Mental health needs in the US are huge.
In 2024 about 1 in 4 US adults experienced some mental illness, according to the National Alliance on Mental Illness [NAMI, source], though for AFAB people, and many people with marginalized race, gender, and sexuality experiences these experiences are more prevalent. NAMI’s data also tells us that 1 in 20 US adults experience a serious mental health illness annually.
So: how might one afford the time to have a menty b, in America, in this economy?
I got a personal look at the reality of mental health breaks earlier this year when someone close to me took one. I had another experience of the same in the past when I had to take my own menty b break. The obvious problem is: when getting the mental health care you really need requires taking a break from working, and working is how you primarily access money and healthcare, it is a major conundrum.
This article offers some guidance to people for whom they themselves, or a loved one just absolutely needs time off to restore mental health. Below is a short quick guide, some stories from this year and from my life a while ago, and a longer strategic section on covering a mental health break and a pep talk. tldr: you deserve care and it’s ok to get creative.
The short version: What can I do if I need a mental health break and am not sure how to pay for it? [more detail below the stories]
- Form a support network: there’s a lot to figure out and the brain of someone with a serious mental illness might not work as efficiently or for as long as a brain that is not sick. Be a helper, get a few helpers, you’re not alone in this.
- Figure out if you have workplace support: If you’re employed part-time, hourly, or full-time, talk to HR or look up if your company offers short or long term disability payments, FMLA, or mental health benefits. Find out what’s needed to apply, and to qualify. See if you have any usable PTO.
- Identify pots of money you can access: savings, friends or family to ask to help, things to sell, credit…
- Make an austerity budget: if money will be tight, what’s the least you can live on? Is there any extra money you can pull together for extra care needed?
- Figure out housing and food: are you paying for these from savings, PTO, unemployment or disability insurance, or is someone else paying for this? Are you moving somewhere cheaper?
- Figure out healthcare: if you have health insurance, how’s it getting paid? If you don’t, is it cheaper to get some now and pay co-pays vs paying out of pocket?
- Create a timeline if you can: is your break looming asap or slightly deferable? Think about when to ideally come back, to give yourself a loose care roadmap and overall cost estimate.
A mental health break best-case scenario in 2026
Someone close to me took a mental health break Jan – April this year, which gave me cause to reflect. She had the best possible option in the US system: a fully-paid 3 month break, with health insurance, and a return to work guarantee.
This mental health break was possible due to:
1/ having a full-time salaried job with benefits,
2/ FMLA, a program that guarantees anyone up to 3 months off work for a family or medical need and the employer has to hold their role for them,
3/ the leave was paid covered by PTO
4/ the power of unions who bargained for great benefits for workers
Even in this best-case scenario, this break was not fully free nor was it as comprehensive as it could have been. She had therapy class that required tediously finagling health insurance approvals. She wanted to do additional treatment, but didn’t feel like spending the additional several thousand dollars was feasible for her. It’s notable that even in the best case, a workplace-supported mental health break has limitations. Max 3 months off to retain your job, still self-paying any treatment that’s not passed insurance panels.
I think of this version of mental health time off as the Ideal model aka How Europeans Do Things:
You need a break, you tell your job, they say “ok,” pay you like usual while you keep your healthcare and benefits, and after the agreed on time, you go back to your job.
Years ago, queer history professor and photographer Ulrika Dahl met with my queer femme community group and told us about how she took most of a year off to “go to the place where overachieving women rest” in Sweden and our – tired, overworked, living in America – jaws dropped. You just… go get rest when you need it? UNTHINKABLE. SHOCK. ENVY. Dahl has a new article out about burnout, by the way.
It should not be shocking to us in the US, but… it is. Generally, while jobs do have to give people FMLA and maintain your insurance, you’re not required to be paid. So unless you have savings, PTO, or some other way to cover your costs, the FMLA period may not be as stress-free as it needs to be, to get better.
Getting a substantial, paid, healthcare-supported break stands out to me as the best possible way, for hopefully obvious reasons. And, of course that’s not reality for a lot of people. This years’ experience gave me a lot to think about compared to how I fared with *my* legit menty b a decade earlier, because it also was not the reality for me.
MY MENTY B: the lean model
In 2013 I had a mental health breakdown – I couldn’t sleep, eat, or work much for about 6 months due to my brain jumping around in time and being mean to me, and it felt verrrry tenuous and scary. I was working part time, in grad school part time, and doing queer community art and being a fabulous gaylord with all my other time.
I didn’t have PTO, much money in savings, or health insurance. I didn’t have a helpful family or anchor partner with money to easily cover me, or a childhood home to return to if shit got really bad. However, I did have a best friend with savings who let me know I’d never end up with no way to pay the rent, and I had a lot of community supporting and sharing resources with me.
And, there were four situational things that made my socially supported but financially tenuous menty b break possible:
1 / by a miraculous occurrence, I got unemployment insurance after the person running the small consultancy I was working at decided to sunset the organization, and I got no-fault laid off. I am so glad I could rest when I needed it so badly and not have to hustle up work for several months.
2 / My life was cheap. I’d been working part time and going to grad school for a few years, so I didn’t have ongoing expensive responsibilities or problems, besides that my brain had stopped working and my body was freaking out. My rent was stabilized and that + bills / basics was like $2000/month. This meant unemployment money covered my costs.
3 / I did have a liiiittle bit of savings and I self-paid for mental health care. I had about $5k in the bank, and about $7k in retirement accounts. I made the decision to use some of the savings on self-pay EMDR mental health treatment, which was hard given that I wasn’t sure if I’d need it for rent or a bigger something eventually – but I also attribute that treatment to starting to restore my sanity from its trip down psychosis lane.
4 / As I started to get better after a few months I eventually did some limited hour gig work. I’d been volunteering at a political art archive, and some associated folks at a worker-owned tech coop reached out to see if I’d do the tech thing I was doing for the archive for their client. I had maybe 4 brain cells available per day, and I used about ½ of them to slowly chip away at this little project [which later landed me a job in the coop], and gave me something to think about besides how completely awful and despondent I felt.
5 / I made art and talked to people. During my breakdown, I wrote and shared a dramatic zine that’s honestly still too painful for me to return to and read, let alone link to here. I was mean and sad and I had friends who’d listen to me be so. I survived through an unwavering desire to not let the bastards who traumatized my ass win, an outright refusal to add to the queer femme death toll in those years, and because I held a glimmer of belief there could again be queer joy out there for me, someday – and I was correct about that.
I share this story because I really, really understand what it feels like to go into a mental health situation with limited financial or family resources, and where working isn’t an option. Sometimes, that is what it is, and rest and recovery and doing what you need to do to live is what’s required.
GETTING A MENTAL HEALTH BREAK TOGETHER
Let’s be clear: you do not need a perfect, airtight plan to take a mental health recovery break. These ideas are here to help make it less bumpy and get you on the way to the care you need with less stress and worry. But if you need to start now, do that and work backwards.
Critical factor #1: RESOURCES
Honestly how people make a long break happen financially is someone, somewhere, is footing a bill.
Your job’s benefits – PTO or short-term or long-term disability insurance [triggered by a letter from a mental health professional] + FMLA is a common path to paid-ish break, where disability insurance covers 60% of what you regularly earned, pre-tax. Because it’s pre-tax, recipients find it’s close to what they had been earning.
Using savings – after a job, this is an obvious next best scenario, but unless you’re already wealthy and financially independent, it has a time limit.
Selling assets – take it from me, you’re not riding that motorcycle if you’re too depressed to move or hearing voices and lights set off your PTSD. Sell it. If you are someone with investments, you can sell some or consider a loan on them. If you have shit you’re not wearing anymore because your body size has changed, sell it.
People, aka the magic resource – people can provide financial, logistical, and emotional support. All are crucial!
Getting financial help from family, partner[s], or friends – aka people who love you are often happy to share money, resources they have, or pay for things for you, so let them. This could look like “I’m paying your rent” or “stay in my guest room” or cutting a check.
Some people have families or partners who attach strings to money, and only you can decide if those strings are worth the runway they get you.
And some people have families, partners, and friends with very limited money and financial support is moot. But: Tactical support from people is also useful!
- Where do you get more affordable mental healthcare that your insurance covers? Someone can look that up for you.
- Where do you get low-cost food? Who has a quiet extra room you can stay in for free for awhile? Someone knows this! Let that someone help you by connecting you to resources
Desperate Measures Hacks
AKA things you can do, only if you really really have to:
- If it’s feasible and needed, live somewhere cheaper or free for awhile – this can extend your runway, but obviously means moving and might mess up your support system and create other kinds of chaos
- Underwork, as in: lazy girl do the least at your job if there’s no alternative way to get income
- See if you can get your job to lay you off and get unemployment
- Gig “whatever” work: get a flexible gig that trickles in money so you can extend your break. Dogsitting, selling plasma, delivery driving, there’s no bar, just find a thing that doesn’t use too much brain cells…
- Deep cut: If it’s really dire and you have no money and no way to meet your needs except what’s in a retirement account or on a credit card, then tap those.
Another really important concept is RUNWAY
As in: “how long can I sustain this recovery period break before I am out of resources?”
The point of funding a mental health break is getting yourself TIME, with minimal stress, to put your brain back together.
| IDEAL: fully funded Extended timeline / as long as you need / 1 year + | LEAN: partially funded Medium length timeline [3-6 months], or long timeline with more limited resources | SURVIVAL: minimally funded Short timeline [get back to work asap] or longer timeline but highly precarious |
| Job pays you in full via PTO Personal wealth/savings fully funds normal spending Family/partner[s] fully funds normal spending | Disability insurance, Unemployment insurance Personal savings Austerity budget Partial help from family/partner[s]/friends | No workplace support No or limited help from family, partner[s], friends No or limited savings Might be working occasionally to fill gaps/needs |
In the example above it was 3 months, the length of FMLA, in this Ideal funded situation.
For me, it was 6 months, the length of my unemployment benefits. I could have used more true break time but I was in a Lean, partially funded situation; and for the 6 months after, I worked part time.
In both cases there was an element of: I’ll get closer to the end and decide if something bigger needs to happen, but having the timeline meant that for a lot of the time, that was not a decision to worry about.
For someone experiencing extreme burnout or trauma recovery, the necessary timeline could be a year or longer.
Research, Outreach, and Decisions
Things you’ll want to do, or get help doing, include:
- Collect people support: get your shortlist of people who care about you who won’t shy away when things are hard and tell them what’s up [ps they may already know and be proud of you for taking a next step]
- If you live with people, talk to them – they won’t be your only support but will probably be more involved than others. What’s needed for them to be well, to support you being well?
- Figure out workplace support: If you’re employed part-time, hourly, or full-time, talk to HR or look up if your company offers short or long term disability payments, FMLA, or mental health benefits of any kind. Find out what you need to apply and qualify. Also see if you have any usable PTO.
- Make an austerity budget: if money will be tight, what’s the least you can live on? What are you spending on that you can cut NOW? Are there unhelpful ways you spend money when mentally ill that you want to stop yourself from doing? Do a brainless gig to make some cash?
- Pull together a healing fund – Is there any extra money you can pull together for extra care needed to advance your recovery? Can you sell anything? Dig into the bonds from Grandma? Do a one-off gig to make some cash?
- Think about how long you can go – is this a “taking a 3-month FMLA then hopefully return to work” time-limited situation? Is this a “give me 6 months not to know anything and try not to die then ask me” extended situation?
- See about health insurance & what it covers: if you have it [and if you don’t this might be a moment to weigh getting on a plan] and exactly what it covers, at which providers, at what cost to you – inpatient or outpatient if you think you’ll need it vs self-paying for therapy, EMDR, ketamine, etc
Just in case funds
What if your budget included a line for falling apart for a while?
Mostly I help people to plan ahead for things like having kids, further education, a celebration, sabbatical, or buying a home; and everyday things like car and home maintenance, travel… but what about the emergency fund nobody talks about: mental health leave.
For a long time, I talked about what I called a “Fuck off fund” with the idea that it’s important to leave a job that’s bad for you. In this case, it might be the job – or it might be that any work is bad for you. Either way, having some fallback savings, even if you don’t know exxacccttllyyy for what, is a way to give yourself options in a bad moment.
The costs for folks not on break, yet impacted by someone’s mental health
Finally, I want to real talk to those of you who are supporting someone on a mental health break. Seeing someone grow new coping skills and heal over the course of a few months is pretty wild.
Sometimes, it might feel like they’re on a special vacation and you’re not. It’s ok to feel that way! This is a reminder they are on a special vacation … in hell. Where you don’t really want to go. And just because they might sometimes look like they are chilling, they are healing. Which looks alllll kinds of ways, including ways that might bring up resentment. If you’re reallllllly wishing you too could get a break, it might be time to do some figuring that out for yourself.
Next, taking on care tasks for someone on a mental health recovery and healing journey is a lot of work! You might want to get your own additional separate therapist, or consider other self-care and resilience support for yourself.
For me, I got TWO [yes, 2] additional therapists because my insurance covers it fully and they are available on off-weeks of each other so why not be fully supported? I also added more exercise into my routine, and took more down time, like time off from making content and blogging. There was a financial repercussion to these choices but I knew I could be resilient to them, so I went ahead.
It’s ok to consider what’s possible for you and to draw boundaries, add self-care, get your own additional mental health support, or care for yourself however you need.
FINAL PEP TALK
There is no shame in taking time to recover and heal when it’s needed. If you need to take a break for your mental health, we all want that break for you. If you really need it, you need it! There’s no global milestone of personal progress that can’t be picked up later if it’s still important.
Fund it like your life depends on it, since it may. Tap savings, make calls to people who’ve said they’d help in the past, put up a fundraiser if it’s needed, and let yourself focus as best you can.
Reduce blowback where you can; by which I mean save credit cards or retirement account draws as a last resort, take advantage of programs at your work even if there’s annoying paperwork or slight delays, and cut spending on shit that isn’t helping you, so your money can go to rest time.
And please for the love of all things good DON’T WORRY about things like: I’m not funding my retirement right now, my savings goals are delayed, people will care I’m not buying new shit… Those things do not matter. Getting well enough to be a resilient you in this challenging, changing world is the absolute most important.
You can do this, and you can be ok. It doesn’t have to be ideal for you to get what you need in a mental health break.