Those individuals who have ever engaged in the search for mental health treatment understand how difficult, confusing, and tiring the process can be. Although the public’s recognition and acceptance of the importance of mental health treatment has increased over the last several decades, our current healthcare infrastructure has done little to provide the acceptable means for individuals to connect with mental healthcare providers. In fact, evidence has shown that only 40% of individuals struggling with a mental health diagnosis receive adequate treatment. There are many systemic barriers for both clinicians and clients which keep individuals from receiving help.
Supply and Demand
According to the Bureau of Labor Statistics, there are roughly 600,000 clinicians in the country who are able to provide and bill for psychotherapy, including psychiatrists, psychologists, licensed counselors, and marriage and family therapists. For reference, that is 100,000 less than the reported number of medical physicians, not including nurses, nurse practitioners, or physician assistants. There’s also the consideration that mental health professionals tend to be concentrated in urban areas. Roughly 50% of all marriage and family therapists in the country are in California alone. There are simply not enough mental health professionals in the country to keep up with the demand.
Many private practicing therapists and group practices are already at capacity. Nearly 52 million individuals in the country have been diagnosed with a mental illness. Nationwide, there are roughly 60 clients to each clinical provider, meaning many therapists are already sitting at full caseloads with waiting lists. In my own personal experience in searching for a therapist, it took roughly four weeks of calling dozens of different practices and therapists before I found someone with an opening in two months. We cannot expect individuals struggling with mental health issues to put that much work and wait into finding help.
Many Clinicians Do Not Take Insurance
Because of the relatively low financial reimbursement rates of medical insurances, many private practicing therapists have forgone the process altogether. While the real reimbursement rate from insurance remains a closely guarded secret, casually discussing this issue with other clinicians has shown that typical reimbursement rates hover between $30-$50 for a session. The majority of, if not all, the payment falls onto the client; making treatment a financial burden.
High Costs for Treatment
The cost of mental health therapy varies nationwide but often ranges from $50 to $250 for a single session! This would mean that an individual looking for weekly individual therapy would have to pay between $200 – $1000 a month for treatment. This high cost creates a barrier to many people in society who would otherwise greatly benefit from individual therapy.
What Can We Do About it?
While all the reasons above can contribute to the difficulty of finding a therapist, connecting with a caring professional is not impossible. While the Bureau of Labor Statistics expects the mental health fields to grow by more than 25% over the next 10 years, much higher than most other industries, what steps can we take now?
College Counseling Centers
Many colleges provide mental health treatment by either licensed professionals or residents-in-training before licensure. These centers are often included in the cost of tuition and services. Some training programs even offer sliding scale sessions for people who are not enrolled in the college. This information can be found by exploring a university’s website or (if you are a student at the college) reaching out to an administrative advisor.
Employee Assistance Programs.
These programs, otherwise known as EAPs, are sometimes offered by places of employment to their workers as an added benefit. These programs are often missed or overlooked, as they are generally only discussed during the employee onboarding period with all the other information presented at time of hire, including benefits, pay, and time off. EAPs are contracts wherein a company has already paid a licensed professional a contract for hours to offer free therapy for their employees. If a company has this policy, employees can reach out to human resources for information.
Online Telehealth Therapy.
It’s probably old hat by now to talk about how COVID-19 shifted us onto online platforms, and the world of therapy is no exception. The majority of mental health providers transitioned to some form of online telehealth over the last two years. This opens possibilities for individuals to access mental health practices previously out of their geographical range. Logistically in some states, for a client to use their insurance, often the only requirement is that the client’s insurance and the clinician’s license need to be from the same state regardless of where either person is physically located during the time of the online session. Check your (and your provider’s) local telehealth laws, as this offers more opportunities for treatment, especially for individuals in rural areas.
Finding a therapist can be a confusing, stressful, and frustrating search. There are few things more demoralizing in this world than trying to reach out for help when we are already struggling. There are societal and logistical issues making it difficult and frustrating for people trying to connect with effective clinicians, but through all the frustrations, there are some options for care that exist, and hopefully more in the future as new providers enter the field and newer technology becomes more accessible.
Drew Lightfoot is a Licensed Professional Counselor and Clinical Director from Philadelphia, Pennsylvania. He is also a professor of psychology and healthcare research at La Salle University and Wilmington University, and spends most of his free time playing old video games or DMing Dungeons & Dragons sessions. He can be followed on Twitter as @GamerShrinks.