Is Counseling Affordable during the Pandemic?

Since the coronavirus pandemic began, at least one-third of Americans have experienced depression or anxiety. And according to a recent poll, nearly half (45%) of US adults have reported that their mental health was negatively impacted by stress and worry over COVID-19. Experts warn that mental health problems will rise across the country, indicating a greater need for mental health services.

But is therapy affordable and accessible for all Americans, or only the wealthy and insured?

In the graph above, we’ve broken down the mean discretionary income of Americans into deciles (brackets of 10%). We used numbers from the U.S. Bureau of Labor Statistics for income and expenditure along with Intuit Turbo’s method for finding discretionary spending.^1,2,3 The number we’re left with is discretionary income, or how much money those brackets are left to spend on whatever they want, including therapy.

Therapy sessions range in price, but, generally, a therapy session with insurance costs about $35, and a therapy session without insurance is about $90.⁴

That means monthly sessions are estimated to be $420 a year with insurance and $1,080 without insurance. And for weekly therapy sessions, the costs are $1,820 with insurance and $4,680 without insurance.

For anyone living in the lower three deciles of mean discretionary income ($1,683 or less per year), consistent weekly therapy is essentially unaffordable, with or without insurance. Meanwhile, the upper 60% of median income brackets can afford consistent weekly therapy sessions, with or without insurance.

Can you afford an extra $35 a week for therapy? How about $90?

While the highest income earners could afford a ridiculous 3,954 visits in a year, the lowest tiers would have to make major financial sacrifices to have a consistent therapy routine—and it’s much worse for those without insurance.

One out of every 10 Americans would have to use all of their discretionary income for the year to afford weekly counseling sessions with insurance. With or without insurance, 20% of Americans would have to dig into their savings or go into debt to afford even one counseling session based on their discretionary income. 

Nearly a third of Americans (30%) would not be able to afford monthly counseling sessions without insurance. And half of Americans would have to spend 50% or more of their discretionary income for the year to cover weekly counseling sessions. How many are willing to do that? And how many have experienced or seen the benefits of therapy to know it's worth it?

On the bright side, insurance significantly helps those who have it. With insurance, 50% of Americans can attend weekly sessions while spending less than 10% of their discretionary income. 

And if weekly is too expensive, you can still try to go monthly, which can be affordable for the majority of Americans. With insurance, 70% of Americans can spend less than 5% of their discretionary income to attend monthly counseling sessions.

Remember, even a little bit of help from insurance can go a long way.

We reached out to doctors and other health and wellness experts, and they consistently recommended the following services as easy and affordable options for counseling and therapy: 

• Better Help
• Talkspace
• Coronavirus Online Therapy
• Open Path Psychotherapy Collective

You can find options locally or online too. If you’re already going to therapy, you can ask your current medical expert for a reduced rate or a sliding fee based on income.

Or you can explore telehealth options, which may be as expensive as an in-person visit. You may find a better fee since you can choose from more clinicians, and you’ll also save on transportation time and money.

If you’re unemployed, you may qualify for Medicaid, which covers medical and behavioral health services at 100%. In most states, it’s easy to sign up online. 

Or if you’re a veteran, student, or healthcare worker, you can contact your physician, school, or employer about discounts and waivers for therapy and other mental health services. Plus, many therapists, clinics, and physicians are offering reduced rates during the pandemic to accommodate patients, so be sure to check within your community.

It may take a while to see significant improvements in costs between employer benefits, insurance rates, coverage, and health-care access. But even if you’re financially or mentally stressed from the pandemic, you can take steps every day to improve your mental health. A healthy diet, exercise, and getting out in nature can help you make the shift, but remember: you don’t have to do it all alone or all at once.

We divided the amount an average therapy session costs (according to Thervo) by the amount of discretionary income each decile has. Each decile breaks the population into one of 10 equal parts based on income.

To get discretionary income, we summed average necessary expenses (food at home, shelter, utilities, transportation, and health care) and subtracted them from after-tax income. The incomes and expenses for each decile come from the Bureau of Labor Statistics’ Consumer Expenditure Survey.