While medication is important in treating depression, psychological therapy is also crucial. However, the high cost of psychological counseling services in the market, ranging from hundreds to thousands of yuan per session, often deters many depression patients.
“Because you are unemployed, you are in mental pain,” the woman with depression was shocked to hear from the doctor.
Recently, a woman suffering from severe depression did not go to work and had suicidal thoughts during her illness. When she went to the hospital for consultation, the doctor’s response to her was, “Because you are unemployed, you are in mental pain.”
Due to the inability to afford the high cost of psychological counseling, the woman was even advised by the doctor to find a job to earn money for treatment, exacerbating her already fragile state of depression and causing her more psychological distress.
â—Ž Image: Screenshot from Weibo
In the comments section, many netizens shared similar experiences and expressed doubts about the psychology counseling industry: Are psychological counseling sessions that cost hundreds or thousands of yuan really effective?
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How expensive is psychological counseling? Ranging from 200 yuan to 1000 yuan per session
In China, there are a considerable number of depression patients in need of treatment. According to a 2021 survey published in “The Lancet Psychiatry,” approximately 95 million people in China suffer from depression, and 40% of the 280,000 suicides each year are related to depression.
The treatment of depression generally includes medication, psychological therapy, biological treatment, and other complementary therapies. Currently, some public hospitals have psychological clinics where, in addition to common medication treatments, face-to-face psychological therapy is the primary method of treatment.
Unlike regular social psychological counseling, psychological therapy can only be conducted in medical institutions by qualified practitioners for diagnosis. However, due to the limited availability of hospitals with psychological clinics, patients often face difficulties in getting appointments, and some good doctors may have appointments scheduled six months in advance.
On the other hand, social psychological counseling institutions only provide counseling services and require at least a Level 2 psychological counselor qualification to provide guidance and advice to visitors.
â—Ž Regular social psychological counselors usually do not handle severe depression patients./Image: Screenshot from the internet
Both psychological therapy and counseling typically involve sessions of around 1 hour, with relatively high individual session prices.
Pingping, a 21-year-old university student, developed moderate depression due to long-term isolation and psychological abuse from her roommates. After receiving several psychological counseling sessions, her emotions worsened – her mood did not improve, but her wallet took a heavy hit.
She booked an appointment online with a mid-level counselor for 400 yuan per hour. Due to the slow progress of the verbal therapy, the counselor recommended she attend at least once a week. After a month, Pingping had spent thousands of yuan.
Pingping described psychological counseling as a venting session. While she felt relieved during the hour of counseling, once she left the counseling room, the depressive cloud returned because the counselor did not provide much helpful advice.
Some people are willing to “spend money to buy happiness,” but others are not willing to pay for happiness. Anna, 30, fell into depression after giving birth. When she called the mental hospital for an appointment and mentioned the name of a renowned specialist, the nurse on the other end of the line asked, “The chief consultant’s fee is relatively high, 1000 yuan per hour. Are you sure you want to make an appointment?”
Anna hesitated for a moment and hung up. She said, “I would rather remain depressed than spend so much money just to feel a bit better.”
â—Ž Image: Ruijing Vision
Public data shows that the fees at psychological counseling institutions vary depending on the counselor’s level. The fees for new or mid-level counselors range from 200 yuan to 600 yuan per hour, while senior counselors charge between 700 yuan and 1500 yuan per session.
Compared to public hospitals, the fees in public hospitals are relatively lower. According to a 2017 survey published in “Investigation of the Current Situation of Psychological Counseling and Treatment Fees in China,” 82.4% of public hospitals charge less than 100 yuan per hour for psychological counseling, and 58.8% of public hospitals charge between 100 yuan and 200 yuan per hour.
However, 39 Shenhu Xi also found that the fees for psychological counseling in some hospitals have been increasing, and some institutions even charge from 500 yuan to 1000 yuan per session.
To maintain emotional or medical stability, patients typically need at least one counseling session per week. This results in a significant cost burden for the patients.
â—Ž Price of services by senior psychological counselors./Image: Screenshot from the internet
Some industry insiders have mentioned that since psychological counseling is still in its initial stage in China, there is no unified pricing standard. Generally, the fees are set based on the counselor’s qualifications and experience – the higher the qualifications, the higher the prices.
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Does high fees correspond to high-quality services in psychological counseling?
So, are the high fees for psychological counseling services proportional to the quality of service provided? In the treatment of mental and psychological disorders, psychological counseling plays an important role in addressing deeply rooted emotional trauma in patients or visitors, helping patients achieve psychological growth and truly overcome their pain.
Although psychological therapy cannot be solely used for severe depressive episodes, studies have shown that psychological therapy has a similar effect on mild to moderate depression as antidepressant medication.
If psychological counselors do have the ability to heal patients, then the high fees can be justified. However, many patients have expressed that psychological counseling did not meet their expectations.
39 Shenhu Xi’s search on social media platforms found that many patients felt deceived during psychological counseling sessions: “I spent a lot of money, but I don’t know if the psychologist is professional or not,” “Seeing a very expensive psychiatrist made me feel more distressed,” “The doctor didn’t understand my situation at all,” “A male doctor at a top-tier hospital in psychiatry told me to have a child, and everything would be fine…”
â—Ž Image: Screenshot from Weibo
Nowadays, with the increasing demand for psychological counseling services among depression patients, a variety of psychological counseling institutions have emerged rapidly. According to a report from the Hua Jing Industry Research Institute, China has seen over 100,000 existing psychological counseling institutions in the past decade, with an average annual growth rate of over 40%.
The rapid development of the psychological counseling market has outpaced the supply of qualified professionals, leading to various irregularities. It is known that some psychological counseling services that charge exorbitant fees have counselors with varying levels of professional competence. As a “non-licensed occupation,” psychological counselors can start working without obtaining relevant licenses or qualifications. However, many institutions tend to promote a “Certificate of Completion of Psychological Counselor Training” as a “professional qualification certificate,” causing misunderstandings.
Furthermore, some institutions even deceive the public by claiming to provide psychological counseling services while engaging in astrology, holistic therapy, and other businesses.
Experts have pointed out that psychological counseling is a lifelong learning course that requires continuous study. Training a psychological counselor is as time-consuming as training an internal medicine doctor, with a similar systematic training process as a master’s degree in medical clinical specialty. However, according to the “Legal Daily” report, achieving a certification and working as a psychological counselor only requires completing a few months of courses, and the professional level of some practitioners is very limited.
â—Ž Image: 123rf
When a severely depressed patient in a breakdown encounters a psychological counselor lacking professional capabilities, it undoubtedly exacerbates the patient’s distress and suffering.
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Multiple regions in China have included psychological therapy in medical insurance
Depression can cause various harms to individuals, such as continuous agitation, insomnia, decreased appetite, low energy, low self-evaluation, feeling that everything is terrible, a bleak future, and a lack of interest in anything. When the condition worsens, it may lead to physical symptoms like palpitations, chest tightness, constipation, weight loss, etc. Some patients are at a loss, and ultimately may choose suicide.
To reduce the treatment costs for mental and psychological illness patients and improve the mental health literacy of the residents, in recent years, several regions in China have included psychological therapy in medical insurance coverage. Beijing, Guangdong, Jiangsu, and other regions have successively included psychological therapy in the medical insurance payment range.
As an example, starting August 15, 2021, Guangdong Province officially reimburses for psychological therapy services. The reimbursement amounts are 200 yuan per session for tertiary hospitals, 180 yuan for secondary hospitals, and 160 yuan for primary hospitals.
This move not only reduces the treatment costs for patients but also to some extent eliminates the stigma associated with seeking treatment for mental illness, enabling patients to openly seek help at hospitals.
â—Ž Image: Panoramic Vision
However, including psychological therapy in medical insurance is currently a localized policy and has not been widely implemented nationwide. The high cost of treatment remains a major concern for depression patients.
Moreover, considering the current situation, the lack of psychological clinics in medical institutions, high counseling fees, the mixed status of the industry, and the difficulty in quantifying the treatment effects all pose significant challenges for patients with mental and psychological disorders, such as depression.
In such circumstances, many patients can only rely on self-help. For patients with mild depression, they can start by adjusting their self-perception for emotional regulation, seeking help from family and friends, or calling toll-free psychological counseling hotlines. Those with economic means can opt for professional psychological counseling services, but it is crucial to select legitimate institutions and qualified counselors.
â—Ž A comparison between professional and non-professional psychological counselors./Image: 39 Shenhu Breath
Since social psychological counseling institutions’ counselors do not have prescribing rights and cannot prescribe medication, it is advisable for patients with severe depression to seek treatment at hospitals. Under the guidance of a doctor, they can undergo systematic treatment through medication or other methods.
(At the request of interviewees, names in the text are pseudonyms.)
Author | Yang Meiyun
Layout | Shen Shen
Cover | Ruijing Vision
First image | 123rf
