Your (Unofficial) Guide to State-Sponsored Therapy in Missouri
There’s a way to get affordable mental health care that you might not know about. That’s Missouri’s mental health system.
If you qualify, you can get mental health care at a Missouri 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 program, Missouri’s system can still give you information, local referrals to affordable 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 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 Missouri, 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 Missouri’s mental health system might be right for you.
Who Is Eligible?
The Missouri public mental health system can meet many people’s 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 Missouri 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.
Use the State 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.
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 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 intake appointment, or get free information about affordable local providers.
There are many options for affordable care. Missouri’s system is designed to serve a wide range of people by including different types of programs and clinics. And there are no statewide restrictions on who can use Missouri’s mental health system. Instead, eligibility criteria vary from provider to provider.
What changes depending on your financial situation and diagnosis is whether you qualify for financial aid. You need to meet income eligibility criteria to qualify for state funding through Medicaid, which all providers who participate in the Missouri public mental health system accept. Other kinds of funding assistance can have even stricter requirements and be even harder to get.
However, you don’t need Medicaid to go to most publicly-funded providers. Most public mental health clinics in Missouri accept out-of-pocket payment, Medicaid, Medicare, and a range of private insurance plans. If you don’t have insurance, the fees you pay will be based on your income.
Usually, these fees are lower than what you’d pay to see a therapist in private practice, but it’s important to compare local rates to check.
Check If You're Eligible for Medicaid
Missouri has fewer requirements for Medicaid than many states. Missouri accepted federal Medicaid expansion, so you’re eligible for Missouri Healthnet, Missouri’s state Medicaid plan, if your income is 138 percent of the federal poverty level or less.
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 Medicaid in Missouri in person, by phone, or online. To learn more, visit the Missouri Department of Social Services’ “Apply for Healthnet” page.
In some ways, going to a publicly-funded provider in Missouri is the same as going to any other provider: you either pay for services with your insurance or pay out of pocket. So, the best way to get affordable care is to look for providers who accept your insurance or who offer sliding-scale discounts.
Many publicly-funded mental health programs and integrated clinics in Missouri offer outpatient mental health services like group and individual therapy, psychiatric evaluation, and medication management for an affordable fee or co-pay. Many private providers do, too. So, where you choose to go will depend on what they charge and where you can find the therapist who’s the best match for you.
However, if you need specialty or intensive services, you’ll need to look for specialty providers who offer them.
Check Out the State System If You Need Specialized Services
Community mental health centers in Missouri 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.
One of the most important requirements you need to meet to get services at a community mental health center in Missouri is to be a resident of the region it serves.
You can find out which mental health programs serve your region, as well as the number for your local crisis line, in the directory below. We encourage you to call even if you think you might not be eligible.
Even if you’re not eligible, or if the program doesn’t offer the service you want, they can probably still help you. The people who work at community mental health centers 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 best way to find out which services your local community mental health center in Missouri offers (and who is eligible) is to call and ask. You can also call a crisis line. Most crisis lines in Missouri also serve as information and access lines for people who need mental health services but who aren’t in an immediate crisis.
You can find the website and contact numbers for your CMHC and regional crisis line in the directory in the next section. For general help or information, you can also call one of the statewide information, crisis, or support lines that are listed directly below.
Important Numbers in Missouri
Public mental health services in Missouri are managed on the state level by the Missouri Department of Mental Health. For general information about Missouri’s system, you can contact DMH at (800) 364-9687. You can reach the Division of Behavioral Health within DMH by calling (800) 575-7480.
However, you’ll probably get the best results by calling your local community mental health center directly. You can find their number in the directory below.
Missouri CMHC Directory
Public outpatient mental health services in Missouri are provided by programs called community mental health centers. Each CMHC serves a region made up of several counties. Some regions also have affiliated providers that are part of the public mental health system. Each region also has its own mental health crisis line.
The best way to find out about public mental health services where you live is to call your regional crisis line or one of your local programs. You can find which CMHC serves your county and which numbers to call below.
You can also use some of the search tools on the Missouri Department of Mental Health website to search for specific kinds of providers or services in your area.
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 Missouri.
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.
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 local 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 Missouri’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.
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. Missouri is no exception.
After the federal Community Mental Health Act was passed in 1963, the Missouri Department of Mental Health (MDMH) began encouraging towns and counties to plan and build community mental health centers.
Missouri started formalizing the structure of its mental health system in the early 1970s, when MDMH divided the state into 36 management regions with the hopes CMHCs would be established in each region. By then, three regional mental health centers had been built that acted as hubs for public access to outpatient mental health care.
There are fewer management regions and more CMHCs now, but the system still basically works in the same way.
What Is the Structure of the Missouri Mental Health System?
The Missouri Department of Mental Health does not directly provide services but is closely involved with the programs that do. In addition to operating the state’s psychiatric hospitals, MDMH certifies CMHCs and distributes state and federal funds to them.
The state is currently divided into 27 mental health catchment areas or regions, each of which is assigned to one or more independent CMHCs. Some regions are served by more than one CMHC and some CMHCs serve more than one region.
Each region is also assigned to a crisis program that operates a crisis hotline and other crisis services including mobile crisis response teams and behavioral health crisis centers. Most CMHCs offer crisis services, but some partner with other organizations who operate a regional 24/7 crisis line.
Despite its strong start, Missouri’s mental health system has had ups and downs in the decades since.
Missouri neglected its mental health system during the 2000s and subjected it to severe funding cuts. Missouri has historically spent less than the national average on community mental health programs and has struggled with the quality of its public psychiatric hospitals.
Recently, however, the state has made an effort to invest more in its mental health system. It has pioneered an integrated approach to medical and mental health care that has become a national trend. By incorporating integrated care into its CMHCs and converting them into certified community behavioral health clinics, it has improved mental and physical health outcomes statewide.
In addition to improving its CMHCs, Missouri has also recently built a cutting-edge inpatient facility to replace the outdated Fulton State Hospital.
Certified Community Behavioral Health Clinics
Missouri was one of the first states selected by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to transform CMHCs into certified community behavioral health clinics (CCBHCs).
This initiative was driven by the Excellence in Mental Health Act. Its goal was to improve funding and access to community mental health care and expand the range of services delivered by community programs.
To be designated a CCBHC, a mental health program has to serve all clients regardless of their diagnosis or ability to pay. They also have to offer 24/7 crisis care, provide treatment for co-occurring mental health and substance use disorders, and meet many other requirements.
Research shows that CCBHCs have met many of these goals, providing more services and serving a wider range of clients than CMHCs. Missouri’s CCBHCs have led to a 35 percent increase in patient access to mental health care.
Public mental health services in Missouri are overseen on the state level by the Missouri Department of Mental Health.
While MDMH oversees the system as a whole and helps determine which CMHC serves each region—and while all CMHCs have to meet state standards—each CMHC ultimately decides how its program works. So, the best way to learn more about services in your region is to call your local program or mental health hotline. They know how it all works and will help you get where you need to go.
According to the Substance Abuse and Mental Health Services Administration, only 47 percent of people in Missouri 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 Missouri 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.