The Future of Mental Health Employment: A Field at a Crossroads
Why the Mental Health Job Market is Deteriorating: AI, Corporate Giants, and the Decline of Community Care
The current state of employment in the mental health field is, to put it bluntly, abysmal.
Six years ago, when I first entered the field, community mental health centers (CMHCs) were the default setting for many new therapists with several job opportunities. Private and group practice existed, but it didn’t dominate the field the way it does now. In my time in CMHCs, I slowly began to see cracks in the foundation. I remember thinking back then: “Community mental health is dying. It wouldn't surprise me if it disappeared altogether.”
Today, it feels like that prediction is coming true.
The Collapse of Community Mental Health
CMHCs were already struggling with poor organizational structures, but what once seemed dysfunctional now appears unsustainable. The guiding principle of “client-centered care” often amounted to little more than a slogan and hollow core values. In reality, many therapists faced overwhelming caseloads, low pay, and minimal respect. Turnover rates were and continue to be high. Some centers have been implicated in fraud by employing uncredentialed staff, billing improperly, and funneling funds to leadership that would never trickle down to clinicians.
In addition, many CMHCs have moved away from hiring licensed therapists with specialized skills or certifications, opting instead for generalists who can see anyone with any issue. Therapists with specific training or interests in working with particular populations are often discouraged or even prevented from focusing on their areas of expertise. This trend not only limits the quality of care provided to clients but also leaves therapists feeling stifled, as they are asked to work with clients who don’t match their areas of competence or passion.
I’ve experienced unethical practices, emotional and verbal abuse, and microaggressions firsthand. I’ve heard similar stories from countless colleagues. Over the last five years, I’ve watched CMHCs close their doors, lose vital funding, and leave entire communities without services. These workplaces have become difficult to trust, let alone rely on for the clients and clinicians.
The Rise of Corporatized Mental Health
As CMHCs fade, private and group practices, large mental health corporations, and tech startups backed by venture capitalists (VC) are filling the gap. These entities are changing the landscape rapidly.
Job listings by insurance companies now include behavioral health coaches, often requiring no master’s degree, yet offering salaries comparable to licensed therapists starting at $40K to $70K. I’ve heard that some insurance companies are backing tech startups or even owning them outright. At the same time, insurance companies are delaying or denying credentialing applications for therapists due to “oversaturation” which is a baffling move during a mental health crisis. Some therapists have felt the need to work for tech companies due to their power in negotiating higher insurance reimbursement rather than their own.
Beyond this, one of the most frustrating and limiting practices I’ve witnessed is the stagnant rates insurance companies reimburse therapists. For years, insurance reimbursement rates have remained unchanged and at times, lowered, despite inflation and the increasing cost of living. Many insurers fail to recognize additional certifications or specialties therapists acquire as part of upholding their license, which offers no increase in pay for advanced training or qualifications. This effectively places a cap on therapists' earning potential, regardless of their experience or expertise.
Therapists are often left with the grim reality of working harder and seeing more clients just to meet the same reimbursement thresholds or rate of inflation. Meanwhile, insurance companies continue to push for lower rates, leaving providers with little recourse other than to accept these conditions or risk losing contracts altogether. It’s an unsustainable cycle that exacerbates burnout and drives therapists away from the field.
Platforms like Indeed and Psychology Today are saturated with listings from VC backed corporations and tech companies, pushing smaller therapist owned practices out of visibility. Local job opportunities are buried until page 15 of a directory or not showcased at all. Therapists I know have seen a sharp drop in directory referrals, while AI driven tools and mass scale corporate mental health “solutions” flood the market. All of this is creating increasing difficulty in finding a local mental health position or building a caseload in therapist owned practices.
The Emergence of “Empathic Listeners” as a Side Hustle
In the growing trend of outsourcing mental health care, we’re seeing the emergence of "empathic listeners,” a new role being marketed to the public as a substitute for therapists. Freelance websites like Upwork and Fiverr are flooded with listings for these positions, where individuals are paid to listen to others' problems without the training or ethical guidelines required of licensed professionals. The role is often framed as a "side hustle," reducing the complexity of mental health work to simply lending an ear while charging $50-100. This blurs the distinction between trained care providers and those with no formal expertise. This undermines the therapeutic profession and diminishes the gravity of mental health care, which involves much more than just being a sounding board. Take a look at this video to see how "empathic listening" is being marketed to the masses:
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Here’s a breakdown of what’s said in the video:
“Are you a good listener? The I have a perfect side hustle for you-and yes this is legit. So there are lots of people out there who are struggling and they don’t even want to talk to family or friends or they just don’t want to be judged. So they seek help from what we call the empathic listener. You don’t need to be a counselor. You don’t need to be a therapist. You don’t need to be certified or you don’t need or you don’t need a degree for this. You do not have to solve any problem, all you have to do is listen. People are offering these services in websites like Fiverr and some are even charging $50 for 30 minute sessions. And you don’t even have to give up your personal information. Some people are using Zoom or video conferencing and you don’t even have to have your video on. If you want to use your phone, you can also get a free number from Google Voice. And before you start commenting again, let me tell you again: this side hustle is legit and you can check it out yourself.”
As you can see, the position is framed as an easy, low-barrier opportunity, reducing the complexity of mental health work to simply offering someone to talk to and a “side hustle.”
The Rise of Coaches in Mental Health
The surge of "coaches" in the field is impossible to ignore. Coaching is currently a heavily unregulated field. You can just about find a coach in anything, from "anxiety coaches" to "intimacy coaches," these individuals charge clients fees of $95–$150 per session for guidance that closely mirrors therapeutic work. I believe that simply reading books like LoveSense by Sue Johnson doesn’t qualify someone to call themselves an 'attachment coach.' The complexity of attachment theory requires a deeper understanding and expertise than what can be gained from a single resource. While some of these coaches may offer valuable insights, the lack of oversight creates a dangerous gray area, where the line between genuine therapy and marketing can become blurry. They're promoted heavily on platforms like TikTok and Instagram, often using language indistinguishable from that of licensed therapists. It is concerning to see terminology used such as “identifying goals,” “creating a treatment plan,” and even claiming they will diagnose.
I've come across self-proclaimed “sex therapists” with no education in therapy, no credentials, and no legal oversight. Most of these coaches' websites offer limited or no information about their experience, education, or training. In fact, I would speculate that many of these coaches deliberately hide their location or credentials, likely out of fear of being reported for practicing outside of legal or ethical boundaries.
I don’t believe all coaches are are nefarious in their work. In fact, there are some excellent coaches who have undergone proper training and earned certifications to do the work. Even therapists transitioning into coaching is something I see as a positive. What concerns me is how easy it is for someone to label themselves a 'coach' without any proper safeguards in place, a lot of harm can be done in these unregulated spaces. Take, for example, the artist SZA, who shared that she mistakenly hired a coach, believing they were a therapist to help improve her anxiety. She spent time and money, only to feel worse. How many people are unknowingly doing the same?
AI Therapists and Automation in Mental Health
Now we face a new frontier: AI-powered therapy.
In the early 2000s, many feared that the rise of computers would mark the end of certain industries. Of course, that didn’t turn out to be the case in masses. Yet, I don’t think mental health professionals are catastrophizing to the rise of AI therapy, but rather their concerns are grounded in reality. I remember reading an article a few years ago titled Jobs Least Likely to Be Replaced by AI, where psychotherapy was ranked among the top five professions least likely to be outsourced by artificial intelligence. Significant investments are being made into the development of AI-driven therapeutic services. We underestimated the influence of venture capital and the sheer speed of technological advancement. Equally, we were naïve to companies wanting to profit and data farm off of mental health care in the name of “client-centered care.” Sound familiar?
Tools like “ChatCBT” have entered the market, offering AI-based cognitive behavioral interventions. An AI program designed to implement CBT skills into your everyday problems.
These tools aren’t bound by ethical codes, privacy laws, or licensure requirements. They don’t need to be human, educated, or trained. It doesn’t have to follow the same regulations that mental health professionals must follow. Worse yet, AI therapists don’t have to be created or co-led by licensed professionals.
Recently, an AI therapist was developed. They claim themselves as, “The first AI designed for therapy.” It’s a free to use AI chat that claims it is synonymous with therapy. Laws impacting this have historically moved at the rate of molasses. Thankfully, three states (Illinois, Nevada, and Utah at the time of this article) have all enacted laws banning AI to be used by therapists in any capacity other than administrative including companies that offer AI therapy services without licensed therapists' involvement. If you’re interested, you can read about a mental health therapist, Daniel Fleshner, who tried the AI therapist out and find more information about it here:
Scams in Therapist Landscape
Therapists face an increase in scams, fraudulent job postings, fake subpoenas, and websites that steal professional identities to advertise services therapists don’t actually provide. It's a disturbing new layer of vulnerability in an already unstable job market.
I've encountered several fake job listings on platforms like Indeed and others that are designed to steal clinicians' personal information. While the theft of such data can lead to various criminal activities, one scam that has been coming up recently is websites that create fake therapists profiles. They steal your name, credentials, and profile picture to falsely claim that you work there and offer services when you don't. Another scam making the rounds involves a phone call to a mental health professionals, claiming that they are being subpoenaed and demanding a large sum of money to resolve the issue. Therapists are also being contacted through their business phone numbers with a message that their “Google Business listing is incorrect,” requesting personal information and payment to fix it. LinkedIn has seen scams where unqualified individuals offer to help therapists with billing or 'optimize' their online listings for a high fee.
One of the more subtle yet pervasive forms of exploitation comes from executives, so-called “thought leaders,” and individuals in leadership positions within organizations. These figures often reach out to therapists under the guise of "networking" or "collaborating," asking them to "pick their brain" or share expertise for free. This is framed as an opportunity to build connections or gain exposure, yet it ultimately serves as another way for therapists to be exploited. These leaders rarely offer compensation for the time, energy, or valuable insights therapists provide. In a profession already undervalued, this type of request only deepens the feeling of being taken advantage of. It's another example of how the system continues to profit off the labor of mental health professionals without offering meaningful support or respect in return.
The Shrinking Landscape of Traditional Jobs
After shifting through the current job market of mental health careers and little available employment opportunities, we are left with two options: W-2 and 1099 positions. A W-2 role might offer malpractice insurance and tax withholdings, but in today’s market lacks health benefits and pays based on productivity. Some group practices can't afford to offer those benefits unless clinicians see 30+ clients a week. 1099 roles offer even fewer protections, usually without malpractice insurance, benefits, or tax support.
It’s hard not get into a comparing war with other therapists thriving in private practice. It’s hard not to feel discouraged when coaches promote six-figure income blueprints while you juggle clients and side gigs just to make rent.
I wonder, were we misled in grad school? We were told we wouldn't make a lot of money, but we weren't told just how broken the system was, or how hard it would be to just make a livable wage. We weren’t taught about insurance systems, private practice marketing, or how deeply capitalism would infiltrate the work we do.
I find myself yearning for the early 2000s when therapists ran paper-based, cash-only practices from home. When the job was simply about helping people, not chasing algorithms or fending off scammers.
Reflections Without Resolution
During the height of the COVID-19 pandemic, the mental health field experienced a surge in demand as people struggled with isolation, anxiety, and other stressors brought on by the crisis. Mental health finally became a major topic of discussion and opened the door to a boom in services. Telehealth became normalized. At the same time, corporations and investors saw this surge as a massive monetization opportunity. With mental health care now at the forefront of national conversations, private companies, tech startups, and venture capitalists quickly capitalized on the moment, looking to profit from an underserved yet essential sector. Corporate interests continued the prioritization of profit over quality care. Business models had a rapid influx to focus on scalability, efficiency, and revenue rather than the needs of clients or the well-being of mental health professionals.
Capitalism is swallowing the field whole. The pandemic-era boom in mental health demand became a monetization opportunity, and now it feels like we, the professionals, are being pushed out of our own industry.
Where Do We Go From Here?
The mental health field is standing at a crossroads. On one path, we see the continuation of unchecked corporatization, unregulated substitutes for genuine care, and a workforce stretched so thin that many of us can no longer sustain ourselves in the profession we worked so hard to join. That road’s current trajectory feels somewhat hopeless with pushing professionals out. On the other, there is the possibility of reclaiming the heart of this work by advocating for fair pay, sustainable caseloads, and ethical structures that protect both clients and clinicians.
Instead of addressing long-standing systemic issues like low wages, unmanageable caseloads, and a lack of respect for the profession, external forces have chosen to apply pricey band-aids. AI programs, coaching models, and corporate platforms are framed as “solutions,” but they outsource and undermine the very thing they claim to fix: access to meaningful, ethical mental health care. The full impact of these shifts won’t be clear for years, but the warning signs are already here.
What can we do now? For one, we need to stop waiting for systemic change to magically arrive. Policy reform and regulation are crucial, but they move slowly. If there’s one constant I’ve seen in this field, it’s that mental health professionals are natural advocates. We don’t have to wait passively for change. In the meantime, therapists can take practical steps:
Strengthen community networks. Word-of-mouth referrals, professional collectives, and cross-referrals among trusted colleagues can help rebuild visibility outside corporate platforms.
Return to grassroots strategies. Old-school marketing, local community talks, and building relationships with schools, clinics, and nonprofits may feel less flashy than PsychologyToday ads, but they keep care rooted in community.
Advocate loudly. Join professional organizations, speak up about unethical practices, and demand transparency from licensing boards, insurance companies, and lawmakers. Even small-scale advocacy matters when done collectively.
Diversify. Whether offering workshops, writing, or teaching, expanding beyond the therapy room can help sustain clinicians financially without abandoning the heart of therapeutic work.
The truth is, mental health professionals are not replaceable, we will always have a place and a need. No AI program, coach, or “empathic listener” can replicate the depth of training, ethical responsibility, and relational attunement that therapists bring. But we cannot assume our place will remain secure if we don’t fight for it. Capitalism may be swallowing much of the industry, but solidarity, advocacy, education, and creativity can keep us from being erased.
💬 So the questions we need to be asking are these: How do mental health professionals navigate this current employment climate? And how do we come together to push back against the larger forces trying to outsource us?
Disclaimer:
It’s important to note that not all CMHCs/private & group practices, coaches, or corporate entities in the mental health field are inherently flawed or exploitative. Many CMHCs continue to provide valuable services and work diligently to support both clients and clinicians. Likewise, there are excellent coaches who adhere to ethical guidelines and provide meaningful, helpful work. The examples shared in this article are drawn from personal experience and observations within the field, but they represent specific challenges that have emerged in certain areas. The intention is not to generalize the entire field, but rather to highlight the growing trends and systemic issues that affect mental health professionals and the quality of care provided.