Kyle MacDonald: Why is mental health therapy in Auckland so expensive?

The truth is, I don't know many rich therapists. More to the point, I don't know a single one who does it for the money. Image / Getty Images

There aren't many jobs where you would happily live in a world where your services are no longer required. But I couldn't think of anything better. It's a strange time to be a psychotherapist and our services are more in demand than ever before.

Some might say, with such unprecedented demand, we could charge what we like. Some critics undoubtedly think we already do.

Particularly in Auckland: In wealthier suburbs you can't swing a cat without hitting a therapist or psychologist's office. And without question, nationally, the prices are highest in Auckland.

It's expensive, no doubt. Many can't afford it, no question.

The breakdown of costs include office rent (this accounts for almost all the regional differences in prices) compliance costs, insurance, ongoing training and courses required for professional development and registration - it all adds up. And we can only see so many people a week - burnout is a real risk in our line of work.

But at the risk of sounding defensive, let's also be clear: this wasn't our idea.

This is the reality of a privatised mental health system where talk therapy has been increasingly pushed out of the public mental health system, where the revolving door - patch them up, push them out approach - holds sway.

Under this model, talk therapies are inconsistently available. If therapy is offered it's largely only via time-limited models, which can provide symptomatic relief for some, but are unlikely to bring about lasting, and meaningful change for most.

The truth is, I don't know many rich therapists. More to the point, I don't know a single one who does it for the money. Many of my colleagues would gladly be part of a public system that worked: one that provided access for everyone. Many also routinely discount, work for koha, have sliding fee scales, and generally try to help those who may not be able to afford private fees.

We know from the research into the psychological effects of inequality, that everyone is adversely affected. It's obvious how those financially struggling are impacted - no doubt they are most severely affected. But even the most well off in unequal societies are worse off than the wealthy in more equal countries.

Inequality is toxic. Nowhere is this inequality more obvious than Auckland.

It causes an underlying anxiety, competition and instability that leaves everyone who lives in unequal societies more likely to fall victim to emotional distress, impulsive addictive behaviours, and avoidable, so called "lifestyle" health problems: heart disease, diabetes etc.

The truth is, I don't know many rich therapists. More to the point, I don't know a single one who does it for the money.

- Kyle MacDonald

And so at the same time this inequality drives the increased need for mental health treatment, our lack of willingness to fund it also means therapy is out of the reach of many.

While ultimately the solution is to make our society more equal, in the meantime we need to fully fund therapy and counselling and make it widely available - especially in Auckland, a city many can no longer afford to live in - let alone get the help they need for the inevitable stress living in the City of Sails causes.