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

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

If you qualify, you can get mental health care at a public mental health program 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, the public mental health system in Massachusetts can still give you information, local referrals to affordable providers, and other essential help for free.

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If you’re in a hurry and want to get the most essential 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 Massachusetts, 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 Massachusetts’ mental health system might be right for you.

Who Is Eligible?

You should consider looking into a public mental health program in Massachusetts if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have MassHealth, or have a limited income.

Everyone in Massachusetts can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call a state or 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 a state or 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 through the Massachusetts Department of Mental Health (DMH). However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!

And there are many other ways to find affordable care even if you’re not eligible for DMH services. Many publicly-funded mental health programs and integrated clinics in Massachusetts offer outpatient mental health services like therapy and medication for an affordable fee or co-pay, and most don’t have strict eligibility criteria.

If you need specialty or intensive services, however, you should definitely reach out to your local DMH office—you may be able to get them from DMH or another local provider that DMH can refer you to.

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Public mental health programs in Massachusetts 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.

Since Massachusetts passed its insurance reform law in 2006, DMH has emphasized using insurance to access mental health care. On its eligibility page, DMH states the following:

“Most mental health services [in Massachusetts], including medication and therapy, are provided through health insurance—MassHealth (Medicaid), the Massachusetts Health Connector (health insurance marketplace), or through private insurance (employer-based). The Department of Mental Health provides supplemental services for people with the most serious needs. These services are beyond those supplied through health insurance and require approval by DMH.”

In other words, DMH requires a diagnosis of a serious mental illness (SMI) to get their specialty services. DMH defines SMI as a condition that causes you severe distress, limits your ability to function, makes it hard for you to live independently without support, or that puts you at risk of hospitalization. Conditions that can qualify as SMI include schizophrenia and major depression.

If you don’t qualify for DMH services for people with SMI, you can use MassHealth to get affordable, publicly-funded mental health care from community behavioral health centers (CBHCs) and other providers that accept it. Many CBHCs also accept other state and commercial insurance plans.

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MassHealth is a great way to access the public mental health system in Massachusetts. Not only do all CBHCs and other publicly-funded mental health clinics in Massachusetts accept MassHealth, but you can also use MassHealth to access services at other providers.

You’re eligible for MassHealth if you meet state-specific income requirements. You may also qualify based on a combination of your income, your medical history, and your mental health condition.

If you’re not sure whether you’re eligible, it’s worth looking into. You can apply for MassHealth in person, by phone, or online. To learn more, you can visit the eligibility determination page or the MassHealth application page.

If you don’t qualify for MassHealth, you should strongly consider signing up for insurance through the Massachusetts Health Connector during an open enrollment period and looking for mental health providers in your plan’s network. The Massachusetts state exchange aims to make insurance accessible to all Massachusetts residents, and publicly-funded providers are strongly encouraged to accept all state insurance plans.

You can call your local DMH office or CBHC to learn more about the services they offer and whether you might be eligible. You can find the numbers for DMH offices and CBHCs in Massachusetts in the directory below.

Even if you’re not eligible for a DMH program, it’s probably still worth it to call a local DMH office, CBHC, or statewide mental health helpline. 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 state mental healthcare in Massachusetts is to call the statewide Behavioral Health Helpline. The people who answer can help guide you to the type and level of services you need and can even help you set up an appointments. You can find the number for the state mental health helpline and other important hotlines in the information box directly below.

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The Massachusetts mental health crisis hotline is 988.

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

The statewide Massachusetts Behavioral Health Helpline is (833) 773-2445.

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 Massachusetts Compass Helpline by calling (617) 704-6264 or (800) 370-9085.

You can speak to a peer on weekday mornings from 8AM to 12PM by calling the Kiva Centers Peer-Run Support Line at (508) 688-5898.

You can speak to a peer during the evening from 4 to 7:45PM by calling the Metro Boston Recovery Learning Community Peer Support Warmline at (877) 733-7563.

You can speak to a peer on weekday evenings from 7 to 9PM and weekend evenings from 7 to 10PM by calling the Western Massachusetts Wildflower Alliance Peer Support Warmline at (888) 407-4515.

You can reach the Massachusetts Department of Mental Health by calling their main number at (617) 626-8000 or the DMH Info Line at (800) 221-0053.

Public mental health services in Massachusetts are managed on the state level by the Department of Mental Health. For general information about Massachusetts’ system, you can contact DMH by calling their main number at (617) 626-8000 or the DMH Info Line at (800) 221-0053.

However, you’ll probably get the best results by calling your local DMH office or the statewide mental health help and information line at (833) 773-2445. You can find the number for your local DMH site office and community behavioral health center in the directory below.

Massachusetts Mental Health Directory

In addition to five regional offices, DMH operates 27 local site offices. Each DMH site office helps oversee the network of public and contracted private providers that make up the local mental health system. They’re also where you go to apply for DMH services or figure out whether you’re eligible. If you’re eligible, they’re also where you’ll meet with a case manager who will help link you with the services you need.

To be eligible for DMH services, you need to have a serious mental health condition that affects your ability to function. However, you don’t have to meet DMH criteria to get help at your local community behavioral health center. Each CBHC provides on-site crisis intervention and has hours when you can walk in when you need help right away. They also operate a local crisis line.

If you have MassHealth or other qualifying insurance, you can get therapy, medication, and other outpatient services at your local CBHC.

You can find which DMH office and CBHC serves your town, as well as links to their websites and contact information, in the directory below.

Local crisis lines and teams are available 24/7. Your local crisis line will connect you with a mobile crisis team based at your local community behavioral health center. You can also call 988 or (833) 773-2445 (the Massachusetts Behavioral Health Helpline) for 24-hour support.

If you aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a state or local 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. Calling a crisis line is free and you don’t need to have insurance.

Also Consider: Federally Qualified Health Centers

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

These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care, meaning 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 less strict than the eligibility requirements for DMH services. (And you don’t need insurance to get outpatient services like you do at Massachusetts CBHCs.)

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 Massachusetts’ 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. Massachusetts is no exception.

It enacted its own community mental health law in 1966, which funded the construction of community mental health programs across the state.

With the support of the public, legislators passed laws expanding the state’s community mental health program in 1978 and 1986. By 1989, Massachusetts had established a strong statewide network of community mental health programs that directly provided case management, day treatment, outpatient care, crisis intervention, and other services.

DEEP DIVE

The Massachusetts Department of Mental Health provides fewer direct mental health services to clients than it used to provide. Now, it encourages most people to use insurance to get the care they need from other local providers.

Massachusetts passed a landmark insurance reform law in 2006, years before the national Affordable Care Act was passed. This law created a statewide insurance exchange where people could sign up for healthcare if they did not have an employer-based plan and did not qualify for Medicare or Medicaid.

Now that this law has made health insurance more accessible in Massachusetts, the role of DMH has been restricted to only provide direct services to clients with the most severe forms of mental illness who need services that are not covered by regular insurance.

Now, DMH directs most people seeking therapy or other outpatient mental health services in Massachusetts to sign up for insurance through MassHealth or the Massachusetts Health Connector and to find providers in their network.

In 2006, Massachusetts passed an insurance reform law that made it much easier to get health insurance statewide. Afterward, the state updated its mental heath system to focus on providing access to care through MassHealth and other insurance plans.

The reform largely worked but made the system more fragmented, especially for people seeking crisis or routine outpatient mental health services. Massachusetts addressed these issues with reforms implemented in 2023. New mental health policies enacted that year increased funding for the public mental health system and established a statewide mental health crisis and information line.

Most significantly, the new mental health policy created a network of Community Behavioral Health Centers (CBHCs) that make it easier for residents to walk in and get same-day crisis and outpatient care. Crisis services at CBHCs are available to everyone regardless of their insurance status, and all CBHCs accept MassHealth and some other public and private insurance plans. There are CBHCs all over the state serving all DMH mental health regions.

DEEP DIVE

Community Behavioral Health Centers are a new type of mental health provider in Massachusetts. They were established by the 2021 “Roadmap to Reform” that was implemented in 2023.

Many CBHCs are agencies that were already providing crisis care and other mental health services—some for decades—but that updated their service models to fulfill the new CBHC requirements.

The main purpose of a CBHC is to provide 24/7 crisis services including a mobile crisis team, crisis stabilization units, and mental health urgent care clinics where clients can walk in and be seen right away. They are also open for appointments outside of typical business hours.

In addition to providing crisis response services to anyone who needs them, regardless of whether they have insurance, CBHCs also provide outpatient mental health services like therapy and medication to people with insurance. All CBHCs accept MassHealth, and many also accept other insurance plans.

Public mental health services in Massachusetts are managed on the state level by the Department of Mental Health.

Unlike many other states, Massachusetts’ mental health system is not county-based. Instead, DMH oversees five regional offices which in turn manage several site offices. Each site office is assigned to a specific set of towns instead of to a set of counties.

You can learn more about how the system works and what’s available nearby by calling a state or local mental health hotline. They know how the system works and will help you get where you need to go.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 53 percent of people in Massachusetts 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 state mental health services, call a state or local mental health access and information line. You may find out you can get mental health services through a publicly-funded 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 Massachusetts

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?

PRO TIP

Use the State System When You're in Crisis

PRO TIP

Check Out the State System If You Need Specialized Services

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Check If You're Eligible for MassHealth

Where Do You Call to Get Started?

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Important Numbers in Massachusetts

Massachusetts Mental Health Directory

Massachusetts Clinics and Crisis Lines

Metro Boston Mental Health Offices, CBHCs, and Crisis Lines

Northeast Massachusetts Mental Health Offices and Crisis Lines

Southeast Massachusetts Mental Health Offices and Crisis Lines

Central Massachusetts Mental Health Offices and Crisis Lines

Western Massachusetts Mental Health Offices 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

Insurance Reform and the Massachusetts Mental Health System

DEEP DIVE

Community Behavioral Health Centers

Conclusion

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

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