Your (Unofficial) Guide to State-Sponsored Therapy in Alabama

There’s a way to get affordable mental health care that you might not know about. That’s Alabama’s mental health system.

If you qualify, you can get mental health care at a community mental health center for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services at a state-funded provider, Alabama’s system can still give you information, referrals to local providers, and other essential help for free.

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If you’re in a hurry and want to get the most important information about what’s available at your local program and who it’s for, you can read our quick start guide below.

To learn more about public mental health services in Alabama, 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 Alabama’s mental health system might be right for you.

Who Is Eligible?

You should consider looking into the Alabama mental health system 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 Alabama can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call your local crisis line to get the help you need, quickly.

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

State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.

The people who answer state 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 your local mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about other affordable local providers.

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 public outpatient mental health care at many Alabama community mental health centers. However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!

It’s also important to understand that requirements vary from program to program and that you’ll need to check with your local program to confirm who they serve. Whether your local CMHC requires you to have a serious mental illness (SMI) to be eligible for outpatient mental health services depends on the program’s normal policies as well as their staffing and funding at the time.

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Most CMHCs in Alabama require you to have a serious mental illness (SMI) to qualify 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.

In general, expect your program to offer some services to people who don’t have SMI but to prioritize admission for people who do have SMI.

For example, the page for the Mental Illness Outpatient Program at Mountain Lakes Behavioral Healthcare states that their program “provides services to children, adolescents, and adults, with a focus on serious and persistent mental illness and severe emotional disturbance.”

However, this isn’t true for all CMHCs. On the other hand, WellStone states that “outpatient counseling is available for a wide variety of behavioral health conditions, including adjustment issues, depression, anxiety, bipolar disorder, and psychosis.”

So, if you don’t have SMI, you’ll need to check with your local CMHC to see what their current policies are and if you’re eligible for any services there.

If you do have a severe condition, you should definitely call your local CMHC. They stand out when it comes to specialty mental health services that are designed to help you like case management, day treatment, and community-based care. Most CMHCs offer these services, and they can be hard to find anywhere else.

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Community mental health centers in Alabama 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.

If you don’t know whether you have a mental health condition but think you may benefit from services at a CMHC, consider calling your local program to set up an assessment. Many people who have a serious mental illness don’t realize it yet. Prevalent mental health diagnoses like major depressive disorder and panic disorder qualify as serious mental illnesses in Alabama.

Ask if there is a charge for an assessment if you find out that you don’t qualify for services there. If there is, ask what it is and whether they think you should come in, then decide whether it might be worth it. If there isn’t, consider going even if you’re not sure. You can often get helpful information and support even if you’re not admitted.

If you qualify for services at an Alabama CMHC, you’ll pay for your care using either cash or insurance. Most CMHCs in Alabama accept both public and private insurance plans and offer affordable sliding-scale fees if you don’t have insurance.

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Medicaid is one of the primary ways to gain access to the public mental health system and other forms of affordable mental health care. However, Alabama did not accept Medicaid expansion, so it is not possible to get Medicaid as a childless adult in Alabama unless you have a disability.

Alabama doesn’t have any special state funding assistance programs other than Medicaid for people who need mental health care, but CMHCs usually accept multiple forms of insurance. And if you don’t have insurance, you can often get mental health services for reduced fees at many state-licensed clinics and CMHCs.

To find out how fees at your local CMHC compare to fees for private providers, you can call your local CMHC and ask what they charge. If they’re your most affordable option, talk to them about whether you might be eligible to get services there.

Whether you can get therapy or other clinical services at your local CMHC doesn’t just depend on whether you’re eligible—it also depends on the CMHC’s funding and staffing at the time.

You can call your local CMHC to learn more about the services they offer and whether you might qualify. You can find the numbers for all Alabama CMHCs, as well as numbers for state and local helplines and hotlines, in the next two sections of this article.

Even if you’re not eligible for services at a CMHC, it’s probably still worth it to call. The people who work at CMHCs are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including non-profits that provide free or low-cost counseling.

Where Do You Call to Get Started?

The easiest way to learn more about state mental healthcare in Alabama is to call your local program directly. You can find contact information for all Alabama community mental health centers and crisis lines in the directory in the next section.

You can also find the numbers for statewide helplines and hotlines in the information box directly below, including the general information line for the Alabama Department of Mental Health, the statewide mental health warmline, and the statewide mental health crisis line.

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The statewide Alabama mental health crisis hotline is 988.

The Crisis Text Line for the state of Alabama is 741741.

For help and referrals for mental health and many other needs, you can also call 211.

You can get support from a peer any time by calling the 24/7 Wings Across Alabama Warmline at (844) 999-4647.

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

You can reach the non-emergency NAMI Alabama Helpline by calling (334) 396-4797.

You can contact the Alabama Department of Mental Health by calling (800) 367-0955.

Public mental health services in Alabama are managed on the state level by the Department of Mental Health. For general information about Alabama’s system, you can contact DMH at (800) 367-0955.

However, you’ll probably get the best results by calling your local community mental health center directly. You can find the number for your CMHC in the directory below.

Alabama CMHC Directory

There are 67 counties in Alabama and 19 community mental health centers that serve those counties. Each CMHC is part of the state mental health system and must follow statewide requirements, but eligibility criteria and which services are available can vary from program to program.

The Alabama Crisis System of Care gives you three ways to get help when you’re having a mental health crisis: the statewide 988 mental health crisis hotline, local mobile crisis teams, and regional crisis centers. There are currently six crisis centers in Alabama, each of which serves several counties. You can call 988, a crisis center, or your CMHC’s crisis line if you need help.

You can find contact information for all Alabama CMHCs, mobile crisis teams, and crisis centers in the directory below.

If you need information after hours or aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a crisis line for help. 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.

Also Consider: Federally Qualified Health Centers

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

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. Their eligibility requirements are generally less strict than the requirements for the state-funded system.

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 state 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.

If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or a state or local mental health hotline) 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 Alabama’s mental health system, 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

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. Alabama is no exception.

Alabama passed its own state community mental health law in 1965. Among other things, Act 881 created the Alabama Department of Mental Health and authorized the establishment of the state’s public mental health system. Many Alabama CMHCs were established soon afterward in the late 1960s and early 1970s. Some of these original CMHCs continue to operate to this day.

Alabama was famously responsible for the 1971 Wyatt v. Stickney court case that changed mental health care in this country. The judge’s ruling required psychiatric institutions to abide by a set of minimum standards including doing everything possible to return patients to society.

These standards ultimately became national standards for inpatient psychiatric treatment. Unable to afford the extensive updates required by the law, Alabama instead released most of the patients in its psychiatric institutions in the mid-1970s.

DEEP DIVE

Mental health services in Alabama are primarily managed on the state level. The Alabama Department of Mental Health oversees a network of independent providers it contracts with to deliver state-funded outpatient mental health and crisis intervention services.

Compared to other contract-based state systems, Alabama’s is relatively simple. Most counties are served by a single CMHC and its satellite clinics. A few counties are served by two CMHCs, and Jefferson County is served by multiple outpatient providers.

Recently, Alabama added crisis centers to its public mental health system. These centers provide hotline, mobile, walk-in, and crisis stabilization services. There are currently six crisis centers, with plans to open more in the future.

Alabama shut down most of its psychiatric hospitals in 2012 and 2013 in one of the fastest and most dramatic mental health service shutdowns in the country.

Alabama’s budget was severely impacted by the 2008 recession, following which the state government limited or eliminated many public mental health services.

This led to many negative mental health outcomes in Alabama. Fortunately, the state is seeking to reverse these trends by taking measures to improve its mental health system, especially its crisis services.

In recent years, Alabama has significantly expanded its Crisis System of Care by launching the statewide 988 crisis line, adding more mobile crisis teams, and opening several crisis centers that provide a variety of stabilization services for people who are experiencing a mental health crisis. The state is looking at a variety of possible funding sources to continue to expand these services.

If you’re in crisis or need mental health services and aren’t sure where to start, you can call the new statewide 988 hotline or a local crisis line. They know how the system works and will help you get where you need to go, whether it’s to a crisis center, a CMHC, or a local non-profit.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 41 percent of people in Alabama who have mental health conditions get 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 Alabama state mental health services, call your local CMHC or crisis line. You may find out you can get mental health services through your local program 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.

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Therapy with No Waiting Rooms or Driving. Take a quick quiz about your preferences and needs and get matched to a therapist in as little as 48 hours.

Your (Unofficial) Guide to State-Sponsored Therapy in Alabama

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Have you been in therapy before?

Quick Start Guide

Who Is Eligible?

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Use the State System When You're in Crisis

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What Is Serious Mental Illness?

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Check Out the State System If You Need Specialized Services

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If You Don't Have Insurance, Ask Your CMHC About Their Fees

Where Do You Call to Get Started?

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Important Numbers in Alabama

Alabama CMHC Directory

Alabama Clinics and Crisis Lines

Region I (Northern Alabama) CMHCs and Crisis Lines

Region II and III (Central Alabama) CMHCs and Crisis Lines

Region IV (Southern Alabama) CMHCs and Crisis Lines

Also Consider: Federally Qualified Health Centers

Troubleshooting Guide

Problems and Solutions

Deep Dive: How Does the System Work?

DEEP DIVE

For More Information

DEEP DIVE

What Is the Structure of the Alabama Mental Heath System?

Conclusion

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