A recent Columbia University-led study highlights a shift in mental health treatment trends from medication to psychotherapy, emphasizing the growing importance and effectiveness of therapeutic intervention.
Psychotherapy is taking center stage in American mental health care as the use of psychiatric medications without accompanying therapy declines, revealed an eye-opening study led by Columbia University Mailman School of Public Health and Columbia University Irving Medical Center. The findings, published in the American Journal of Psychiatry, indicate a notable shift from a medication-centric approach to one emphasizing therapeutic sessions.
“After years of American mental health care moving towards greater use of psychiatric medications, the pendulum has started swinging back towards psychotherapy,” Mark Olfson, a professor of epidemiology and psychiatry at Columbia Mailman School, said in a news release.
The study, focusing on outpatient mental health treatment data from 2018 to 2021, observed an increase in psychotherapy-only treatments from 11.5% in 2018 to 15.4% in 2021.
In contrast, the reliance on medication-only treatments decreased from 68% to 62% during the same period.
Additionally, national psychotherapy expenditures soared from $31 billion to $51 billion, reflecting the growing emphasis on therapy over medication.
Analysis of the Medical Expenditure Panel Survey data revealed that while the number of patients receiving psychotherapy from psychiatrists declined from 41% to 34%, non-physician therapists like social workers and counselors filled the gap.
“Psychiatrists provided psychotherapy to a decreasing percentage of all psychotherapy patients, which may have increased the need for psychiatrists to refer patients to and collaborate with non-physician psychotherapists,” added Olfson. “At the same time, social workers and counselors, but not psychologists, assumed a larger role in providing psychotherapy and there was an increase in the average number [of] psychotherapy visits per patient. A decrease in the fraction of patients with just one or two psychotherapy visits further suggests there was a decline in early drop out.”
Interestingly, the study found that much of the change happened between 2018 and 2019, suggesting that the shift was influenced by factors other than the COVID-19 pandemic and the rise of telemental health services.
“Americans are becoming more willing to seek out and stick with psychotherapy,” Olfson said, adding that psychotherapy by mental health counselors might see further growth following a change in Medicare reimbursement policy now allowing mental health counselors and licensed marital and family therapists to bill for their services.
The shift has significant implications for the future of mental health care in the United States, potentially leading to improved patient outcomes by providing more holistic and personalized treatment approaches.
Co-authors of the study include Chandler McClellan and Samuel H. Zuvekas of the Agency for Healthcare Research and Quality, Melanie Wall of Columbia Mailman School of Public Health and Columbia University Irving Medical Center, and Carlos Blanco of the National Institute on Drug Abuse.