Neuroses, like luxury cars, are for the well-off. Right?
If you can’t afford a home, a vacation, or the latest kitchen gadget, how could you afford a collection of anxieties and complexes that cost $150 an hour to diagnose in a therapist’s office?
Food on the table — that’s what struggling people need. Or so it’s supposed. Which is why, in social services, mental health is rarely factored in. And why, among the needy, therapy is mostly not a thing.
It should be, says Tasia Milicevic, psychotherapist, founder and clinical director of TMR Mental Heath Care, based in Hackensack. They’ve recently been able to offer mental health treatment for those in financial hardship — thanks to a program that, alas, could soon dry up. That, she says, would be tragic.
“It’s 100 percent essential,” Milicevic said. “If you lose your mind, you have nothing else.”
Sliding scale
TMR stands for Treat Me Right. Which is what the 25 staffers, including 15 therapists, 2 nurse practitioners, one psychiatrist, one collaborating MD and one registered dietician, who work out of two offices on Main Street in Hackensack, aim to do.
And to treat right means — among other things — to treat affordably.
That’s where the Bergen Mental Health Initiative, a program originating with the Teaneck-based All Access Community Development Corporation, or CDC, comes in.
Patients can get six sessions — either on-site, or virtually by phone or Zoom — and pay for them on a sliding-scale basis. The program, begun in June, is funded by a $50,000 Community Development Block Grant from Bergen County. TMR is its vendor.
Over the past two months, the Bergen Mental Health Initiative has been able to treat as many as 18 patients at affordable fees. But money has just about run out, said All Access founder Randy Glover.
“We are desperately looking for funding,” said Glover, a Hackensack resident. “This is an urgent need in this community.”
Days of discontent
Is it news that these are stressful times?
To the pressure of political instability, and looming climate disaster, there is the shadow of a pandemic that killed 1.12 million people in the U.S., and disrupted the lives of millions more. During COVID, jobs disappeared, marriages collapsed, loved ones died, and people — shut inside their homes for months — became dangerously depressed.
And that’s just the comfortably off.
These same problems affect those in financial straits — including, disproportionately, people of color, and non-English speakers.
“The people who need it most never have access,” Glover said. “Like they say: ‘When white people catch a cold, Black people catch pneumonia.’ “
Those who struggle have even fewer resources, fewer ways to cope. So it hits them that much worse.
Nowhere to turn
When Haneefah Colon, a middle school teacher, caught COVID in November 2021, she had to be hospitalized for half a year. “It was the worst experience I ever had in my life,” said Colon, 45, a Hackensack resident. “Going to the hospital and not knowing if you were coming home. Seeing people die around you.”
She came out of the hospital — lucky to survive — only to find she had been laid off. “I was just depressed, really depressed,” she said. “Crying all the time. Reliving it. And when you want to talk to your family all they say is, ‘Be thankful you’re here.’ I definitely needed to talk to someone other than my family.”
Without a job? Without insurance? Not so easy. Where Blue Cross Blue Shield might pay $125 of a $150 therapy session, Medicaid — the joint federal and state program that provides aid to people of limited income — only pays $30.
No therapist can afford to treat a patient on that basis, Milicevic said. And no struggling patient can afford to pay $120 out of pocket. Assistance, of the kind that All Access provides, is crucial. Patients, with their help, essentially get free therapy. Or at least, six sessions’ worth.
“It’s really hard for financially constrained people to find mental health services” said Wallezka Melendez, TMR’s office manager.
She’s the one who helps route TMR’s patients through the clinic’s many specialists. TMR uses a holistic model: there are dieticians to tackle eating problems, psychiatrists to prescribe medication, and clinical social workers to handle family issues. Body, mind, life circumstances — all connected. “It’s one-stop shopping,” Melendez said.
About a year ago, Colon went there, to try to get her life back. And thanks to her therapist Milicevic, and the county funding that aided her, she could continue to get the treatment she needed. “She said, ‘OK, we’ll figure it out,'” Colon said.
Money problems
Some of the issues TMR treats are universal. Teens with gender identity issues. Adults with suicidal thoughts. Seniors struggling with problems of isolation and loneliness.
But there are also the special problems that go with financial hardship.
There are parents, whose conflicts with their kids are directly tied to lack of money — children demanding the expensive sneakers and iPads their friends have. And so: anger, guilt, recriminations.
There are many people whose depression is tied to low self-esteem, directly linked to their having lost — or never having had — a job. Depression makes it all the more difficult to find one. And so the shame spiral gets worse and worse.
“When I first started therapy, I had my own insurance,” said Seraiah Jones, 23, a Hackensack resident. “Then I lost my job.” Which made the anxieties about not being in control, of not having a direction in life, that much worse. “I would say 65 percent of the stress was about that,” she said.
For her, too, Milicevic was able to offer the sliding-scale fees. “She said, ‘I don’t want that to be the reason you can’t have therapy anymore.’ “
Therapy itself can be anxiety-producing — to time-strapped people who are hustling just to get by.
“If you’re working two or three jobs, it can be stressful,” Milicevic said. “I’ve seen situations where people come in and say, ‘It’s hard to do this.’ Maybe they have kids. That’s where virtual services can be helpful. But even at home, you have to have a quiet place where you can talk freely.”
Add to this the stigma of being treated for mental health — in communities where such things are not so common. But that, Milicevic said, is starting to change.
“Recently it’s become more normalized to seek mental health,” she said. “You see things online, like, ‘What is narcissism?’ ‘How to create boundaries.’ ‘What is depression?’ ‘What is anxiety?’ I think that sort of education makes people more likely to seek out mental health. People say, ‘I’m not crazy, there’s nothing wrong with me, I can get help.’ “
Help for all
The key thing, Glover said, is to familiarize people with therapy — make them understand it, not as a luxury for the few, but a basic service that everyone, rich or poor, is entitled to. Glover’s All Access-CDC also funds, with county assistance, the Hackensack Sustainability Food Program: 70 restaurant meals, on Tuesdays and Thursdays, for people in need. Why shouldn’t health for the mind be as important as health for the body?
“That’s what this was set up for — to give everyone a shot if they wanted it,” Glover said. “To be able to experience mental health services and find out if they like them.”
The clinic, which she opened in 2019 (Milicevic moved to Hackensack in 2013) is specially geared to make those new to therapy more comfortable. At TMR, there are therapists from a wide range of backgrounds: Black, white, Hispanic, Indian. Having someone relatable, who shares your background and experiences, can be more than just helpful. It can save time.
“One of the things Black people will complain about is that if you go to a therapist that’s white, you now have to educate them on Black culture,” Glover said. “And meanwhile, you’re being charged by the hour.”
Time is running out
Right now, the clock is ticking in other ways.
The funds from the county’s block grant are just about used up; TMR can’t afford to take on any more patients at reduced rates. And there remains a waiting list about four weeks, Milicevic said.
Bottom line: the program that has helped so many could itself use some help right now.
“We are here to serve anybody,” Glover said. “We’re talking mainly about very low to moderate income people. But we want any Bergen County resident to be able to come in and get this service.”
TMR Mental Health Care PC, 861 Main St #1 Hackensack. (201) 678-1802 tmrmentalhealthcare.com, www.allaccess-cdc.com/index.html.
T
