Behavioral Health: What Therapists and Psychiatrists Treat

What behavioral health means

Behavioral health is the umbrella term for mental health care and substance use treatment. SAMHSA, the federal agency that oversees the field, defines it as "the promotion of mental health, resilience, and well-being; the treatment of mental and substance use disorders; and the support of those who experience or are in recovery from these conditions." 2Ref 2Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Behavioral Health Workforce — SAMHSA.SAMHSA definition of behavioral health; projected shortage of 31,000 full-time mental health practitioners by 2025

The term is broader than "mental health" alone: it encompasses how thoughts, emotions, and behaviors affect overall physical health, and it includes the treatment of addiction alongside conditions like depression, anxiety, ADHD, PTSD, and bipolar disorder.

Behavioral health conditions are common. In 2022, 23.1% of U.S. adults — about 59.3 million people — experienced a mental illness in the past year, according to the National Survey on Drug Use and Health. 1Ref 1Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Mental Illness — Statistics: National Survey on Drug Use and Health 2022.23.1% of U.S. adults (59.3 million) experienced any mental illness in 2022; 50.6% received treatment Yet fewer than half (50.6%) received any mental health treatment. 1Ref 1Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Mental Illness — Statistics: National Survey on Drug Use and Health 2022.23.1% of U.S. adults (59.3 million) experienced any mental illness in 2022; 50.6% received treatment

Conditions behavioral health providers treat

Behavioral health spans a wide range of diagnoses. Common conditions include:

• Anxiety disorders — generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, specific phobias. About one in three U.S. adults will experience an anxiety disorder at some point in their lives. 3Ref 3National Institute of Mental Health (NIMH) (2024).Anxiety Disorders — NIMH.About one-third of U.S. adolescents and adults experience an anxiety disorder at some point in their lives
• Depression — major depressive disorder affects an estimated 8.3% of U.S. adults (21 million people) in any given year; 61% received treatment in 2021. 4Ref 4Substance Abuse and Mental Health Services Administration (SAMHSA) (2022).Major Depression — National Survey on Drug Use and Health 2021.8.3% of U.S. adults (21 million) had a major depressive episode in 2021; 61% received treatment
• ADHD in adults — 15.5 million U.S. adults (6.0%) have a current ADHD diagnosis; 55.9% received that diagnosis as an adult rather than as a child. 5Ref 5Staley BS, Robinson LR, Claussen AH, et al. (2024).Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — United States, October–November 2023.15.5 million U.S. adults (6.0%) have current ADHD diagnosis; 55.9% diagnosed as adults; 46% used telehealth for ADHD care
• Trauma and PTSD — post-traumatic stress disorder, complex trauma, and acute stress reactions.
• Bipolar disorder, OCD, and psychotic disorders — conditions requiring coordinated psychiatric and therapy care.
• Substance use disorders — alcohol, opioid, stimulant, and other substance use, often co-occurring with mental health conditions.
• Eating disorders and somatic conditions — anorexia nervosa, bulimia nervosa, binge eating disorder, health anxiety, and insomnia.

Types of behavioral health providers

The term "therapist" covers several license types; a psychiatrist is a different kind of clinician entirely.

Psychiatrist (MD or DO) — a physician with a psychiatric residency who can prescribe and manage medication, diagnose conditions, and provide therapy. Appropriate for complex, severe, or treatment-resistant presentations, or when a medical cause of symptoms needs to be ruled out.

Psychologist (PhD or PsyD) — doctoral-level clinician who provides psychotherapy and psychological testing (for ADHD, learning disabilities, diagnostic clarification). Cannot prescribe in most U.S. states.

Licensed clinical social worker (LCSW) — master's-level clinician providing therapy and resource coordination. The largest segment of the behavioral health workforce; accepted by most insurance plans.

Licensed professional counselor / licensed mental health counselor (LPC / LMHC) — master's-level therapist providing psychotherapy for a broad range of conditions. Titles vary by state.

Marriage and family therapist (LMFT) — specializes in relational and family-system dynamics alongside individual therapy.

Psychiatric nurse practitioner (PMHNP) — an advanced practice nurse who can diagnose and prescribe; increasingly the primary prescriber given psychiatrist shortages.

About 47% of mental health prescriptions in the U.S. are written by primary care physicians, not psychiatrists 6Ref 6American Academy of Family Physicians (AAFP) (2023).Mental and Behavioral Health Care Services by Family Physicians (Position Paper).47% of mental health prescriptions written by primary care physicians; 40% of mental health visits occur in primary care; two-thirds of PCPs cannot connect patients to outpatient mental health services, and roughly two-thirds of primary care physicians cannot connect patients to outpatient mental health care. 6Ref 6American Academy of Family Physicians (AAFP) (2023).Mental and Behavioral Health Care Services by Family Physicians (Position Paper).47% of mental health prescriptions written by primary care physicians; 40% of mental health visits occur in primary care; two-thirds of PCPs cannot connect patients to outpatient mental health services A behavioral health specialist bridges that gap.

How treatment works: therapy and medication

Behavioral health treatment draws on two main tools, often used together.

Psychotherapy (talk therapy) is the foundation of care for most conditions. Cognitive behavioral therapy (CBT) is the most studied form: a 2023 meta-analysis of 10 randomized placebo-controlled trials found that CBT produced significant reductions in anxiety symptoms (Hedges' g = 0.24) compared with active control conditions, consistent with decades of prior evidence. 7Ref 7Bhattacharya S, Goicoechea C, Heshmati S, Carpenter JK, Hofmann SG (2023).Efficacy of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Meta-Analysis of Recent Literature.CBT produced significant reductions in anxiety symptoms (Hedges' g = 0.24) vs. placebo controls across 10 randomized trials CBT typically runs 12–20 weekly sessions and focuses on identifying and changing unhelpful thought patterns and behaviors.

Other evidence-based modalities include: - Dialectical behavior therapy (DBT) — adapted CBT for emotional dysregulation, self-harm, and borderline personality disorder. - EMDR (eye movement desensitization and reprocessing) — a structured trauma therapy with strong evidence for PTSD. - Exposure and response prevention (ERP) — the gold-standard behavioral therapy for OCD. - Interpersonal therapy (IPT) — focused on relationship patterns contributing to depression.

Psychiatric medication is appropriate when symptoms are severe, when therapy alone has not produced adequate response, or when the biology of the condition makes pharmacological support important. SSRIs (selective serotonin reuptake inhibitors) such as sertraline, escitalopram, and fluoxetine are commonly prescribed first-line for depression and anxiety. Stimulant medications (amphetamine salts, methylphenidate) and non-stimulants (atomoxetine, guanfacine) are the evidence-based pharmacological treatments for ADHD. 5Ref 5Staley BS, Robinson LR, Claussen AH, et al. (2024).Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — United States, October–November 2023.15.5 million U.S. adults (6.0%) have current ADHD diagnosis; 55.9% diagnosed as adults; 46% used telehealth for ADHD care

For many conditions — particularly moderate-to-severe depression, anxiety disorders, and ADHD — combining therapy with medication produces better outcomes than either treatment alone.

Telehealth in behavioral health

Telehealth has become the dominant access point for behavioral health care. By late 2023, approximately 37% of all mental health visits in the U.S. were conducted via telehealth, making mental health the leading use case for telemedicine. 8Ref 8Trends in mental health care and telehealth use across area deprivation — PNAS Nexus (2025).Trends in mental health care and telehealth use across area deprivation: An analysis of electronic health records from 2016 to 2024.By late 2023, approximately 37% of all mental health visits were conducted via telehealth, the leading use of telemedicine

Video-based therapy has been shown to produce outcomes comparable to in-person care for depression and anxiety in randomized trials, with drop-out rates for remote CBT no worse than in-person. 8Ref 8Trends in mental health care and telehealth use across area deprivation — PNAS Nexus (2025).Trends in mental health care and telehealth use across area deprivation: An analysis of electronic health records from 2016 to 2024.By late 2023, approximately 37% of all mental health visits were conducted via telehealth, the leading use of telemedicine Approximately 46% of adults with ADHD have used telehealth services, and about half of those used it for counseling or medication management. 5Ref 5Staley BS, Robinson LR, Claussen AH, et al. (2024).Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — United States, October–November 2023.15.5 million U.S. adults (6.0%) have current ADHD diagnosis; 55.9% diagnosed as adults; 46% used telehealth for ADHD care

Telehealth is particularly relevant given persistent workforce shortages: by 2025, the U.S. was estimated to be short approximately 31,000 full-time mental health practitioners, and 40% of the population lives in federally designated mental health shortage areas. 2Ref 2Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Behavioral Health Workforce — SAMHSA.SAMHSA definition of behavioral health; projected shortage of 31,000 full-time mental health practitioners by 2025 Video appointments eliminate geography as a barrier and frequently shorten wait times compared with in-person care.

Cost and access

Without insurance: A therapy session (45–50 minutes) typically costs $100–$250 depending on credential and location. The national median is approximately $143 per session based on a 2024 analysis of private-practice therapists.

With insurance: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires most commercial insurers to cover mental health care at parity with physical health. In-network copays typically run $20–$50; high-deductible plans may mean paying full cost until the deductible is met.

Lower-cost options: - Sliding-scale therapists — many adjust fees based on income; ask directly. - Open Path Collective — a directory of therapists offering $30–$80 sessions for lower-income clients. - Community mental health centers — accept Medicaid and often use income-based fees. - Employee Assistance Programs (EAPs) — many employers offer 3–8 free sessions per year.

Psychiatric evaluation (medication management) typically costs $200–$500 out of pocket for an initial visit; follow-ups run $100–$200. Telehealth psychiatric services are widely available and often less expensive than in-person.

When to start with a therapist and when to see a psychiatrist

Start with a therapist when: - Anxiety, low mood, stress, relationship difficulties, or grief are affecting daily functioning - Symptoms are mild to moderate and no prior mental health treatment has been tried - The primary goal is understanding patterns, developing coping skills, or processing past experiences

Prioritize a psychiatrist or psychiatric NP when: - Symptoms are severe — depression with inability to function, daily panic attacks, or psychotic symptoms such as hallucinations or delusions - Previous therapy alone has not produced adequate improvement - Medication is needed to stabilize a condition before therapy can be productive - There is a history of bipolar disorder, schizophrenia, or treatment-resistant depression

Many people benefit from both. Primary care physicians also handle a significant share of mental health care — approximately 40% of all mental health visits occur in primary care settings. 6Ref 6American Academy of Family Physicians (AAFP) (2023).Mental and Behavioral Health Care Services by Family Physicians (Position Paper).47% of mental health prescriptions written by primary care physicians; 40% of mental health visits occur in primary care; two-thirds of PCPs cannot connect patients to outpatient mental health services