Getting mental health care is confusing even for people who work in it. Below are the questions we hear most, grouped so you can jump to what you need. Nothing here is medical advice, and none of it replaces talking to a licensed clinician. It is meant to help you walk into that conversation knowing what to ask.
Start with one of three calls. If you are in immediate danger, call 911. If you are struggling but safe, call or text 988 for the Suicide and Crisis Lifeline. If you are managing but know something needs to change, call the behavioral health number on the back of your insurance card, or book a visit with your primary care doctor and tell them you want help. Your own doctor is often the easiest and most effective first step. Our getting started guide walks through this in order.
Call or text 988, the Suicide and Crisis Lifeline, any time. The St. Louis region is served by Behavioral Health Response, a 24-hour crisis line reachable through the 988 network, which includes local teams. You do not need insurance to call, and veterans can press 1.
Yes. MO HealthNet, which is Missouri's Medicaid program, covers mental health care, and many clinics across the metro accept it. Eligibility is broader than many people assume, so it is worth checking even if you are unsure you qualify.
The St. Louis region has community mental health centers and sliding-scale clinics that charge based on your income, and you will not be turned away for lack of an insurance card. Crisis lines like 988 are always free. NAMI St. Louis can also help you find low-cost options.
It generally means depression that has not improved after trying at least two different antidepressants, each at a real dose for a real length of time. It is common, it is not a personal failure, and it signals that the plan should change rather than repeating more of the same. Our guide on antidepressants that are not working covers the next steps.
Common next steps include switching to a different antidepressant, adding a second medication to boost the first, and adding structured therapy. When those are not enough, doctor-supervised options like TMS and Spravato work on different brain systems and are designed specifically for treatment-resistant depression.
TMS uses focused magnetic pulses to stimulate mood-related brain areas, involves no medication, and is done in short awake sessions, usually five days a week for about six weeks. Spravato is a nasal spray form of esketamine, given in a certified clinic with at least two hours of monitoring per visit, and taken alongside an oral antidepressant. Both are for depression that has not responded to standard treatment.
Many insurance plans cover both TMS and Spravato for treatment-resistant depression after other treatments have been tried, usually with a prior authorization. Coverage varies by plan. Some local clinics accept MO HealthNet for these treatments. The most reliable way to know your cost is to have the clinic verify your benefits before you start.
Look for a provider who offers trauma-focused therapy such as Cognitive Processing Therapy, Prolonged Exposure, or EMDR, and ask directly whether they treat PTSD regularly. The VA also offers PTSD care for veterans, and the Veterans Crisis Line is reachable by dialing 988 and pressing 1. Our PTSD guide covers what works.
You do not need perfect medical words. Try something plain like, "I think I am depressed and I want help," or, "I have taken these medications for this long and still feel this way, what are my options beyond another pill." A recommendation from your own doctor is the single thing most likely to move you into treatment, so raising it directly matters.
No. The St. Louis Mental Health Guide is an independent informational website, not a medical provider, clinic, or crisis line. The content is general information, not medical advice. For care you need a licensed clinician, and for an emergency you should call 911 or 988 or go to the nearest emergency room.