wider range of people.

You can often get therapy and medication at both types of providers, but CSAs have stricter eligibility criteria than FSMHCs. Many publicly-funded agencies run both types of programs. The best way to find out whether a particular agency is right for you is to call them directly.

The following list includes CSAs and FSMHCs that are certified by the Department of Behavioral Health to provide publicly-funded outpatient mental health services to residents of the District of Columbia.

Washington, DC, Mental Health Clinics

If you’re not sure where to start or what kind of services you need, you can call the Access HelpLine at (888) 793-4357. The staff who answer are trained to quickly figure out what you need and can tell you what steps you need to take to connect with the right services.

The Access Helpline is not only the crisis hotline for the District, but it’s also the primary point of access for services certified by the Department of Behavioral Health. Some Core Service Agencies even prefer clients to call the Helpline first to get a referral instead of calling them directly. It’s available 24/7 and is the quickest, easiest way to get the mental health help you need in Washington, DC.

Also Consider: Federally Qualified Health Centers

Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Washington, DC.

These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care so you can get primary medical and mental health services at the same location. Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance.

You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.

Troubleshooting Guide

The public mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.

Problems and Solutions

 1.   You can’t get through to someone on the phone.

Except in extremely rare circumstances, someone should answer the Access Helpline or other mental health crisis lines any time you call. But if you’re not in crisis, the person you talked to gave you another number to call, and you’re having a hard time getting through, you can try going to a walk-in clinic instead.

Many Core Service Agencies and free-standing mental health clinics in Washington, DC, run walk-in centers where you can be seen during regular business hours on Monday through Friday. Some let you walk in and wait without an appointment. You can often be seen the same day. If the wait is long or they don’t have availability, you can schedule an appointment and come back.

We recommend checking program websites for clinic locations and hours.

2.    There’s a long waiting list.

Publicly-funded services are often in high demand. The District of Columbia is working to shorten waiting times and make sure you can get seen for essential services right away. However, if you’re not in crisis, you may still have to wait before you can be seen by a therapist or other mental health provider.

Sometimes, it’s worth it to wait if you’ve found a good therapist or service. You can read our article on what to do before your first therapy session for tips on how to maintain your mental health while you wait.

If your symptoms are getting worse and you’re worried you can’t wait, you should call a crisis line. The caring people who answer can help you figure out if you need help right away and can tell you where and how to get the level of care you need.

If you’re not in crisis but don’t want to wait, you can call the Access Helpline, an intake worker, the main number, or your contact person at the agency to ask if there are other options. There may be another affordable local program they could tell you about that could meet your needs but has a shorter waiting list.

3.    You’re not eligible for publicly-funded services.

If you’re not eligible for publicly-funded mental health services at a Core Service Agency or free-standing mental health clinic in Washington, DC, you’re not eligible for the service you want, or a local program doesn’t offer that service, the people who work at public programs in your area should still be able to help you.

Intake workers usually keep lists of affordable local mental health resources for people who aren’t eligible or would prefer to go somewhere else. Ask for information, a printed resource list, or even a direct referral to another provider.

4.   The public mental health system doesn’t offer the service you want.

Publicly-funded mental health programs sometimes have to change or limit the services they offer based on their current funding. If you’re admitted to a DBH-certified public mental health agency but it doesn’t offer the service you need, you have two options.

One is to try an alternative service that they do offer. The other is to ask if they can recommend an affordable alternative provider who does offer that service.

If they do offer the service you want, but it’s limited, stand up for yourself if they try to get you to do something else. Don’t accept getting pushed into something you don’t want just because it’s easier for them or because they can get you in faster.

If you’re willing and able to wait, tell them you would prefer to wait for the service you want, whether that’s therapy, medication, or something else.

5.    You don’t like your therapist.

You should never accept bad therapy—or bad mental healthcare of any kind—for any reason. This is just as true in the public system as it is anywhere else. If you have a bad therapist, ask for a new one. Tell your main contact person at the agency, an intake worker, or a manager that you want to try a different therapist.

If you’re not sure whether you have a bad therapist, you can read our articles on how to spot an unethical therapist and how to do a background check on a therapist. If you don’t like your therapist but wonder if it the problem might be fixable, you can read our articles, “What If I Don’t Like My Therapist?” and “How to Fix Problems with Your Therapist.”

If you don’t like the first therapist you’re assigned, ask someone at the agency if they have a webpage or list of therapists you can review. You can read their bios and see if you think one might be a better match. Not all agencies do this, but it doesn’t hurt to ask. You can read our article on how to choose a therapist for information on what to look for.

If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or the Access Helpline) and tell them what’s going on.

You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.

If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.

Deep Dive: How Does the System Work?

To understand the mental health system in Washington, DC, it helps to understand how it started and how it’s changed since then.

Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.

In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.

In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.

DEEP DIVE

For More Information

To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”

To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”

Many state mental health programs trace their origins back to the 1960s when these important changes started to happen.

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 of Columbia, 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.

DEEP DIVE

What Is the Role of the Department of Behavioral Health?

In the past, the Department of Behavioral Health directly operated several community-based programs. Their role started to change in 2009. Currently, their main role 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 NE.

The Washington, DC, mental health system remained under court supervision until 2012. That year, the court ruled that the District had made improvements and established a functional community mental health system. Contingent on the completion of ongoing improvements over the next few years, the court approved a settlement agreement that finally ended the litigation that began in 1974.

However, in 2023, the District faced a new lawsuit over its mental health system. The suit alleged that sending police officers to respond to mental health emergencies violated the civil rights of people with mental health conditions. In response, DC started overhauling its mental health crisis response system, including expanding an initiative that began in 2021 to have more mental health professionals respond to crisis calls along with (or instead of) police.

Some updates Washington, DC, has made to its crisis response system in the last few years include launching the 988 crisis hotline in 2022 and expanding the role of its Access Helpline (888-793-4357)  during the pandemic. These hotlines were set up to serve the entire city, so they’re a great resource if you need mental health help. The caring people who answer know how the system works and can help you get where you need to go.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 45 percent of people in Washington, DC, who have mental health conditions get any treatment for them. Many of them qualify for public mental health services but don’t know about them.

You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for public mental health services, call the Access Helpline at (888) 793-4357. You may find out you can get mental health services from a publicly-funded agency or that there’s another affordable option nearby.

The most important thing is to get started—the help you need may be only a call or click away.

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