The High Costs of Mental Health Care: A Barrier, A Burden and a Call to Action

​By Bart Magee, P.h.D.

A major barrier to accessing mental health care has always been stigma. Thanks to successful advocacy efforts and a cultural shift surrounding mental health, the stigma associated with seeking treatment has gradually diminished. That’s something to celebrate. At the same time, it highlights today’s most pressing issue: the high cost of treatment remains a barrier for too many people. This requires urgent action and Access Institute is leading the way on multiple fronts. Here’s an update:  
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Why do costs remain so high? Supply and demand are way out of balance. Therapy is increasingly viewed as essential not only for those struggling with mental health disorders, but also as a valuable resource for personal development, increasing demand. On the other hand, the education and training pipeline for mental health professionals has not grown significantly.

Another culprit is insurance companies who keep reimbursement for treatment low. Despite a federal mental health parity law enacted over 15 years ago, insurance plans still limit coverage for mental health treatment.

Those who do manage to begin therapy often cannot afford to keep going. A 2022 survey of 1,000 adults in therapy from Verywell Mind, found that seventy percent of people either limited their sessions or temporarily suspended treatment to due to cost and almost half were worried about continuing to pay.

This is why I’m proud of Access Institute and the work it does every day to remove the cost burden and make care accessible and affordable to all San Franciscans.

​Demand for our low-fee services continues to grow. Calls to our intake line jumped by 55% this year and remain at a high volume. Callers are reaching out seeking individual therapy, couples' treatment, psychological assessment and psychiatry services.

​Seventy five percent of callers reported incomes below $40,000 per year and many explicitly state that the high cost of care has kept them searching for an affordable option.
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We have seen an increase in families calling in search of treatment for children experiencing serious challenges with depression, substance abuse and self-harm. Finding a mental health provider trained to work with children and families can be one of the greatest challenges for those without financial means.

With the new school-year underway, our therapists providing school-based services report that children continue to struggle with loneliness, isolation and difficulty making friends. Something we’ve observed every year since the COVID restrictions ended. The distress these children are expressing worries their teachers and disrupts learning. We have responded by creating more therapy groups expressly focused on supporting children as they build connection with their peers. ​

​Our Psychiatry Program staffed by Psychiatric Nurse Practitioners from UCSF continues to grow with more people enrolled seeking help managing complex problems like ADHD, acute anxiety, and major depression. We hope to continue to grow this program to meet demand.  
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Access Institute addresses the cost burden of care in the long term though our provider training programs, increasing the pool of skilled professionals, most of whom remain in the Bay Area serving the local community. To date, Access Institute has trained over 200 clinical Psychologists, Clinical Social Workers, Marriage and Family Therapists and Psychiatric Nurse Practitioners.  This commitment not only helps meet the growing demand for mental health services today, but also ensures that more individuals have access to affordable care in the future.
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With the stigma surrounding mental health care diminishing, the financial barriers remain daunting for far too many. Powered by the support of our community, Access Institute is working to change this unfortunate reality by leading the movement to provide more services directed to those who need them most and by actively investing in the training of the mental health professionals of tomorrow. We remain steadfast in our drive to eliminate all barriers to accessing transformative mental health care.