Frequently Asked Questions

Below is a list of Frequently Asked Questions. To view the answer simply click on the question. If you would like more information on these topics or other topics please visit our Information and Referrals page under Services for a complete listing of topics available and downloadable fact sheets. The information provided may not be specific to your needs or situation. Only you and your health care provider can determine whether the quality of care is appropriate for your need.

1. How do I locate resources? (food, clothing, housing, etc).
2. How do I get better?
3. How is Mental Illness treated?
4. How do I maintain my Mental Wellness?
5. What is the difference between a psychiatrist/therapist/counselor?
6. Where do I go for treatment? (with and without insurance/income)
7. I have ________ symptoms, what do I do?
8. What do I do if I feel a panic attack starting?
9. Where do I find a support group?
10. How do I get help paying for medications? (with or without insurance/income)
11. What do I do if a friend or family member talks about committing suicide?
12. How can I work to build my self-esteem?
13. What do I do when I get mad?
14. What do I do to treat my anger issues?
15. How do I say “NO” by setting positive limits and boundaries?
16. What do I do if I can’t manage my money?
17. What is the difference in Social Security Disability (SSDI) and Supplemental Security Income (SSI)?
18. What is the difference between Medicaid (medical card) and Medicare?
19. How do I apply for Social Security?
20. Where can I find answers to other frequently asked questions?

3. How is Mental Illness treated?

First, a mental illness has to be diagnosed correctly. Once the diagnosis is correct, it can be treated in many ways. No one treatment works for every person. You must find the treatment that works for you. Some treatment ideas are as follows: medication treatment by a psychiatrist, therapy treatment (cognitive, behavioral by a psychologist, or other clinician), support groups, alternative therapies (tia chi, yoga, EMDR, and others). It is important to continue treatment even when you start to feel better. If you would like more information about alternative therapies or anything else mentioned, contact us.
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4. How do I maintain my Mental Wellness?

There are many things we can do to maintain our mental wellness. Some of them include: ongoing treatment (by a psychiatrist, therapist, support groups), maintaining a healthy diet, getting enough rest, doing something to relax, taking time for yourself, or incorperating positive thinking. If you would like to learn more about any of these things or other things to stay healthy, talk to your doctor and/or contact us.
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5. What is the difference between a psychiatrist/therapist/counselor?

a. Psychiatrists are trained Medical Doctors who are uniquely qualified to assess both the mental and physical aspects of emotional distress and mental illness. Their education has given them a full working knowledge of the many causes for patients’ feelings and symptoms. They know which tests or evaluations are needed to make a complete, accurate diagnosis. Psychiatrists can recommend or prescribe treatment. They have a broad knowledge of medications, which are used to treat emotional distress and mental illness.

b. Therapists are trained at a Master’s degree level in a variety of different fields (such as psychology, social work, education). They are qualified individuals who have been trained to help people deal more effectively with the problems/stress they are experiencing. Therapists work to alleviate and prevent emotional problems and mental illness. Therapy usually deals with more serious or long-term problems through somewhat extended one-on-one work. Problem areas might include: emotional difficulties such as anxiety or depression; problematic behaviors such as addictions, phobias or compulsions; relationship problems with family, spouse, children, etc.

c. Counselors are used to help someone deal with a crisis. Counseling usually deals with specific problems in the “here and now” through relatively brief one-on-one work. Problem area might include: educational/career planning, marital problems, situational stress.
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6. Where do I go for treatment? (with and without insurance/income)

This answer will differ based on what insurance, if any, you have. Two options are to ask your family doctor for a referral and/or contact us and we can provide you with a Clinical Services list that has numerous providers listed, from psychiatrists, to therapists and nurse practitioners. The list indicates whether or not they take Medicaid, Medicare, offer fees on a sliding scale, etc. You will have to check with your private insurance company to see if a specific clinician is covered.
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7. I have ___________symptoms, what do I do?

First, identify the symptoms. We offer free mental health screenings. You can call the office to make an appointment, we can conduct the screening over the phone or you can access free mental health screenings at www.guidetofeelingbetter.org. Talk to your family doctor about the symptoms and they may refer you to a psychiatrist for further evaluation. Make sure you have a complete physical to rule out any medical condition that could have similar symptoms.
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8. What do I do if I feel a panic attack starting?

Panic Disorder is a type of anxiety disorder marked by frightening physical symptoms and a sense of great fear. Panic attacks can come on without warning and sometimes for no apparent reason. A panic attack can be a terrifying experience, particularly for someone who does not know what is happening. Symptoms of panic attacks are varied and include physical, mental and emotional effects. There are different treatment methods for individuals, such as, therapy, medication, support groups, etc. In order to cope with the panic attacks, you must first learn to identify your own warning signs of a potential panic attack. Fighting panic is not a good idea, but doing nothing and just remaining passive can even be less helpful. The following are coping strategies to help counteract panic at an early stage:

• Retreat – If you are near or already in a situation in which you feel phobic, simply exit the situation until the anxiety subsides. If you feel the onset on the freeway, get over into the far right lane, slow down and pull off onto the shoulder or get off on the next exit. If you’re standing in line at the grocery store, you can simply put your groceries aside and walk out without explaining. Retreat means that you leave a situation temporarily with the intention of returning when you feel better.
• Talk to Another Person – Talking to someone nearby will help you get your mind off your panic symptoms and anxious thoughts.
• Move Around or Engage in Physical Activity – Moving and doing something physical lets you release the extra energy or adrenalin created by the fight-or-flight reaction. Instead of resisting the normal physiological reaction that comes with panic, you can move with it. At work, you can walk to the bathroom and back or walk outdoors for 10 minutes. At home you can do household chores requiring physical activity or engage in your usual physical exercise – jogging, swimming, etc.
• Stay in the Present – Focus on concrete objects around you in your immediate environment.
• Engage in a Simple Repetitive Activity – There are many simple, repetitive acts that can distract your attention from your panic symptoms or anxiety-provoking thoughts. You can: Unwrap and chew a piece of gum, 2. Count backward from 100 by 3’s, 3. Count the number of people in line at the grocery store count the money in your wallet; or take out and read a 3x5 card on which you’ve listed coping statements for panic, 4. While driving, count the bumps on the steering wheel; count the number of red cars you see; time the length of the stoplight, 5. Feel the sharp edge of a key or the tines of a comb, 6. Sing.

This list can be extended indefinitely. The point is to find some simple form of distraction that redirects your attention away from your bodily sensations or anxiety-provoking thoughts.

• Do Something That Requires Focused Concentration – These activities are harder to initiate when you’re feeling anxious or panicky. They work very well as distracters from worry. Once you’re involved in them, they have a greater and more lasting capacity to distract your attention. They are as follows:
  • Read a good novel or magazine
  • Solve puzzles
  • Write a running account of your changing level of anxiety
  • Engage in card or board games
  • Play a musical instrument
  • Plan your day’s activities
• Experience Something Immediately Pleasurable – A feeling of pleasure is incompatible with the anxiety reaction. Any of the follow may work to abort a panic attack:
  • Have your spouse or significant other hold you
  • Have a pleasurable snack or meal (this snack should consist of complex carbohydrates and protein – such as cheese and crackers or nuts- not sugar or junk food
  • Take a hot shower or sit and relax in a hot bath
  • Visualize a comforting Person or Scene – If you are visually inclined and you catch your anxiety while it’s still at a relatively low level, try imagining a safe person or a peaceful scene. When you visualize a safe person, see him or her standing right there with you, offering you support or reassurance.
• Practice Thought Stopping – This is a time-honored behavior modification technique for disrupting a pattern of negative or anxious thoughts. Many people have found thought stopping to be a highly effective technique for diverting panic attacks. Follow these steps:
• Take a deep breath and then shout, “Stop!” “Stop It!” or “Get out!” (if there are people around you might want to do this silently or just visualize a huge stop sign).
• Repeat several times, if necessary.
• Replace anxious thoughts with calming and supportive statements to yourself, such as “This too will pass,” “I am calm and strong,” or any of the coping statements listed above.
• Practice Abdominal Breathing – Breathing slowly from your abdomen can help reduce the bodily symptoms of panic.
• Practice Muscle Relaxation – Much of the discomfort you feel during a panic attack is due to your voluntary muscles tensing up. By practicing deep muscle relaxation at the first onset of panic, you can reverse the panic. The following are ways to practice muscle relaxation when you feel panic coming on:
  • Clench your fists. Hold for 10 seconds and then release for about 15-20 seconds
  • Tighten your bicep muscles by drawing your forearms up toward your shoulders and “making a muscle” with both arms. Hold about 10 seconds… and then relax for 15-20 seconds.
    Repeat this with every muscle in your body as needed
• Repeat Positive Coping Statements – Positive self-talk is very important. Change your negative thoughts to something positive.
• Express Anger – Anger and anxiety are incompatible reactions. It’s impossible to experience both at the same time. Symptoms of anxiety and panic are a stand-in for deeper-lying feelings of anger, frustration, or rage. If you can express anger physically on to an object-not just talk about it-at the moment you feel sensations of panic coming on, you often can abort the occurrence of a panic attack. Below are some effective ways to do this:
  • Pound on a pillow or your bed with both fists
  • Scream into a pillow or in your car alone with the windows rolled up.
  • Hit a punching bag

• Take the person to an emergency room or walk-in clinic at a psychiatric hospital. Do not leave the person alone until help is available.
• Remove from the vicinity of the potentially suicidal person any firearms, drugs, razors or scissors that could be used in a suicide attempt.
• Medication and/or hospitalization may be indicated and may be necessary at least until the crisis abates.
• If the above options are unavailable, call your local emergency number (911).

Suicidal patients are often hesitant to seek help and may run away after an initial contact unless there is support for their continuing treatment. For more information you can contact us, or the American Foundation for Suicide Prevention (AFSP) at www.afsp.org

North Key Community Care has a crisis stabilization program. Call (859) 331-3292 and ask for the crisis team. They will have someone call you back within 3 hours. In an acute crisis they will have someone to the home in a quick fashion.

Danger signals:

• Previous suicide attempts: Between 20-50% of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at much higher risk for actually taking their lives.
• Talking about death or suicide: People who end up taking their own lives have often talked about it directly or indirectly. Be alert to such statements like, “My family would be better off without me.” Sometimes those contemplating suicide talk as if they are saying goodbye or going away.
• Planning for suicide: Suicidal individuals often arrange to put their affairs in order. They may give away articles they value, pay off debts or mortgage on a house, or change a will.
• Depression: Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is expressed instead as a loss of pleasure or withdrawal from activities that had once been enjoyable.

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12. How can I work to build my self-esteem?

Self - esteem is the combination of self-confidence and self-respect. It is the belief that you are capable of coping with life’s challenges and are worthy of happiness. People with high self-esteem:

• Have confidence in themselves
• Have the ability to solve problems rather than just worry about them
• Have the ability to confront or eliminate things that frighten them
• Have the ability to take reasonable risks
• Take care of & nurture themselves

The first step in building self-esteem is to accept yourself now, as you are, before you attempt to improve. Self-acceptance and self-knowledge are key to creating positive self-esteem. When you know and accept yourself you feel better. When you feel better you do more. When you do more you accomplish more. When you accomplish more, your self-confidence increases. As your self-confidence rises so does your self-respect. And when you have more pride, self-respect and self-confidence, you can confidently say that you have more self-esteem and you feel more comfortable with yourself.

There’s plenty of self-help information available for building self-esteem and also professional help from support groups, counselors and therapists.

Refer to our Services section under information and referrals for more information on boosting your self-esteem and to take a self-esteem test, or call 859-431-1077 for more information.
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13. What do I do when I get mad?

The first step to solving an anger issue is to first know what makes you angry. If you can point out the things in life that cause you to get angry then you can start to help yourself control that anger. The following are some simple steps you can take to control your anger before the anger controls you:

Relaxation

• Deep breathing, from diaphragm not the chest.
• Repeat a calming word or phrase like “relax” or “take it easy”
• Imagine you are at the beach or another calming environment
• Yoga, Tai Chi, or other relaxing, light exercise

Cognitive Restructuring

• Instead of cursing or yelling about the situation try to tell yourself that it is ok to be upset but that you are not going to let your anger control you
• Try not to use the words “never” or “always”
• Remind yourself that being angry is not going to “fix” anything and will not make you feel any better in the long run

Use Humor

• Think of something silly or funny that you can focus on rather then the anger
• Use humor to help you face the problem more constructively
• Don’t take yourself too seriously

Changing Your Environment

• When you find yourself in a situation that angers you, walk away from it
• Try to give yourself some “personal time” each day
• If you understand what angers you, then you can “avoid” that environment as much as possible

If you have any other questions about anger and ways to deal with it, you can refer to the next question on treating anger issues or give us a call at 859-431-1077.
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14. What do I do to treat my anger issues?

If you feel as though your anger is too intense to handle with relaxation, humor, changing your environment or the way you think then you may want to consider Anger Management Classes or Therapy. If your anger controls you to the point of it affecting your relationships and other important parts of your life then you may want to consider anger management classes or therapy.

Anger management classes would usually be held in a group in which you are taught ways to redirect your anger and to better handle life situations. These classes are taught on a more general basis while as therapy would be individualized to meet your personal needs. A therapist can help you identify what causes you anger and help you learn techniques to overcome your anger issues.

If you have other questions or are looking for anger management resources please give us a call at 859-431-1077.
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15. How do I say “NO” by setting positive limits and boundaries?

The first thing you must know and understand is that saying “NO” is OK. Boundaries are an essential part of our everyday lives. By setting positive limits or boundaries we are learning how to take care of ourselves in any situation. Boundaries help us to take responsibility for ourselves and demand the respect and equality we all deserve.

Boundaries can be external or internal in nature. External boundaries help control and protect your physical person. Examples of external boundaries are distance and touch. Internal boundaries work as a filter to protect your thoughts, feelings, and behavior. Boundaries can be crossed at any time if we have not set strong limits for both the external and internal boundaries. An external boundary can be crossed by someone standing too close to you, in which they invade your personal space or when someone goes through your personal belongings without permission. Yelling, name-calling, sarcasm, and demanding of one’s own way cross internal boundaries. Boundaries can be crossed by anyone including your spouse, parent, sibling, close friend, or neighbor.
People who sense they have trouble setting limits need to learn how to create boundaries. They must begin with developing self-esteem through:

• Positive mental assertions.
• Engaging in satisfying activities in which they can experience success.
• Being with people who affirm and support them.

They can adopt the mental outlook of the self-confident person and practice applying limits in specific areas of their lives in which they feel imposed or intruded upon. When their boundaries are intruded upon, they can calm themselves by taking deep breaths, remind themselves of their right to set limits, then firmly and composedly tell the other person how they feel. They can communicate clearly to others what these limits are, especially if setting boundaries results in changed patterns in certain relationships. They can ask others to respect these boundaries, and make decisions about the relationship according to how the other person responds to that request. Most important of all, they can seek their value as individuals and learn to have self-respect.
If you have other questions or would like more information on setting healthy boundaries please call us at 859-431-1077.
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16. What do I do if I can’t manage my money?

If you are finding it difficult to manage your money or have been mandated to have someone else manage your money, you may be in need of a payee. A payee is someone other than yourself that would obtain your income, regardless of the source (job, SSI, Social Security, Retirement, etc) and pay your bills for you. The payee is responsible to ensure you have the basic necessities (housing, food, clothing) and then whatever you can afford above and beyond that would be discussed with your payee. You may have a family member or close friend who would be willing to take over this responsibility for you or you could contact an agency that offers payee services.

The Mental Health Association of Northern Kentucky currently offers a payee program for individuals who have been diagnosed with Mental Illness and are in need of this service. To find out more information on our payee program please visit the Services section under Payee Services of this website.
(We currently have a waiting list for these services)
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17. What is the difference in Social Security Disability (SSDI) and Supplemental Security Income (SSI)?

Social Security Disability Insurance (SSDI) pays benefits to you and certain members of your family if you are "insured" meaning that you worked long enough and paid Social Security taxes.

Supplemental Security Income (SSI) pays benefits based on financial need.

SSDI is paid to those individuals that are “disabled” determined by the Social Security Administration or to survivors of the individual that has paid into the system. This form of disability is for those who have enough work points earned, meaning that they have paid enough Social Security taxes while working. If you have not worked enough or paid enough Social Security taxes but are still determined disabled by the Social Security Administration then you would qualify for SSI.

The amount of monthly benefit you would receive from SSDI is based upon how many work points you have earned and varies from person to person. The maximum amount you can earn from SSI per month in 2004 is $564. It is possible for you to have both SSDI and SSI, if you qualify.

Please contact us at 859-431-1077 with any questions or call the Social Security office locally at 859-282-7360. The local Social Security office is in Florence, KY.
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18. What is the difference between Medicaid (medical card) and Medicare?

Medicaid (medical card) is a joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state.
Medicare is the federal health insurance program for: people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD). Medicare is made up of two parts: Hospital Insurance (Part A) and Medical Insurance (Part B).
Medicaid in the state of Kentucky is automatically given to individuals that qualify for Supplemental Security Income (SSI) and to other individuals that may qualify. Medicare is given to those over 65 and also those younger who qualify for Social Security Disability Insurance (SSDI) after they have received benefits for 2 years.
If you have additional questions please call us at 859-431-1077 or contact your local DCBS or Social Security office.
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19. How do I apply for Social Security?

Below is a step by step guide of how to apply for Social Security Benefits. If you have any questions or need assistance in applying please call MHA at 859-431-1077.

APPLYING FOR SOCIAL SECURITY DISABILITY

An Important Point : applying for Social Security Disability & Supplemental Security Income (SSI) is not a quick process. The Social Security Administration estimates that it will take a 3 - 6 months to process your application. Also, by applying for disability you are saying you are not able to work for at least a year. Because of that, you cannot work or receive services from Vocational Rehabilitation while applying for disability.

First step = call the local office (282-7360) & let them know you are interested in applying for Social Security Disability. They will get your name, phone number, etc. and schedule a phone interview (a specific day & time to call you back & begin the process).

Second step = write down the day & time of the phone interview & make sure you are there to take the call. The worker will ask you questions about when your illness / condition first started bothering you, when you stopped working, etc. He / she will put this information into the computer & mail you a print out of the answers you gave them.

Third step = Call your consultant when you receive the paperwork so that you can schedule an appointment. Also, before you meet with your consultant, to make things easier, you can start working on a couple of lists

1) Make a list of the doctor(s) you have seen, hospitals you have been to, etc. for your illness. You will need to write down when you first saw the doctor, when you last saw the doctor & when your next appointment is. You will also need their addresses & phone numbers. Start with the doctor you have seen the longest, or the one who has the most recent records.

2) Make a list of the jobs you have had in the last 15 years. You will need to write down the position you held, the type of business, dates of employment & how much you were paid. Start with your most recent job & work backwards.

Fourth step = Keep your appointment with your consultant. Remember to bring the forms Social Security mailed to you & the lists you made. You will probably work on the forms for an hour, maybe longer. You can ask your consultant to split the work into 2 meetings or ask if you can stay longer if you want to finish in one meeting. After finishing the application, your consultant should make a copy to keep in your file & then you can drop it in the mail.

Fifth step = Call your consultant when you get any letters or more forms to work on. It is very important that you let your consultant know when you are assigned a disability examiner. Your disability examiner is the person in charge of getting your records from the doctors, hospitals, etc. Your consultant will want to contact your disability examiner to check on the status of your application.

Sixth step = Social Security may ask you to see one of their doctors. You will not have to pay for that exam. It’s very important that you keep the appointment if they schedule one for you.

Seventh step = Once you have completed all the paperwork (& may have gone to see another doctor) all you can do is wait. You can ask your consultant to check on the status of your application. However, we don’t want to bother your disability examiner too much either. Usually we’ll call once every 3 - 4 weeks. Remember that you can also call yourself but it’s important to let your consultant know if you’re also calling.

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20. Where can I find answers to other frequently asked questions?
Medline Plus a trusted research-based health information source. A service of the U.S. National Library of Medicine and the National Institute of Health.

http://medlineplus.gov

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