• Julie Raworth

Are we exploiting mental health by charging?

Updated: Jul 25, 2021

I just read a post online criticising us Private Practitioners for exploiting people with mental health issues into spending money when there are free services available. I cannot help but feel defensive about this.


I don't see what I do as exploiting this system but at times helping people recover from it when it has failed them. More importantly by paying for my service tells me the client values their mental health and is willing to put the hard work in because they need to see something for their money. It enables clients autonomy, accountability, responsibility, control and thus empowerment of their own well-being, increasing their confidence and self-esteem in the world. By having to find the funds mean they are actually taking their mental health seriously. They value and respect it and see it as something worth investing in, the same way we would pay to go to the gym.

Do we accuse gyms of exploitation?

Why is physical health different to mental health?


Instead of giving all power and control to the system which may be part of the cause of their problems they are taking control of their own wellbeing.


People prefer to pay privately, as they do with other healthcare facilities, because they have more control over who they see and when they see them. They are not restricted to time-limited sessions and can choose the therapist that they feel suits them best. The relationship between client and therapist has proven to be the most important factor in making progress, not the tools they provide.


It makes the client the expert of themselves, not the clinicians.



On a more personal level;

1; To be a private practitioner we have had to have spent many years and money studying and training to do so to reach any accredited status that warrants us to be worthy of charging for our services. You cannot just declare yourself a counsellor without years of training. I personally spent 10yrs to gain my Counselling Psychology chartership and still remain in debt because there was no government funding to support this course. I worked full-time whilst seeing clients, having my own therapy, attending uni and doing my masters research.


2; We all need to earn a living the same way those who work in the NHS mental services do. Why should we be providing this for free when those working in the NHS get a salary?



3; Our work does not stop after the client session ends. We have to have regular supervision, we have to continually train and keep up with CPD to keep our accreditation. I have just spent 3hrs emailing new referrals and managing my own client case load and calendar.These referrals come in all hours of the day, not just 9-5


4; We work unsociable hours to accommodate client needs.


5; Because of confidentiality we cannot just go home and have a good offload about our work. We have to hold and manage all of this within ourselves and through supervision. This is part of what we train to do.


6; If the NHS system for mental health support got it right there would be no need for us. Maybe not great for my business but I would love to hear my services were no longer needed.


Unfortunately people are on huge waiting lists, they are restricted to the kind of 'talking therapy' they get that may not actually be clinically appropriate and so we are merely filling the gaps of this service.



Recent Posts