Healing Shouldn’t Be a Luxury: How Cost Creates a Barrier to Mental Health Care

For many people, especially those reentering society after incarceration or navigating economic instability, the cost of therapy is one of the biggest barriers to getting mental health support. Therapy is often talked about as an essential tool for healing but, for too many, it remains a luxury they simply cannot afford.

A standard therapy session in the Pacific Northwest can cost anywhere from $120 to $250-plus per hour for licensed clinicians. For those who need weekly or biweekly care, that price quickly becomes overwhelming. Some community members spend more on one session than they do on groceries for the week. And for people who are rebuilding their lives after incarceration- often starting from scratch with employment, housing, transportation, and family responsibilities- mental health care is rarely something they can prioritize financially.

Insurance is often seen as the solution, but the reality is far more complicated. Many therapists do not accept insurance due to low reimbursement rates, administrative burden, and delayed payments. Even when insurance is accepted, high deductibles or copays mean clients still pay out of pocket. Some insurance plans cover only a limited number of sessions, leaving people unsupported once benefits run out. Medicaid offers more coverage, but not all therapists accept it, and waitlists for Medicaid-based care can stretch months.

This leads many people to face a painful choice: prioritize their mental health or prioritize basic needs. And when someone is recently released from incarceration- when they’re trying to secure employment, find stable housing, reconnect with family, and navigate supervision requirements- basic needs almost always win.

For people living on fixed or low incomes, the calculation is even more stark. Therapy may feel important, but rent is due. Utilities need to be paid. Children need food, clothes, and support. Transportation, court fees, and reentry-related expenses stack up. Even when someone knows therapy would help them process trauma, regulate emotions, or stay on the right path, the financial reality makes it feel out of reach.

The emotional weight of this barrier is heavy, too. People may internalize the belief that healing is “not for people like them,” that therapy is something only the financially comfortable can afford. This belief can deepen feelings of isolation, stress, and hopelessness.

But the truth is that cost is not a reflection of someone’s worthiness of support. It is a reflection of a system that has not been built for equitable access.

Community-based solutions such as sliding-scale programs, therapy voucher initiatives, peer support models, and culturally grounded community healing spaces are critical in closing this gap. They remind people that healing should not be a privilege reserved for those who can pay, but a right deserved by everyone.