Have you ever noticed how therapy seems more accessible than ever—and yet, somehow, people who really need it still get left behind? That’s exactly what Darragh Sheehan explores in his thought-provoking piece, “The Quiet Crisis in Mental Health,” on Mad in America.
And honestly? He’s onto something.
Therapy for the “Worried Well”?
Let’s talk about the people who are most likely to be seen by therapists today. They’re often functioning just fine on the outside—managing jobs, school, families—but feeling stressed, overwhelmed, or maybe just looking for a little personal growth. And there’s nothing wrong with that! Therapy should be for everyone.
But here’s the problem: this group, sometimes called the “worried well,” has started to dominate the therapy space. Why? Because their issues are considered easier to treat. Insurance companies love that. Therapy platforms love that. It’s efficient, tidy, and billable.
But what happens to people struggling with deep, serious mental health challenges? Schizophrenia, severe trauma, complex PTSD? Many of them are getting left behind—not because therapists don’t care, but because the system makes it incredibly hard to care for them properly.
Fast-Tracked and Burned Out
Sheehan also points out another tough truth: the therapist workforce is changing—fast. More people than ever are becoming therapists through shortened, fast-tracked programs. While these programs might get you licensed quicker, they sometimes skip over deep, hands-on clinical experience.
Add to that the rise of “side hustle” therapists (folks doing therapy part-time, often through big-name apps), and you’ve got a field that’s starting to feel a bit like the gig economy. The heart-centered, steady presence that therapy used to promise? It’s being replaced with quick sessions, shorter commitments, and burnt-out clinicians trying to make ends meet.
The Money Problem (Surprise, Surprise)
It’s no secret that insurance companies shape the way mental health care is delivered. They favor short-term treatment. They limit session lengths. And they certainly don’t reimburse well for the kind of time and energy it takes to help someone in deep psychological distress.
So, it’s not shocking that many therapists are choosing to see clients who are “easier” to work with—people who won’t need crisis intervention, extra coordination, or constant documentation. That’s not a moral failing. It’s an economic one.
So… What Can We Do?
Sheehan’s message is clear: this quiet crisis needs our attention. We need a mental health system that values deep, relational work. That supports therapists in doing long-term therapy when it’s needed. That doesn’t penalize professionals for wanting to help people who are really struggling.
We also need to stop pretending therapy is a one-size-fits-all solution. Because it’s not.