Real-Talk: Mental Health is Too Expensive

$200. It’s a lot of money. It’s a good chunk of my monthly rent, and it’s about how much my husband and I need to feed ourselves every 30 days. It’s also worth one hour. One hour of someone listening to me talk about my struggles and provide me with productive options for how to overcome those struggles. It costs $200 for one private session with a therapist. In other words, it’s $800 per month to maintain regular or weekly discussions with a certified professional about my mental health. That’s 20% of my monthly income — and I (a privileged white female) am a part of the upper middle class in Canada. Which means those that are not considered middle class would need to have over 20% of discretionary income every month just to seek help for their mental health.

Let’s talk about mental health. Yes — more. Yes — again.

It’s that taboo topic we used to avoid, and now we talk about as much as possible. We have finally brought some serious topics of conversation into the light, and I am thrilled. However, the one thing we have forgotten to talk about is the unaffordability of what those suffering from mental health issues need. Cost. It’s too expensive to seek help.

To be perfectly honest with you — I’ve been struggling to write this piece all month. I’ve been telling myself that it’s too personal, or too hard to explain, or that I’d probably say something wrong even though I have the best intentions. But then I remembered that writing about stuff like this is why I have a blog in the first place. Whether it helps or harms what my readers think of me, it’s important that I get it off my chest.

You see, if you’ve been reading my blog for the past year, you’ll know that I’ve touched base on my personal experiences with mental health. Almost a year ago, I started to face a lot of struggles. I was sad all the time, and I didn’t know why. Situations that I used to be comfortable in started to become difficult. I felt guilty because from anyone else’s perspective I should have nothing to complain about. However, it wasn’t going away. In fact, it was getting worse.

After seeking help from friends and being faced with the realization that I was putting myself in danger by avoiding the problem, the only option that felt right for me was therapy. I did some research, asked friends for suggestions, and booked an appointment that day.

My personal experience with therapy

The first thing I noticed when I booked my appointment was that one hour with a therapist was going to cost me $200. However, as someone who always has a little bit of cushion in her budget, I knew that the price tag was worthwhile. One week later, as much as I didn’t want to go to the appointment, I did. I spent an hour telling a complete stranger about all of the thoughts in my head that I would never tell anyone else. I left the appointment feeling drained, but relieved. Over the next five months, I had an appointment every two weeks to keep myself in check and also because it seemed a lot more affordable than once a week.

In total, I attended six appointments (after cancelling quite a few because I’m a chicken) and spent $1,200. Four of those meetings were luckily covered through my work’s health insurance program that I paid for. Two of them were not. I’m fortunate and thankful for that.

However, at my sixth and final appointment with my therapist, I was told that she would be closing her practice within one months time. I played it off like it wasn’t a big deal when she told me, but as soon as we were done, I was devastated. Finally feeling like I was making progress, I realized that I couldn’t bear to start over with someone else and find another therapist who would understand what I needed. I also got angry. I had spent a lot of money building a relationship with someone who could stop our progress just like that. Within one of our hour-long sessions that I was paying for. Why is it so expensive to attend appointments that are clearly so disposable?

Why aren’t there more affordable options — for everyone?

Some important things to mention (before I go on another rant) is that there are more affordable options for those seeking help for their mental health issues. Some medical clinics and hospitals provide counselling at no cost. There are plenty of affordable options for students K-12 and also for those attending post-secondary institutions. There are some group counselling options available depending on where you are located, and there are some service-agencies that price their sessions on a sliding scale according to income levels. There are options.

I am also aware that I did choose the most expensive option. I chose this option because I could afford to. I chose this option because I wasn’t comfortable attending group sessions. I chose this option because I am not a student. I chose this option because I wanted to. So, why the hell am I (someone who can pay for this opportunity) still complaining? Great question.

Everyone should be able to access private counselling at an affordable rate. Just because I have graduated from school doesn’t mean that my mental health is secure. Just because I would like to seek help for my mental health doesn’t mean that my choice for help will be counselling or therapy. Just because I have an extra $200 in my bank account doesn’t mean it should have to be spent on an hour-long session that might not accomplish anything.

Some statistics from Canadian Centre for Addiction and Mental Health:

  • “Mental illness accounts for about 10% of the burden of disease in Ontario; it receives just 7% of health care dollars. Relative to this burden, mental health care in Ontario is underfunded by about $1.5 billion.”
  • “Only about half of Canadians experiencing a major depressive episode receive ‘‘potentially adequate care.”
  • “The economic burden of mental illness in Canada is estimated at $51 billion per year. This includes health care costs, lost productivity, and reductions in health-related quality of life.”
  • “In any given week, at least 500,000 employed Canadians are unable to work due to mental health problems. This includes:
    • approximately 355,000 disability cases due to mental and behavioural disorders
    • approximately 175,000 full-time workers absent from work due to mental illness.”

What are some options you may not know about? 

Thankfully, I’m not alone in seeing that mental health care is not as accessible or as affordable as it should be. Digital therapy is becoming more prevalent in healthcare these days. American companies such as betterhelp and talkspace offer online counselling by paying a monthly or weekly membership rather than a session by session fee.

Although super cool, I can completely relate to those who need the face to face contact or would prefer not to talk to anyone at all. For those of us who would prefer to do worksheets or modules on our own, heretohelp, a group of seven mental health and addictions non-profit agencies in BC has free information sheets, modules and journals that are all available on their site.

As frustrating as it is to see how costly it can be to seek help for your struggles or hardships, I can say from personal experience that it’s always worthwhile. I so badly want to work towards helping mental health become less of a buzzword and more of a real and accessible option for all Canadians. Not just those of us who can afford it.

I know that writing this blog post about it isn’t helping anyone find an affordable counsellor in an instant. But it is me providing another discussion point we tend to forget about mental health other than the fact that we need to talk about it. We also need to take action.

What is your personal opinion on the accessibility and affordability of mental health support in your city or country? Let me know in the comments.

23 Responses to “Real-Talk: Mental Health is Too Expensive

  • Thank you so much for tackling this topic! It’s another important dimension of the mental health conversation. I live in Northwestern Ontario and mental health issues are very prevalent (for lots of reasons), so I think we actually have a good number of resources available for free or at a reduced cost for people who need them (though I don’t know if they are accessed). But, I know that’s not the case everywhere. Since the vast majority of us are impactes by mental health issues in one way or another, I absolutely believe that tools and resources should be easily and readily accessible. Thanks for sharing your journey!

    • Thank you for your support, Britt! That’s awesome that there are affordable resources in your area.

  • As a physician, I definitely see that it is difficult for people to access mental health care, although where I am there are more free/low-cost options than most people are aware of. Often a GP/social worker/psychologist can be a great starting place for finding resources that won’t break the bank.

    The advice blogger Captain Awkward has compiled a list of free resources that I think can also be helpful:

    • Thank you so much for sharing!! I’m sure a ton of people will find that post useful.

  • I am so, so sorry you developed a relationship with a therapist you loved and then she left. I would be devastated if mine closed her practice. My insurance is really comprehensive and any services work up to my deductible. So sure I had to pay out of pocket for my $800 MRI and $115 per session with my therapist, but once I hit my $2,000 deductible, it’s only $11.50 to see my therapist. It has been incredibly helpful through the mess of the last few years to continue to see her, but it sure is expensive.

    • Thanks for the kind words, Leigh. Wow, that is a very expensive deductible!

      • I have a $6,500 deductible! The toughest part is that not all the doctors are going to be “in network”, so in some cases insurance covers very little or nothing at all.

        I went to therapy for a while in middle school and in the middle of college. Thankfully my parents paid for it. I have no idea what it cost. It couldn’t have been cheap. It’s so long ago that I Don’t really remember my experience.

        I took a DNA test at Christmas and just I started a “medical food” to boost a deficiency in my body which allegedly helps with mood, motivation etc – some of my family members say they have really noticed a difference. It’s kind of annoying to spend $60/mo on a pill, but if it actually works, I’m sure it will be worth it.

        • Wowza! I don’t think I’ve heard of a deductible that high. The “medical food” you’re taking sounds very interesting 😉 ! To be honest, if it helps, it’s absolutely worth $60/month. Although, after watching that pharmaceutical episode of Dirty Money on Netflix I can’t believe how highly priced pills are in the US. It’s wild.

  • I’m actually in the middle of writing a similar post. I’m lucky that my work covers $1000 but that’s 5 sessions and as I’ve written before I have pretty bad anxiety and see my therapist about once a month for over a year. All I can say is we are going to have a nice tax credit because we’ve spent so much on mental health this past year. It’s been a hard post to write so I can appreciate how hard it’s been for you to hit publish on this.

    • Anxiety is so so hard to tackle on your own! It’s seriously wild because you’d assume $1000 would be more than enough to make a dent, but you could use all five of those sessions within the first two months. Amen to tax credits haha 😉

      Also, thank you for your support!

  • We are fortunate to not have to pay for everything out of pocket. Neither my husband or I use that part of our insurance at the moment, but knowing that mental health is covered (at least in some capacity) means a lot to me. Our plan also includes physical therapy (which includes massage). There are a lot of things that I don’t like about our plan (doesn’t cover a lot with postpartum/maternity, have to pay for HP’s well care/vaccines), there’s a lot that I do. The best thing that anyone can do is a deep dive into their benefits before they need them!

    I am so sorry that your therapist is closing up shop. How incredibly frustrating. I wish I could do something more than say I’m thinking of you. We definitely need to have more conversations about mental health!

    • They make you pay for your son’s vaccines? That seems ridiculous!

    • A couple of people have mentioned physical therapy which is another great point! Massage, chiro, physio — all equally important. Can’t believe you have to pay for vaccinations!

  • Both the expense and the hassle of finding someone I clicked with and who had appointments available in the evening kept me from going to therapy for a VERY long time. I’m so sorry yours closed her practice-that’s devastating! I really hope you find a new therapist that you like soon.

    It’s not quite as expensive for me to go to therapy: my sessions are $100. But that’s still so expensive for the many people who can’t afford that! I am incredibly fortunate to a) be on a work health plan that has mental health covered, b) that the plan covers my therapy sessions 100% once I hit my deductible, and c) that my work gives everyone money to use before they hit their deductible. So I’m not actually paying for my therapy sessions. If I had to pay on my own, I honestly don’t know that I could go. It’s a huge problem.

    • Oh, I totally know what you mean! It’s hard to find someone that you fit with immediately. $100 is still quite high depending on the frequency of sessions, but that’s still much better than what I was paying! Your work plan sounds awesome!

  • We’re in the States and unfortunately we have similar problems with availability of mental health care. If you have health insurance, it might cover some portion of your mental health needs but you may be limited to those practitioners in network, or you may be limited in the number of appointments you can have. If you go outside of managed care to a private therapist, it costs significantly more. I’ve been able to access some in network help recently at $35 an appointment to help me work through a non-acute difficult set of issues with my family but the quality may be questionable.

    • Wow! $35 would be totally reasonable. However, if the quality isn’t there then I guess that’s a different story. Thanks for sharing your experience.

  • Victoria
    10 months ago

    Mental health treatment on the NHS is pretty rubbish. I privately pay £120 per session (1.5hrs) which is a deduction on their usual rate. It’s hard to see that disappearing from my budget sometimes, especially as I pay for other medical treatment that I wouldn’t be able to access on the NHS (which is broadly free). I’m lucky that my partner fully supports any money spent on my health but I can imagine it is even harder with an unsupportive partner. I’m lucky that I earn enough to afford this but it does have an impact on what we can spend money on. When my chronic illness is bad I sometimes spend £500 a week on treatment and you’d better believe that I could find other things to spend that on!

    It’s important to note that group therapy is different and has different ambitions often to 1-1therapy. It’s cheaper to deliver as you’re getting more people through at a time, which is why it is usually the first, or sometimes only, option offered. I don’t think people should feel the need to justify mental health treatment but it is so hard not to feel indulgent sometimes.

    If your therapist had planned to close then I think it was out of order to take on a new client without making the time limitations clear. Some people just need four sessions say, but I sympathise with you that they did that to you. Therapy requires such trust to work. I would say to anyone reading that you have to click with a therapist and it is ok to try different ones. I have had poor therapists, and therapists that were probably great but not for me, and am very lucky to have a long-term, intuitive and trusting relationship with my current therapist. Keep trying. It’s worth it.

    • Thank you so much for sharing some of what you have to pay for treatment. It’s really interesting to see the differences country to country. Totally agree that group therapy is an entirely unique experience in comparison to 1-1. I wouldn’t personally feel comfortable in a group setting.

  • Thank you SO MUCH for writing this. I’m a ‘Merican, but mental health shit sucks down here too… obviously. I remember before getting treatment for my anxiety I despaired of getting better or finding help because it was so damn hard to afford and to find the medical professionals I needed. Which, you know, created more anxiety…
    Stay strong. You are wonderful.

    • Thanks, Piggy! You are a wonderful person as well. I am so glad we’ve been able to connect. It totally creates more anxiety finding an option that works (financially & mentally). That’s the worst part by far!

  • Hi Alyssa, I really get your concerns about the cost of therapy. I grew up poor, had outdoor plumbing for most of my early life and we didn’t always have enough to eat. Even so I’d like to share an alternate way of seeing therapy. This won’t apply to those folks who have no disposable income. It’s for those who decide a house or a degree is more important.

    I struggled with issues since my adolescence. I’m a psychologist now so I see things from both sides. I’m speaking as someone who knew something was very wrong from an early age. I could fake it because I was smart but as the years went by it got to be harder and harder to put out that “pulled together” look. (I’m sure I wasn’t fooling the majority of people).

    I looked for help with 14 therapists until age 40 when I finally found someone that knew what the heck was going on with me. (Yeah, I went through my doctorate and not one professor noticed how dissociative I was. (not the DID type but the zoning out type). Even if they saw it I’m sure they wouldn’t know what to do with it.)

    I mention all this because now I see my therapy and the cost of it like post secondary education. In fact, for how my therapy has helped, I’d say it’s a bargain compared to the cost and benefits of higher education. What’s the sense of getting an education when you don’t even know yourself or whether you’re pursuing the right thing. If I had gotten the right kind of therapy as a young adult – I’d have been a dancer. I might later pursue a career in psychology but I’d go in knowing I pursued my first passion. I’ve seen many clients who feel they’re now trapped in careers that their parents pushed them into. Worse though are all the decisions they’ve made with family, partners, friendships etc. that might have been much better if they were actually grounded in themselves before making those choices.) And finally, what if you’re not happy in your own skin? So now you’ve finished College or you have the supposed house of your dreams and you struggle everyday to have meaningful connections and be happy. Who needs that. (People often mistake what’s outside of them will make them happy.)

    So to have a good feeling of “me” I put off buying a home and put a ton of money into therapy. I chose the right type of therapy and it came back to me in spades. I may not have the same financial security as my colleagues today but I have something I feel is much more valuable – the security of a stable frame of mind. I know how to grow younger as I age and I love who I am today. I wouldn’t trade it for my younger self in the least.

  • Eric Castro
    5 days ago

    Hi, I just wanted to say that, as an Argentine, I wish more countries in the world took example from our culture in regards to therapy. See, Argentina is the country with the most mental health professionals per capital in the world and with good reason: therapy isn’t taboo there, therapy is part of everyone’s day to day life and we take it as if it was going to the gym or taking dancing lessons; you talk about it with family, friends and they will share their own experiences with you -without getting into anything too personal. It’s not just affordable, but often just free as it is covered by social security. If you want to get a private professional that you might consider better qualified, it will still not break your bank account. Brazil is also a lot like this. Now I live in Paris and I did therapy for 80 euros a session for a while (less that 200 dollars but still too expensive) until I decided I preferred to use that money elsewhere, it was too much. Lucky me, as an Argentine I decided to start a new one but over Skype with someone in Argentina. Not only is affordable there, but also becomes so much cheaper because of the difference in cost of living. And it’s going great, she’s much better than the one I had here and can do it in my mother tongue which is another plus. I wish it could be this easy for anyone, because it’s a key part of our emotional development for anyone in our culture.

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