Psychotherapy Trends in the United States

Area of Science:

• Health Services Research
• Mental Health Services
• Psychiatry and Psychology

Background:

• Outpatient mental health care is a critical component of overall health.
• Understanding trends in mental health treatment modalities, such as psychotherapy and psychotropic medications, is essential for effective healthcare delivery.
• Recent shifts in treatment preferences and provider utilization warrant investigation.

Purpose of the Study:

• To investigate national trends in outpatient mental health care utilization and psychotherapy.
• To analyze changes in the use of psychotherapy alone, psychotropic medications alone, and their combination.
• To examine trends in psychotherapy visit frequency, expenditures, and provider types.

Main Methods:

• Analysis of service data from the 2018-2021 Medical Expenditure Panel Survey (MEPS) household population.
• Focus on adults with outpatient mental health visits (N=17,821) and psychotherapy visits (N=6,415).
• Age, sex, and Kessler-6 distress adjusted percentages were used to present trends in treatment modalities, visit frequency, expenditures, and provider characteristics.

Main Results:

• The use of psychotherapy alone increased significantly from 11.5% in 2018 to 15.4% in 2021.
• The use of psychotropic medication alone decreased from 67.6% to 62.1% during the same period.
• Psychotherapy visits per patient increased, national expenditures rose to $51.0 billion, and the percentage of patients receiving psychotherapy from psychiatrists decreased.

Conclusions:

• Psychotherapy played an increasingly significant role in outpatient mental health care between 2018 and 2021.
• Psychotropic medication monotherapy became less prevalent, despite remaining the most common treatment.
• A declining proportion of psychotherapy was delivered by psychiatrists, suggesting a potential rise in the need for interprofessional collaboration with non-physician psychotherapists.