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Illustration by Brittany England

Finding a therapist is a huge step in taking charge of your mental health. But unlike a cold or the flu, mental illnesses — like anxiety and depression — can take some time to heal.

In fact, some studies have shown that most people in therapy remain in treatment for 5-10 sessions, and meet with their counselors weekly. What this means is that therapy is a commitment, and depending on your health insurance coverage, it can be costly.

Unfortunately, having health insurance doesn’t guarantee that you won’t need to pay upfront for therapy. Plans with high deductibles won’t cover any medical costs until the deductible has been met. Until that time, you’ll need to pay out-of-pocket for your appointments.

Unlike a $10-$30 insurance co-pay, most therapists charge between $75-$150 per session. In expensive cities, like San Francisco, Los Angeles, and New York, however, therapy can cost as much as $200 per session.

Luckily, for people who want to book in with a therapist but don’t have the means to shell out a significant amount of cash, cost-effective services are available. To help you get started, we’ve provided a list of affordable mental healthcare options.

Sliding scale therapists are psychotherapists, psychologists, and social workers who adjust their hourly fee to help make therapy more affordable for the client.

Finding this type of therapist may be a good option if you need to pay out-of-pocket for counseling, or if your insurance provider doesn’t offer referrals to specialists.

All mental health providers are trained to treat concerns, like anxiety, depression, and adjustment disorders, but not all specialize in treating things like postpartum depression, complicated grief, or post-traumatic stress disorder (PTSD). People seeking help for these types of conditions may benefit from finding a specialist who will slide their scale.

Mental health directories, like Psychology Today and GoodTherapy.org, allow you to search for sliding scale therapists who practice in cities across the nation. Most of these therapists charge between $75 to $160 per session, and the rate is determined by each provider.

If you need a more affordable option, Open Path Psychotherapy Collective is a nationwide network of mental health professionals who charge between $30-$80 per session. Unlike more extensive mental health directories, this website only includes sliding scale therapists in their searchable database.

If you don’t have health insurance and you can’t pay out-of-pocket for mental healthcare, low-fee or free community mental health clinics can provide the care you need.

These clinics are staffed by psychotherapists and psychologists, but often are able to expand their services through the use of student psychologists, student mental health counselors, and student social workers who are supervised by licensed, experienced professionals. Services are often provided at no cost, or at a remarkably reduced rate.

At the clinics, mental health professionals offer a variety of services, including individual and family counseling, medication management, and drug addiction counseling. They’re also trained to treat a wide range of psychological concerns, like depression, anxiety, bipolar disorder, and schizophrenia.

To find a clinic in your local area, contact the National Alliance on Mental Illness (NAMI) HelpLine or go to MentalHealth.gov. Your primary care physician can also provide recommendations in your community.

Therapy apps like Talkspace and Betterhelp let you connect with a therapist online or via text. Busy business and healthcare professionals, new moms, and students often find teletherapy appealing because you can talk to your therapist from anywhere.

Before signing up for online therapy, individuals complete a mental health questionnaire. Based on those results, each new client is matched with a psychotherapist. Similar to in-person therapy, fees for online therapy vary. Talkspace fees are as low as $49 per week while Betterhelp charges between $35-$80 per week.

According to the American Psychological Association (APA), online therapy may be as helpful as meeting with a therapist in-person. However, this type of care isn’t for everyone. The APA cautions that those with more serious mental health concerns, like schizophrenia, PTSD, and substance use disorder often need more attention and care than remote treatment offers.

In addition to online therapy, mental health apps, like Calm, Headspace, and Expectful can teach you meditation, relaxation, and breathing exercises. Not only do these apps help you create a daily habit of self-care, but research shows that meditation can reduce stress and increase well-being.

Individuals experiencing eating disorders, postpartum depression, alcohol and substance use disorder, and those coping with grief or loss may benefit from attending a local support group.

Different from individual therapy, support groups connect you with others who are going through a similar experience. While individual therapists often steer clear from giving direct advice, support groups allow you to ask for other people’s opinions.

It can also be healing to hear other people share their stories, because it reminds you that you’re not alone. This can be especially helpful if you’re coping with an illness, like cancer, or supporting a loved one with a chronic health condition or mental illness.

Similar to individual therapy, it’s important to find a group that meets your needs. Before joining a group, it can be helpful to ask the group leader about the group dynamic (i.e., how their participants engage with one another) and to find out about the structure of the group.

Open-ended groups like new mom support circles allow participants to share at any time during the session. Structured groups, especially those that teach participants a set of life skills like mindfulness, may follow a set curriculum each week.

Mental Health America lists specialized support group resources on their webpage. If you or a loved one has recently been diagnosed with an illness, like cancer or diabetes, hospital social workers can also provide a list of local support groups in the community.

Finally, costs for support groups can vary. Addiction support groups, like Alcoholics Anonymous, are free of charge, while other groups may charge a small fee.

Mental health emergencies — like suicidal thoughts, sexual assault, and domestic violence —require immediate psychiatric care and attention.

If these crises arise, hotlines can be called at any hour of the day. These hotlines are staffed by trained volunteers and professionals who provide emotional support and can connect you with assistance.

Suicide prevention

  • If you think someone is at immediate risk of self-harm or hurting another person:
  • •  Call 911 or your local emergency number.
  • •  Stay with the person until help arrives.
  • •  Remove any guns, knives, medications, or other things that may cause harm.
  • •  Listen, but don’t judge, argue, threaten, or yell.
  • If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Juli Fraga is a licensed psychologist based in San Francisco, California. She graduated with a PsyD from the University of Northern Colorado and attended a postdoctoral fellowship at UC Berkeley. Passionate about women’s health, she approaches all her sessions with warmth, honesty, and compassion. See what she’s up to on Twitter.