Therapy reality #1: It ain’t cheap

Therapy reality #1: It ain’t cheap

Mark Twain once quipped, “There are three kinds of lies: lies, damned lies and statistics,” a maxim he attributed to Benjamin Disraeli, British Prime Minister. I had to come with some hard facts for this topic and found plenty. So please bear with me because it really gets to the heart of the matter.

Mental illness is not a disease of aging. Mental illness costs Americans under age 70 more years of healthy life than any other illness, according to a study by the National Institutes of Mental Health (NIMH). It often develops in the prime of life arising during adolescence or young adulthood. The NIMH estimates that 14 percent or 43 million American adults have some form of mental illness that can be diagnosed.

Nearly 10 million American adults have serious functional impairment due to a mental illness such as psychotic or serious mood or anxiety disorder such as major depression the NIMH said. Left untreated, mental illness can rob people of decades of health. Mental health costs the country at least $444 billion per year, the study reports.

The World Economic Forum asked a group of health economists to estimate global costs and project costs to 2030. Their estimate based on 2010 data showed mental disorders as the largest cost driver $2.5 trillion and projected $6 trillion by 2030. Costs for mental disorders were greater than diabetes, respiratory disorders and cancer combined, they reported. The bulk of the cost to society stems from disability payments and lost productivity.

“The way we pay for mental health today is the most expensive way possible,” said Thomas Insel, director of the NIMH. “We don’t provide support early so we end up paying for lifelong support.”

But I didn’t care about mental illness
When I figured out I’d need a long-term therapeutic relationship with my therapist I was staring at a $2,000 per month bill. I negotiated down to $1,500 per month because my medical insurance wouldn’t cover it and he wouldn’t accept it. He doesn’t work with any medical insurance providers including MediCAL and Medicare.

He and many others told me the overhead to manage billing and receivables alone would negate any possible profit. Even worse MediCAL and Medicare pay next to nothing for services and expect tons of paperwork submitted annually as well as whenever he had new patients. Moreover, they also demand a progress report every year for each patient. It’s a small-business nightmare.

Those in the middle are people like me who desperately need treatment because what we have is serious functional impairment. Every day is a personal victory only if we are still alive by the end of the day.

Searching for psychotherapy alternatives
I joined various Yahoo! groups trying to find a substitute for talk therapy. What I soon figured out was that I had something so many didn’t have. I had means to pay for intensive psychotherapy that required a significant investment not only in time but money.

There were people who couldn’t afford therapy much less find a therapist who understood trauma and catastrophic loss. I remember reading nightmare stories of people in other countries with therapists who refused to believe what they said was their history. They were invalidated at every turn and eventually went hopping from therapist to therapist trying to find anyone who could help to no avail.

In another Yahoo! group, there people all over the country who lived in remote places so they struggled just to find one therapist within 50 miles. If they found someone, often they didn’t specialize in trauma and related disorders.

Access to mental health care is worse than other types of medical services because 89.3 million Americans live in federally-designated Mental Health Professional Shortage Areas, according to a Washington Post article. The Bureau of Labor Statistics (BLS) estimated in 2010 that there were 156,300 mental health counselors. However, there were those like me who had plenty of access but limited resources.

“These findings suggest that even though the majority of adults have some form of health insurance coverage, there are significant limitations on coverage for mental health services,” federal researchers wrote in a July 2011 brief.

… Stay tuned for part II.


  1. Wonderful site you have here but I was wondering if you knew of any community forums that cover the same topics discussed here? I’d really like to be a part of community where I can get feed-back from other experienced individuals that share the same interest. If you have any suggestions, please let me know. Many thanks!

    1. Author

      I think Psych Central is your best bet. If you Google them, you’ll find them.


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