Increase in Psychotherapy Visits Signals Shift Away from Medication in Mental Health Care

Recent research from Columbia University Mailman School of Public Health indicates a notable increase in the number of outpatient psychotherapy visits while the reliance on psychiatric medications has seen a decline. These findings, published in the American Journal of Psychiatry, highlight a significant shift in the landscape of mental health care in the United States.

The study reveals that from 2018 to 2021, the percentage of adults seeking outpatient mental health services who opted for psychotherapy alone rose from 11.5% to 15.4%. In contrast, those using medication without psychotherapy decreased from 68% to 62%. This trend suggests a growing preference for therapeutic approaches over pharmacological treatments.

Furthermore, the total expenditures on psychotherapy have increased substantially, climbing from $31 billion to $51 billion during the same period. Interestingly, the proportion of psychotherapy patients receiving treatment from psychiatrists declined from 41% to 34%. This indicates a potential shift in the roles of various mental health professionals in providing care.

Dr. Mark Olfson, a professor of Epidemiology and Psychiatry at Columbia, noted that this shift towards psychotherapy had been underway prior to the COVID-19 pandemic. The data indicates that the increase in psychotherapy visits was particularly notable among patients experiencing mild to moderate distress, while those with severe mental health issues did not see a corresponding increase in treatment visits.

The research analyzed data from multiple surveys of the U.S. household population, focusing on adults who had outpatient mental health visits. This comprehensive analysis included information from 17,821 adults, with 6,415 specifically engaging in psychotherapy.

Dr. Olfson pointed out that the decreasing percentage of psychotherapy patients being treated by psychiatrists may underscore the need for these professionals to collaborate more with non-physician therapists. The growing role of social workers and counselors in providing psychotherapy is noteworthy, although psychologists did not see a similar increase in participation. Additionally, the average number of psychotherapy visits per patient has risen, suggesting that patients are more committed to their therapeutic journeys, with fewer individuals dropping out after just one or two sessions.

With recent changes in Medicare reimbursement policies allowing mental health counselors and licensed marriage and family therapists to bill for psychotherapy, there is potential for further growth in this sector. Such policy shifts may enhance access to psychotherapy services, contributing to the increasing trend of patients seeking and continuing treatment.

The findings of this study paint a promising picture for the future of mental health treatment in the U.S., indicative of a cultural shift towards valuing therapy as a primary treatment modality. This trend could lead to more comprehensive and effective mental health care, emphasizing the importance of therapeutic interventions alongside or instead of medication.