What’s the Deal With Therapy Rates?
Therapy services can be difficult to navigate, and truly don’t seem to be accessible to all, leading to the impression that mental health treatment is commodified. While that impression might ring true for some mental health companies, a majority of therapists strive to balance a variety of factors in determining their cost for services. Many things are considered- a living wage, the economy’s impact on both therapist and client alike, the cost of owning your own business, valuing your expertise as a therapist, the time needed to not only provide services but engage in continuing education to ensure service quality, maintaining a manageable caseload in order to be present with those you work with and decrease the likelihood of burnout, and of course considering what individuals receiving services can afford. Most therapists reserve a number of sliding scale spots on their caseload in order to provide lower cost services, as private pay rates aren’t affordable for all.
When accepting insurance reimbursement, therapists must adhere to rigorous regulations that might impact your quality or length of services. This includes providing a mental health diagnosis in order for services to be covered, requiring significant documentation and proof that services are “medically necessary”, and agreeing to limitations on types of therapy and duration of services based on insurance companies’ expectations. It is incredibly common for individuals to seek therapy for a variety of reasons outside of those indicated in a formal mental health diagnosis- self-growth, relationship issues, difficulties at work, or even for anxiety and mood issues that don’t meet any diagnostic criteria. Insurance companies will not pay for therapy services unless a mental health diagnosis is provided that fits within the criteria set within the mental health diagnostic manual, one that many mental health providers have critiqued as being disease-focused instead of person-focused.
Once a diagnosis is provided, specific documentation is required following each session to continue to prove to insurance companies that the problem at hand has not been fixed, and to justify the need for therapy services in the eyes of the insurer. You might also find your premium rates rising now due to having a mental health condition on file with your insurer. Despite all of this, insurers’ reimbursement rates are low and it is unfortunately a tedious process to get paneled as an insurance-approved provider.
The mental health system exists within a medical framework that views mental health treatment as a time-limited fix to a solvable problem, while mental health professionals continue to push back on that idea and instead advocate for services that are humanizing, person-centered, and flexible. As with any broken and imperfect system there is not an easy path to accessibility and equity. At minimum there is a compilation of individuals attempting to set appropriate standards of care for themselves, for those they provide services to, and for the system at large.
There is an incredible amount of room for growth when it comes to insurance and mental health companies paying therapists what they are worth (or even just an acceptable living wage). Beyond that, there is plenty we can unpack surrounding the culture around mental health treatment. Are we unfairly equating the kindness and empathy of a therapist with how much their services are? Is it possible for some to financially prioritize therapy as a necessity instead of a luxury? Can we consider the cost of therapy services without taking into account other societal shifts that need to take place around an individual’s wages, healthcare, perception of mental health and mental health treatment, etc.?
To be candid, I ask myself these same questions. I find myself exploring these questions on both an individual and systemic level with no clear, simple answer. What I know to be true is that we must continue to push for quality mental health services for all while taking into account the therapist and client alike.
