The Mass Marketing of Mental Health

Mental health is having a moment. As online counseling, holistic medicine and unlicensed alternatives to therapy proliferate, psychotherapy remains a critical service. However, as the world shifts to accommodate more interest in (and access to) psychotherapy, corporation-driven directives often compromise our ability to provide a consistently valuable service.

The New York Times recently ran an article describing a new project by a popular pharmacy chain to provide mental health services in their drugstores. Admittedly, it’s easy to understand the appeal. For starters, popular pharmacy chains have enormous marketing potential; they lead with the message that psychotherapy is too difficult to access — and too expensive — and they can do it cheaper, faster and better.

Tempting though this idea may be, however, the practice of “marketing” rigorous psychotherapy through untested marketing channels is fraught with complication.

The one-stop-shop approach might work well when you need to develop some photos and pick up some Tylenol, but the limits of this service are obvious; the critical, intimate relationship between patient and psychotherapist is not something one can buy at a drugstore.

The implications for sole practitioners or small businesses are particularly discouraging; we have only to cite the example of how large pharmacy companies have cornered the market not only on drugstores, forcing smaller stores out of business, but have contributed to the rising prices of pharmaceuticals in the process.

And finally, there is the issue of motive: Pharmacies often work in tandem with insurance companies, sharing an incentive to limit coverage and reduce reimbursements. This presents the challenge of not being free to conduct therapy well, as long, or as frequently as may be indicated. Many therapists already feel constrained by insurance companies that second-guess their judgment — and, as other industries demonstrate, the benefits of mass production come at significant cost.

I contend that conflating psychotherapy with retail therapy will not result in “cheaper, faster, better” treatment, but will instead result in a full-scale reduction in standards of practice and professional compensation—a profit-driven model that considers the needs of the company before the needs of the client.

It’s not just pharmacies angling for industry inroads. Consider the proliferation of apps and online offerings that market their services by promising that you’ll be connected with a licensed therapist 24 hours a day; not only does this present an obvious work/life-balance challenge for mental health professionals, but it conflates the work of the psychotherapist and crisis line operator. We do not — and should not — serve in the same capacity.

Large-scale changes to the messy, nuanced, deeply personal and highly effective practice of psychotherapy must be scrutinized from every angle. The fate of the practice of psychotherapy must be taken seriously. As we witness the next chapter in the corporatization of mental health, we should do all we can to warn against the dangers of shopping for psychotherapists at the same place you shop for bubble gum.