This should be good. I'd be interested to know how different the process is in different parts of the US. I wrote a post about my experiences during the last two years which have involved having private health insurance, having no health insurance, and then being approved for Social Security disability and getting health coverage with that.

After I finished writing it, I realized that I sounded so complicated that I could barely understand it myself.

I'll just say that my current psych meds provider is a physician assistant, not a psychiatrist, and the wait time for my initial appointment was about three weeks.

I go to a mental health agency which leans towards serving patients without health insurance or with Medicaid or Medicare. It offers psychological assessment and testing, individual and group psychotherapy, meds management visits, and social worker case managers for those with mental illness severe enough to need them.

It also has crisis management teams to help people avoid inpatient hospitalization unless it's absolutely necessary.

As far as referral, for psychiatric services, my state uses a "mental health clearing house" type organization to make referrals for people with no insurance or with Medicaid.

When I had private health insurance, I could "self-refer" to a mental health provider on my list of approved doctors. The particular health insurance I had, though, reimbursed so poorly for outpatient meds management visits that I could only see a nurse practitioner at the psych providers group that I went to.

I haven't been able to see a psychiatrist for meds management for about the last ten years and my treatment has suffered for it.

(Although I really like the PA I see now - I like PAs in general. I don't think I've ever seen a poorly-trained one.)