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But many of them instead set up a private practice, where they can charge $400 an hour in cash to help people who Humphreys calls “the worried well” — people who enjoy the self-exploration of therapy but do not necessarily have a mental health problem.

“A minute I spend training that person is a minute of my life wasted,” Humphreys said. “That very well trained person should be taking care of very, very troubled people. When they don’t, everyone who needs that care loses out.”

Humphreys said this trend of psychiatrists and other mental health clinicians shunning the health insurance industry and decamping to the cash market dates back 70 years, to the end of the Second World War.

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Image: By Jty33 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=25405611

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