2 ms·

You make a completely benign mechanism sound like a vast conspiracy... The simple fact, which you already mentioned, is that psychotherapy takes dozens of sess

You make a completely benign mechanism sound like a vast conspiracy... The simple fact, which you already mentioned, is that psychotherapy takes dozens of sessions with an expert to be effective. Cost of treatment is in the four digits, easily, while medication costs less than $10/week since most SSRIs are no longer protected by patents. Psychotherapy and medication have almost identical effectiveness, making the latter the preferable first-line option in almost all cases.

aaavl2821 9y ago
It may be rational for payers to minimize cost of care rather than try to find a better balance between cost of care and outcomes, but that doesn't make it benign. The preferable first line option would be medication + psychotherapy, or at least medication and regular follow up to ensure it's working and adjust dose if needed 6-12 sessions of CBT (NICE recommends 6-8 for mild to moderate depression) with a licensed clinical social worker would be comparable in cost to a year of generic SSRIs. However 55% of US counties don't even have a mental health professional (because payers stopped paying for it), so CBT isn't really an option for many