Finding Affordable Mental Health Care

 Sliding Scale Counseling

A rising number of people are suffering from mental health problems today. However, mental health services remain inaccessible to millions of people who need them.

The American Psychological Association claims that one of the main barriers to mental health care is affordability. In their research, 39 percent of people reported they could not afford the cost of mental health care. Sliding scale counseling may make it easier for people with trouble paying for mental health care to get the help they need.


Mental Health Problems in Numbers

According to the National Alliance on Mental Health (NAMI), one in every five adult Americans has a mental illness each year, with one in every twenty U.S. adults having a severe mental disease. At the same time, 17 percent of children and adolescents aged 6 to 17 have a mental health disorder. Suicide is the second leading cause of death among children and adolescents aged 10 to 14.

In 2019, nearly a billion people, or 14 percent of the world's population, had a mental disorder, according to the WHO's most extensive review of world mental health in the 21st century. In addition, the number of people seeking treatment for mental health issues such as anxiety and depression has surged considerably since the COVID-19 outbreak began in 2020. According to the WHO, anxiety and depression skyrocketed by more than 25 percent in the first year of the pandemic alone.

Mental health illnesses are a large group of mental problems that affect almost half a billion people worldwide. Mental health problems like anxiety, depression, PTSD, and others significantly affect people, their families, and society. Furthermore, mental illness stigma and difficulties in accessing affordable mental health treatment exacerbate an already challenging situation.

Why Mental Health Matters?

The WHO defines mental health as "a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community" (World Health Organization: WHO, 2022).

Therefore, good mental health allows us to feel good about ourselves, reach our full potential, create and sustain positive relationships, and live happy, fulfilling lives. Moreover, mental and physical health are closely interrelated, so poor mental health can increase the risk of chronic physical illnesses.

Emotional difficulties may be as debilitating as physical diseases. So, making mental health care accessible to everyone, regardless of income, is just as essential as focusing on physical health care.

Furthermore, poor mental health is associated with loneliness and isolation, social withdrawal, and self-esteem issues. If you experience mental health issues, you may have difficulties in your academic and professional lives, struggle with poverty, and be at an increased risk of self-harm and harm to others, suicidal thoughts, and actual suicide.

Why People Struggle Accessing Mental Health Care?

There are several challenges with the present mental health care system, including:

  • Mental illness stigma
  • Access to mental health treatment
  • Affordability
  • A shortage of available therapists
  • Long waiting lists
  • Insurance issues
  • Prescription costs
  • Mental health care financing

Because mental health is an essential component of our general health and a critical predictor of a society's social, economic, and general well-being, it is critical to raise awareness of mental health care difficulties and address the stigma associated with mental illness.

Above all, sliding scale or low-cost counseling might help make therapy more accessible to those with different income levels.

Mental Illness Sigma

According to research, almost half of American adults will require mental health care at some point in their lives. However, the stigma around mental illness may prevent you from seeking mental health care, as you might feel unsafe and uncomfortable discussing your issues. Stigma can worsen your mental health issues, discourage treatment, and hinder recovery.

Nearly 90% of those with mental illness claim that stigmatization has a detrimental impact on their lives, making it challenging to live in decent housing, get a job, have healthy, long-lasting relationships, and be involved in society.

The Cost of Mental Health Care Services and Insurance Barriers

Mental health care can be costly. Unfortunately, many people do not have access to reduced cost counseling. At the same time, research by Mental Health America (MHA) showed that more than 5.5 million (11.1 percent) adult Americans with mental illness were uninsured in 2022.

Low-income, uninsured, and underinsured individuals cannot afford to pay for therapy or medication out of pocket. At the same time, counselors who accept insurance are frequently underpaid and overburdened with too many clients, putting their personal well-being and the quality of treatment they provide in danger.

Lack of Mental Health Professionals

Unquestionably, there is a rising need for mental health services in the United States. Millions of individuals nationally, however, are battling mental illness alone due to a lack of certified mental health practitioners. Even among people with insurance, issues such as a shortage of mental health providers, long waiting lists, and high prices persist.

For instance, most mental health counselors that accept insurance do not take new clients or have long waiting lists. But, on the other hand, those that don't accept insurance are typically too expensive and out of reach for millions of people in need of mental health support.

Also, a lack of mental health care providers, especially in remote and rural areas, can make it challenging for people with mental health issues to find a therapist with the needed skills.

Additionally, long waiting times to see a mental health provider, whether due to a shortage of therapists, a lack of funding for mental health services, or long waiting times, can make it difficult to receive proper mental health care.

Mental Health Funding Issues

The WHO reports that mental health presently receives 1% of worldwide aid, including funding for prevention, promotion, and treatment. Mental health financing in the U.S. is equally inadequate. With depression being the top cause of disability internationally, the issue comes down to a rise in the global cost of mental health illnesses.

How Does Difficulty Obtaining Affordable Counseling Affect Clients?

Lack of affordable counseling leads to delayed or inadequate treatment for people with mental health problems. For example, clients who don't have access to low-cost counseling may resort to self-medicating or self-help resources. Unfortunately, while self-help tools might be beneficial, they are frequently provided by people without adequate qualifications and knowledge who spread misinformation about mental health, which may mislead the client and increase the risk of their condition worsening.

Moreover, challenges in getting low-cost counseling can increase stress, anxiety, and frustration due to not being able to get much-needed help. It can also cause you to feel disconnected from your support system and less likely to seek help in the future.

How Challenges Finding Affordable Counseling Affects Therapists?

Challenges linked to finding affordable therapy can also significantly affect therapists who provide these services, as high demand for mental health services can lead to work overload. Taking on more clients than they can handle can cause increased stress, exhaustion, and burnout, affecting the practitioner's mental health as well as their ability to provide quality care.

Furthermore, most therapists feel powerless and frustrated when they see clients who are unable to receive the care they require. This may pose an ethical concern, as a counselor may believe that their client needs a higher level of therapy that they cannot get owing to barriers such as cost, long waiting periods, insurance concerns, and so on.

It is essential for mental health providers to be aware of these challenges and to seek support so they can protect their own well-being and provide the best possible care for their clients.

One solution to these challenges may be sliding scale counseling.

What is Sliding Scale Counseling?

Sliding scale counseling is a type of psychotherapy service that offers different pricing based on the client's financial situation or ability to pay for the therapy. In other words, the fee for counseling "slides" up or down depending on the client's income level.

What are the Benefits of Sliding Scale Mental Health Counseling?

People with mental health problems who are unable to afford the total cost of therapy may find that sliding scale counseling is an excellent option to consider. Some of the main benefits of sliding scale counseling are the following:

Affordability. Undeniably, sliding scale counseling is a more affordable option for individuals who require treatment but don't see therapy as a possible addition to their budgets. So, when you seek sliding scale counseling, your mental health care provider will determine the cost of treatment based on your income and ability to cover the costs of conventional or online counseling. This approach makes it possible to receive the mental health treatment you require without worrying about the cost.

Tailored mental health care. Sliding scale counseling is flexible enough to meet your unique needs. It's a great way to offer personalized care to people based on their finances while considering their unique situations.

Improved mental health outcomes. Affordable therapy can improve results for people with mental illness who might not have been able to get therapy otherwise. This is because it enables you to pay for treatment according to your financial ability. So, you are more likely to continue with treatment and experience positive changes in your mental health when you have access to affordable and convenient mental health treatment.

Flexibility. Similar to conventional therapy, sliding scale counseling offers flexibility in scheduling and duration, which is especially helpful for clients with busy schedules. This means that you have more options when it comes to scheduling your sessions. You and your therapist will decide together how long your counseling sessions will last based on your needs.

How Sliding Scale Counseling Works?

Clients without a health insurance plan with generous mental health coverage may want to seek out affordable therapy options such as sliding scale counseling.

At Serenity Counseling Center, we are committed to making psychotherapy accessible to people with different income levels by offering a range of fees and offering low-cost counseling to clients who struggle financially.

We offer out-of-pocket services, meaning that our clients pay for the entire cost of their therapy sessions. We also understand that, for many people, seeing a therapist over the long term (which is how most therapies typically work) can create a heavy financial burden. However, we host interns who work closely with our licensed counselors and supervisors to provide high-quality counseling, offering a sliding scale to clients who seek their services.

Clients interested in psychotherapy on a sliding scale must typically provide information about their financial situation and income to determine the appropriate fee. So, naturally, the lower the client's income, the less they must pay for mental health care services.

For example, if you make $50k a year, a counselor may charge $55 per session, but someone earning $150k a year may be charged $150 per session.

At Serenity Counseling Center, we believe that low-cost counseling could encourage more individuals to pursue treatment for their mental health concerns. However, it is essential to note that the cost of therapy does not necessarily determine the quality of treatment. Clients who receive therapy on a sliding scale can still receive high-quality care from a trained mental health professional.


Sliding scale counseling may be a great way to provide mental health treatment to people who may not have the financial means to afford it. This can make mental health care accessible to anyone who needs it, help improve mental health outcomes, and reduce the negative perception surrounding mental illness.

To make a difference, we must start offering sliding scale counseling to make mental health care services available to people of all income levels. Furthermore, we must do everything we can in our communities and society to eliminate the stigma associated with mental health.

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