Access to psychotherapy in the United States has significantly increased among adults with mild to moderate distress since 2018, as indicated by a recent study conducted by Columbia University’s Mailman School of Public Health and the Department of Psychiatry at Columbia Vagelos College of Physicians and Surgeons.
The surge in psychotherapy utilization is particularly prominent among younger adults, women, individuals with higher education levels, and those with higher family incomes. Privately insured individuals have also experienced a greater uptick in psychotherapy utilization compared to those who are publicly insured or uninsured. These findings have been documented in the prestigious journal, JAMA Psychiatry.
In 2021, the use of psychotherapy through telehealth services was notably higher among adults with higher incomes, higher education levels, and full-time employment status. Dr. Mark Olfson, a professor at Columbia Mailman School specializing in Epidemiology and Psychiatry, expressed concern about the unequal distribution of recent gains in psychotherapy access, especially with the growing popularity of teletherapy.
Despite the expansion of psychotherapy access in the U.S., there are concerns that certain demographic groups may not be benefiting equally from these advancements. The study revealed that the increase in psychotherapy use, largely driven by the rise of teletherapy, has predominantly favored socioeconomically advantaged adults with mild to moderate distress.
Psychotherapy remains one of the most prevalent forms of mental health care in the U.S. According to previous research by Olfson, the percentage of adults receiving psychotherapy rose from 6.5% in 2018 to 8.5% in 2021. The researchers analyzed data from the 2018-2021 Medical Expenditure Panel Surveys, including a sample of 86,658 adults.
In 2021, psychotherapy utilization was highest among young adults, followed by middle-aged adults, and lowest among older adults. The rates of psychotherapy use were directly correlated with the severity of distress, with those experiencing severe distress seeking therapy at higher rates. Nearly 40% of adults receiving outpatient psychotherapy in 2021 accessed at least one session via teletherapy.
The COVID-19 pandemic significantly accelerated the adoption of telemental health services, providing a convenient and less stigmatizing option for mental health care. However, concerns persist about disparities in access to teletherapy, particularly among individuals with more severe mental health issues, older adults, lower-income individuals, and certain minority groups.
Financial barriers, such as lack of insurance coverage and high out-of-pocket costs, pose significant obstacles to seeking mental health care. Additionally, low reimbursement rates for Medicaid can deter therapists from participating in insurance networks, exacerbating therapy availability shortages.
Olfson’s research underscores that adults with lower incomes or without private health insurance are less likely to utilize teletherapy compared to their wealthier, privately insured counterparts. Addressing technical and financial barriers to teletherapy is crucial to bridging the gap in access and promoting equity in mental health care.
In conclusion, the study highlights the importance of targeted interventions and health policies to expand psychotherapy access to underserved populations. Ensuring that individuals in psychological distress can access care is a national priority, and addressing barriers to teletherapy could help promote equity in mental health care.
