Is professional mental health treatment too expensive?

Jason Brien.

Mental health care is just as important as physical health care. When we spend money on services, whether it be for our physical or mental health, we want to make sure we get good value for our money. Unfortunately, though, too many people have had negative experiences with mental health professionals. These negative experiences make some people question the need or value of mental health professionals. Some people may ask themselves “Why am I paying this therapist, counsellor, life coach, etc., x-amount of dollars and all they seem interested in doing is talking about themselves, mumbling “aha”, “yes” or “no” or they are constantly looking at their watch and pressuring me to book another unproductive session”.

Some psychologists and psychiatrists can charge several hundreds of dollars per hour. Counsellors and life coaches may be considered ‘cheaper’ alternatives but then some of them may lack the knowledge and skills of their more ‘educated’ counterparts (clinical psychologists, psychiatrists, etc). It seems to be a damned if I do and damned if I don’t scenario. This problem becomes even more exacerbated in countries which don’t offer universal health care. Australians are quite fortunate in that we can visit a local doctor or hospital, receive a quick assessment and, if we qualify, we will be granted up to 12 free sessions a year with a licensed and accredited psychologist or psychiatrist. We also have a bulked-billed Medicare system and there are also several mental health professionals who will lower or waive their fees for low-income clients.

Why are mental health professionals so expensive though and how can these expenses be reduced so that everyone can feel comfortable accessing their services? For those mental health professionals that have undergone significant education and training, their study and training debts are often through the roof. As soon as these professionals have finished their study and training, they are entering the workforce with a tonne of debt and so they feel pressured to charge fees which will help them cover both their living expenses and their debts. How can this overwhelming debt  and pressure be reduced? Perhaps state and federal governments can step in and waive or significantly reduce the training and education fees of mental health care professionals?

Likewise, these mental health care professionals can help themselves in some ways. Some of them may need to ask themselves “Do I need to rent or lease this office right in the middle of the city or are there cheaper locations available”? Obviously, the less overheads a business has, either the more profit they can make or the lower they can charge their services. I think mental health care professionals would benefit the masses by adopting the second approach as their business model. This may require some mental health professionals to question and remind themselves why they chose this career choice. Was it for the money or the ability to help others?

Anytime that mental health care becomes a business, it runs the risk of putting profits over clients. Making money is the whole point of a business, right? Businesses also require repeat customers if it wants to survive. This can lead some mental health professionals to keep their client’s ‘sick’ so that they keep coming back for more sessions. My business model has incorporated the old adage “Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for a lifetime”. My business goal is to get rid of clients as soon as I can. By get rid of clients I mean my goal is to provide my clients with the support and skills that they need which allows them to confidently progress in life with minimal support from me. Mental health professionals have an obligation to encourage independence over dependence (on them).

With regards to mental health care consumers and clients, you have a responsibility to conduct research about who you plan on sharing your most intimate details with. Is the mental health professional you are planning on visiting reputable? Are they open and honest in how they advertise their services? As a consumer and a client, you also have a responsibility to seek out mental health care professionals who work or specialise in the areas that you are wanting help and support with. If you are dealing with grief for example, a counsellor, psychologist or psychiatrist is better equipped to help and support you than a life coach is. Likewise, if you are looking to set goals and you are looking to be respectfully and productively challenged, then a life coach is exactly what you may need.

You also have a responsibility to be open and honest with your mental health care professional (as much as possible). The more the professional knows about you and your symptoms, challenges, etc., the more able they are to help you. It is also your responsibility as a client or consumer to complete homework the professional gives you. Homework is not assigned for the same reasons it was at school. It is primarily assigned to help you to start thinking about and incorporating these new skills and techniques in your life. If you are thinking about and applying these new skills ONLY when you are in session with your therapist, how long will it take you to learn and adopt these new skills into your everyday life? My guess is it will take a while.

Think of mental health homework this way. When a professional assigns you homework for the week, and you leave it in your bag or on your phone without even looking at it, you have spent approximately 160+ hours reinforcing ‘old’, ‘unhealthy’ and ‘maladaptive’ thoughts, feelings, behaviours, etc. What chance do new skills have if you keep favouring the old habits? Completing homework also makes your therapy time more productive thus allowing you to receive as much benefit for your money as possible. Does it make sense to pay for college, not study or do any exams, and then complain about how much you had to pay? Of course not. Mental health therapy works along the same lines – you get out what you put in.

All in all, there are several factors which make mental health care expensive. Both the mental health professionals and the consumers and clients can take several steps to ensure that sessions are productive which ensures that the consumer or client does not need to be paying out money unnecessarily (by keeping them ‘sick’). Mental health professionals have a responsibility to lower their overheads as much as possible so that they can keep the cost of their services as low as possible. State and federal governments also have a responsibility to ensure that mental health care is affordable and accessible. This may mean wavering or reducing education and training debts if mental health professionals agree to maintain low fees for their services perhaps for a fixed period of time (5 years).