Firing Line: Can the mental health crisis be averted with therapy?

Alexander Banks, Columnist

Editor’s Note: This column does not represent the opinion of The Daily Barometer. This column reflects the personal opinions of the writer.

High rates of mental illness raise concerns on whether treatment opportunities, with its price and accessibility, are effective for people seeking help, especially with the institution suffering from a shortage.  

Last year, the American Psychiatric Association reported six in 10 practitioners saying they no longer have openings for new patients. Psychologists reported being contacted by more than 15 potential new patients seeking care a month. Furthermore, 46% of practitioners said they have been unable to meet the demand for treatment.

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The National Institute of Mental Health estimated more than one in five U.S. adults live with a mental illness (57.8 million in 2021). In 2019, spending on mental health reached $225 billion, with hour-long conventional therapy sessions ranging from $65 to $250 for people without insurance, according to a CNBC report

The effectiveness of modern therapy, including treatment online, can’t be solely relied on due to capitalist greed from the middle and upper class, choosing to feed on the money and mental health struggles of the poor as opposed to healing the patient.  

With the rate of practitioners unable to handle the growing rate of people seeking treatment, and 30 million uninsured Americans, many have turned to alternative forms of therapy, such as BetterHelp. 

Simran Khinda, a third-year student studying biohealth and art, has been using therapeutic services for around a month, starting with BetterHelp–an online platform that provides mental health services. 

“I got matched up with a wonderful therapist and my progress with her was (on an) upward trajectory,” Khinda said. 

Khinda felt that by using BetterHelp, she’s spent more time repairing the “damage,” as opposed to excessively talking about her issues. In conventional therapy, Khinda feels she hasn’t made much progress yet because she’s spent too much time talking about her trauma. 

She switched to conventional therapy because BetterHelp isn’t covered by insurance and could cost anywhere from $60 to $90 per week, or $360 each month, according to their website. 

With 64% of Americans living paycheck to paycheck according to CNBC, some may consider BetterHelp a waste of money. 

In their own terms and conditions, BetterHelp states the therapist they provide “may not be appropriate for every particular situation and/or a substitute for certain mental health needs that might require in-person therapy services.”

Would you spend $360 a month on a service that says you still might need conventional therapy? 

According to Indeed–a worldwide American employment website–the average therapist in the United States makes about $35 per hour, almost $73,000 per year. 

Would a therapist risk losing money used to feed his family by telling you they might not be your best fit? 

A blog post from a university in the Netherlands, Maastricht University, detailed the controversies surrounding BetterHelp: excessive fees, unresponsive counselors and ones who even refused treatment, in some extreme cases. 

Using the Wayback Machine, a digital archive of the World Wide Web founded by the nonprofit Internet Archive, in 2019, BetterHelp said in their terms and conditions: 

  • We make no representation or warranty whatsoever as to whether you will find the counselor services relevant, useful, correct, satisfactory or suitable to your needs.
  • We do not control the quality of the counselor services and we do not determine whether any counselor is qualified to provide any specific service as well as whether a counselor is categorized correctly or matched correctly to you.

Today, BetterHelp now requires “an accredited, trained, and experienced licensed U.S. psychologist (PhD / PsyD), licensed marriage and family therapist (LMFT), licensed clinical social worker (LCSW), licensed professional counselor (LPC), or similar applicable recognized professional certification based on their state and/or jurisdiction.” 

Last month, the Federal Trade Commission reported coming to a $7.8 million settlement with BetterHelp for sharing user information with advertising platforms including Facebook, Snapchat and Pinterest. The FTC said the company pushed people to hand over sensitive health information through unavoidable questionnaires. Capitalism rears its ugly head again.

Does needing mental health services outweigh your innate desire to keep your private information private? Is $360 a month worth Facebook knowing your trauma? 

I don’t know when BetterHelp updated their terms of service, but with 25 thousand therapists on the platform, 50 million interactions and $1 billion in revenue in 2022, according to Behavioral Health Business–an independent source for breaking news on the mental health and addiction recovery industry–I’d assume it was before then.

Tiffany Spendiff, an incoming graduate student in biomedical science, is someone who isn’t comfortable with online therapy.

“There’s something about it that doesn’t feel very personal to me,” Spendiff said. Although she has the insurance for conventional therapy, she’s also at a point where her frustration has led her to give up on the system.

Spendiff could only find group therapy at the Counseling and Psychological Services on campus, because there were no one-on-one sessions available. When she tried group therapy she found that results were mixed. 

After the experience with CAPS, Spendiff found conventional therapy off campus but one of her therapists later quit, and the replacement for them transitioned to virtual therapy. 

Of the 30 million Americans that are uninsured, most of them are adults aged 18 to 64, or working-aged people who could benefit the most from insurance. The Kaiser Family Foundation reported, among the uninsured, most are in low-income families, with 60 percent of them being people of color. 

The Center for Disease Control and Prevention reported, in 2020, suicide was a top three leading cause of death for people ranging from 10 to 34. Not coincidentally, as people age, suicides rates increasingly decrease until it is no longer a top leading cause of death. 

In other words, mental health issues are most prevalent among people 10 to 34, but mental health services are widely inaccessible for low-income people of color, aged 18 to 64. The most at risk people would then be low-income people of color, aged 18 to 34. 

What’s causing this age group to suffer the most from mental illness, and for those who don’t have access to therapy, what’s the next best thing? 

There isn’t one, specific, factor that can be pointed to, but likely a multitude of many and a culmination of some. Though living paycheck to paycheck and feeling tied to your underpaid job because they provide insurance doesn’t do mental health any favors. 

Thomas Szasz, a Hungarian-American academic and psychiatrist, said the idea of therapy is “crippling” and psychoanalysis is a contractual conversation about a person’s problems and how to resolve them, in an interview with Reason magazine.

“I tried to avoid the idea … that the therapist knows more about the patient than the patient himself. That seems to me so offensive,” Szasz said. “How can you know more about a person after seeing him a few hours, a few days, or even a few months, than he knows about himself? He has known himself a lot longer!”

Szasz said that mental illnesses are “metaphoric diseases.” They are essentially conflicts within oneself and conflicts between oneself and other people.

“They are problems, but they are not medical problems in that they do not involve somatic, organic etiologies and are not amenable to a somatic, organic resolution,” said Szasz. 

Understanding Szasz would then suggest that therapy and medication aren’t necessary in curing “mental illness,” but understanding and resolving the conflicts between oneself and other people. He criticizes psychiatry more profoundly in his 1961 book The Myth of Mental Illness.

Audiobooks, fitness, and taking pride in reaching my small goals first before the big ones have done more for me than antidepressants and therapy. However, I can only speak for myself, because I also know there are different severities to mental illness. 

However, depending on a government system to fix your problems, especially one that values profit over well-being, doesn’t yield good results. 

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