• Posted December 4, 2024

As 'Teletherapy' Takes Hold, Nearly 12% of Young Adults Now Undergo Psychotherapy

Access to psychotherapy has increased substantially among Americans, particularly young adults, a new study has found.

About 12% of young adults received psychotherapy in 2021, followed by 8% of the middle-aged and 5% of seniors, researchers found.

Overall, the percentage of U.S. adults receiving psychotherapy rose from about 7% in 2018 to 9% in 2021, and telemedicine may be the reason why.

Nearly 40% of adults who got psychotherapy in 2021 had at least one session using telemedicine.

However, that means psychotherapy is also significantly more available to adults with more money, higher education and full-time employment.

"While psychotherapy access has expanded in the U.S., there's concern that recent gains may not be equally distributed, despite or maybe because of the growth of teletherapy," said researcher Dr. Mark Olfson, a professor of epidemiology and psychiatry with Columbia University’s Mailman School of Public Health, in New York City.

"This increase in psychotherapy use, driven by the rise of teletherapy, has largely benefited socioeconomically advantaged adults with mild to moderate distress,” Olfson added in a Columbia news release.

For the study, researchers analyzed survey data on medical expenditures collected between 2018 and 2021 from a total of more than 86,600 adults.

As the researchers explained, teletherapy is more convenient for many patients, and is less stigmatizing than showing up at a therapist’s office.

Dr. Manish Sapra is executive director of behavioral health services at Northwell Health in New Hyde Park, N.Y. He wasn't involved in the new study, but agreed that teletherapy is revolutionizing mental health care.

"Now we're in this world where everybody's comfortable with it, open to get these services, any provider can start a private practice from their living room," Sapra said. "And then there are so many digital mental health startups that have aggregated these individual therapists and brought them under one umbrella. So there has been, in a way, a democratization of availability of psychotherapy services and an ease of access to these services."

However, a lack of insurance coverage, high out-of-pocket costs and poorer access to the necessary technology means that some aren’t able to take advantage of that, Olfson's team noted.

Sapra agreed.

"As the study highlights, these services are being accessed by folks who have more means, they have better commercial insurance, they have the technology, and it is worsening [access to] services for folks who may not have the best insurance or may have more severe illnesses," he said.

In addition, Medicaid has low reimbursement rates, which might discourage therapists from taking low-income clients, the researchers said.

The findings were published Dec. 4 in the journal JAMA Psychiatry.

"The trends we are seeing underscore the need for targeted interventions and health policies that expand psychotherapy access to underserved groups," Olfson said. "Ensuring that individuals in psychological distress can access care is a national priority. Addressing technical and financial barriers to teletherapy could help bridge the gap in access and promote equity in mental health care."

More information

The American Psychological Association has more on psychotherapy.

SOURCE: Manish Sapra, MD, executive director, behavioral health services, Northwell Health, New Hyde Park, N.Y.; Columbia University, news release, Dec. 4, 2024