A recent study in the American Journal of Psychiatry reveals that more American adults are seeking talk therapy for mental health issues than in past years. Interestingly, the number of individuals relying solely on psychiatric medication has also decreased for the first time in a long while.
Dr. Mark Olfson, a psychiatrist and epidemiologist at Columbia University, mentions that this rise indicates psychotherapy is playing a more crucial role in outpatient mental health care now. The proportion of adults engaging in therapy grew from about 6.5% in 2018 to roughly 8.5% in 2021, translating to an increase from around 16.5 million to nearly 22 million individuals.
These findings represent a notable shift from earlier trends, according to Olfson. Talk therapy usage had reportedly decreased and plateaued since the late 1990s, during a period when psychiatric medications became more popular.
Olfson elaborates, “From the late 1980s, with the introduction of Prozac and other SSRIs, medications became increasingly central in outpatient mental health care.” However, between 2018 and 2021, the percentage of adults using only medication dropped from 67.6% to 62.1%. Meanwhile, there was an uptick in patients solely receiving talk therapy, particularly among those facing depression, anxiety, and stress-related disorders.
Another encouraging aspect of the study is that newly starting patients appear to be continuing with therapy. The study noted an increase in the number of therapy visits compared to previous years.
“This generally suggests that psychotherapy is becoming more accessible, and people are recognizing its value,” Olfson points out. Dr. Jessi Gold, Chief Wellness Officer at the University of Tennessee System, suggests the increasing awareness of what therapy involves might contribute to this trend. Individuals now seem less likely to expect quick fixes or to disengage from the process prematurely.
Although some of these trends had begun before 2019, the COVID-19 pandemic likely opened up more discussions about mental health and encouraged more individuals to seek help, Gold notes.
Telehealth’s Role
The expansion of telehealth during the pandemic has also likely made it easier for more people to access talk therapy. Gold asserts that telehealth significantly increased accessibility for individuals who might have had trouble finding a therapist due to location or availability.
Both Olfson and Gold emphasize that there is now a wider range of providers available, including licensed counselors and social workers, rather than just psychiatrists and psychologists as it was previously.
However, Olfson mentions a continued issue regarding access: those benefiting most from talk therapy tend to be more affluent individuals. “Typically, it’s the more educated, those with private insurance, and higher income levels in urban areas who are seeing the most benefit,” he explains. He hopes these insights can help improve access for those who may face financial barriers.
According to the National Institute of Mental Health, only about half of Americans with any mental illness received care in the past year, highlighting ongoing challenges in mental health treatment access.
