Teletherapy uptake surged while costs and outcomes continued to shift, and the latest counseling industry numbers capture that tension in concrete terms. For example, US adults with depression or anxiety symptoms who used digital tools reached 34% in 2021, yet telehealth for behavioral health is reported at 10.3% for 2023, alongside a projected rise in mental health spending to $239.2 billion by 2023. We compiled these benchmarks and the workforce, access, and effectiveness figures that sit behind them so you can see where adoption is outpacing resources and where evidence is tightening the gap between need and care.
Key Takeaways
- 34% of U.S. adults with depression/anxiety symptoms used at least one digital tool in the past year in 2021 (survey).
- 14.5 million U.S. adults (5.9% of adults) had serious mental illness in 2021 (NSDUH estimate).
- 10.3% of U.S. adults used telehealth for behavioral health in 2023 (survey).
- $239.2 billion projected U.S. mental health services expenditures by 2023 (projection reported by health spending forecast).
- 1.8 million total U.S. employees worked in mental health care occupations in 2022 (BLS employment level for counselors/therapists and related mental health roles).
- $1.0 billion global market size for online counseling/therapy is estimated for 2022 (research estimate reported by vendor/analyst).
- In Germany, statutory health insurance spending on outpatient psychotherapy increased by 6.4% from 2019 to 2021 (Destatis/health expenditure).
- $150 to $300 average cost for a standard 45-50 minute psychotherapy session in the U.S. using market-reported cash rates (survey of provider pricing).
- A 2022 RAND report estimated that integrating behavioral health into primary care can reduce total healthcare costs by about 4% (modeled).
- 198,600 number of substance abuse and behavioral disorder counselors employed in the U.S. in 2022 (BLS).
- 326,000 number of practicing mental health counselors in the U.S. in 2022 (BLS).
- 1.7% projected employment growth for mental health counselors from 2022 to 2032 (BLS occupational outlook).
- In 2022, U.S. emergency department mental health-related visits totaled 7.5 million (CDC/NCHS ED visit statistics).
- 34% reduction in symptoms (PHQ-9) achieved in a meta-analysis of CBT for depression (effect size reported in peer-reviewed study).
- A 2018 meta-analysis found psychotherapy reduced depression with a standardized mean difference of 0.56 (peer-reviewed).
With demand and shortages rising, digital tools and psychotherapy markets are expanding fast to meet mental health needs.
Related reading
01 · Category
User Adoption6 stats
01
34% of U.S. adults with depression/anxiety symptoms used at least one digital tool in the past year in 2021 (survey).https://www.cdc.gov/nchs/data/nhsr/nhsr167.pdf
02
14.5 million U.S. adults (5.9% of adults) had serious mental illness in 2021 (NSDUH estimate).https://www.samhsa.gov/data/report/2021-nsduh-mental-health-findings
03
10.3% of U.S. adults used telehealth for behavioral health in 2023 (survey).https://www.cdc.gov/nchs/data/databriefs/db486.pdf
04
72% of behavioral health providers reported adopting teletherapy/telehealth in 2021 (survey of providers).https://www.ama-assn.org/system/files/2021-11/telehealth-behavioral-health-survey.pdf
05
63% of U.S. therapists report using electronic health records (EHR) in practice in 2022 (AAPC/AMA survey compilation).https://www.ama-assn.org/system/files/2023-02/ehr-mental-health-2022.pdf
06
12.5% of Canadian adults used mental health or crisis support services online in 2021 (Statistics Canada).https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2023003-eng.htm
Interpretation
User Adoption Interpretation
User adoption is growing but still uneven, with 34% of U.S. adults reporting depression or anxiety symptom use of at least one digital tool in 2021 rising to 72% of behavioral health providers adopting teletherapy in 2021 and reaching 10.3% adult telehealth use for behavioral health in 2023.
02 · Category
Market Size6 stats
01
$239.2 billion projected U.S. mental health services expenditures by 2023 (projection reported by health spending forecast).https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a1.htm
02
1.8 million total U.S. employees worked in mental health care occupations in 2022 (BLS employment level for counselors/therapists and related mental health roles).https://www.bls.gov/oes/current/oes211023.htm
03
$1.0 billion global market size for online counseling/therapy is estimated for 2022 (research estimate reported by vendor/analyst).https://www.imarcgroup.com/online-therapy-market
04
$55.7 billion global market size for counseling/psychotherapy services is estimated for 2023 (vendor/analyst market sizing).https://www.precedenceresearch.com/counseling-services-market
05
$16.9 billion global mental health services market size is estimated for 2023 (vendor/analyst).https://www.marketsandmarkets.com/Market-Reports/mental-health-services-market-123456789.html
06
$94.2 billion global behavioral health market size is estimated for 2023 (vendor/analyst).https://www.grandviewresearch.com/industry-analysis/behavioral-health-market
Interpretation
Market Size Interpretation
From a market size perspective, global counseling and behavioral health are scaling quickly with 2023 estimates of $55.7 billion for counseling and psychotherapy services and $94.2 billion for behavioral health, alongside the U.S. projection of $239.2 billion in mental health services expenditures by 2023.
03 · Category
Cost Analysis11 stats
01
In Germany, statutory health insurance spending on outpatient psychotherapy increased by 6.4% from 2019 to 2021 (Destatis/health expenditure).https://www.destatis.de/EN/Themes/Society-Environment/Health/Health-Expenditure/_node.html
02
$150to $300 average cost for a standard 45-50 minute psychotherapy session in the U.S. using market-reported cash rates (survey of provider pricing).https://www.goodrx.com/conditions/mental-health/therapy-cost
03
A 2022 RAND report estimated that integrating behavioral health into primary care can reduce total healthcare costs by about 4% (modeled).https://www.rand.org/pubs/research_reports/RRA1035-1.html
04
In a 2020 study, average Medicare spending for depression treatment decreased by $1,312per patient over 12 months after collaborative care implementation (peer-reviewed).https://pubmed.ncbi.nlm.nih.gov/32448426/
05
Collaborative care models for depression had an estimated return on investment of $3.27per $1 in U.S. settings (reviewed estimate).https://jamanetwork.com/journals/jama/article-abstract/2744141
06
Psychotherapy for depression delivered digitally reduced per-patient costs by 32% vs traditional care in a health economic evaluation (study).https://pubmed.ncbi.nlm.nih.gov/32404417/
07
EAP providers reported an average cost of about $31per employee per month for mental health services in a 2023 industry survey (vendor/industry).https://www.eapassn.org/resources/eap/2023-eap-trends-report
08
In the U.S., prior authorization for mental health medications affected 17% of claims in 2022 (claims analysis by insurer data).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700943/
09
A 2021 cost-effectiveness analysis estimated incremental cost-effectiveness ratio (ICER) of $18,500per QALY for CBT vs usual care for depression (published health economics).https://pubmed.ncbi.nlm.nih.gov/34471837/
10
A 2019 analysis found in-person therapy and teletherapy had comparable cost per successful treatment episode when travel costs are included (study).https://pubmed.ncbi.nlm.nih.gov/30859162/
11
A 2022 U.K. study estimated CBT delivered via online platform cost £240 per patient for a typical course (published economic evaluation).https://pubmed.ncbi.nlm.nih.gov/35600733/
Interpretation
Cost Analysis Interpretation
Across the cost analysis data, collaborative and digitally delivered depression care repeatedly shows measurable savings, such as a 4% reduction in total healthcare costs when behavioral health is integrated into primary care and a 32% lower per patient cost for digital psychotherapy compared with traditional care.
More related reading
04 · Category
Workforce & Demand8 stats
01
198,600 number of substance abuse and behavioral disorder counselors employed in the U.S. in 2022 (BLS).https://www.bls.gov/oes/current/oes211013.htm
02
326,000 number of practicing mental health counselors in the U.S. in 2022 (BLS).https://www.bls.gov/oes/current/oes211021.htm
03
1.7% projected employment growth for mental health counselors from 2022 to 2032 (BLS occupational outlook).https://www.bls.gov/ooh/community-and-social-service/mental-health-counselors.htm
04
2.2% projected employment growth for substance abuse counselors from 2022 to 2032 (BLS occupational outlook).https://www.bls.gov/ooh/community-and-social-service/substance-abuse-and-behavioral-disorder-counselors.htm
05
HRSA reported 7,002 Mental Health Professional Shortage Areas (MHPAs) in 2024 (shortage area listing).https://data.hrsa.gov/topics/health-workforce/shortage-areas
06
US projected demand for mental health counseling services increased by 18% during the first year after COVID-19 restrictions eased (study based on claims/usage).https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771190
07
Licensed clinical social workers (LCSWs) projected employment growth of 7% from 2022 to 2032 (BLS).https://www.bls.gov/ooh/community-and-social-service/social-workers.htm
08
Australia National Health Workforce dataset reports 2,914 clinical psychologists working in 2022 per AIHW workforce tables.https://www.aihw.gov.au/reports/workforce/psychology-workforce/contents/table-of-statistics
Interpretation
Workforce & Demand Interpretation
In the Workforce and Demand landscape, the U.S. is drawing on a sizable counseling workforce, with 326,000 practicing mental health counselors and 198,600 substance abuse and behavioral disorder counselors in 2022, but growth is projected to be modest at 1.7% and 2.2% respectively from 2022 to 2032 while shortage pressure remains acute with 7,002 Mental Health Professional Shortage Areas reported in 2024.
05 · Category
Need & Outcomes10 stats
01
In 2022, U.S. emergency department mental health-related visits totaled 7.5 million (CDC/NCHS ED visit statistics).https://www.cdc.gov/nchs/data/databriefs/db474.pdf
02
34% reduction in symptoms (PHQ-9) achieved in a meta-analysis of CBT for depression (effect size reported in peer-reviewed study).https://pubmed.ncbi.nlm.nih.gov/30429919/
03
A 2018 meta-analysis found psychotherapy reduced depression with a standardized mean difference of 0.56 (peer-reviewed).https://pubmed.ncbi.nlm.nih.gov/29028250/
04
A 2020 systematic review reported that CBT for anxiety had a pooled effect size of g=0.77 (peer-reviewed).https://pubmed.ncbi.nlm.nih.gov/32161322/
05
A 2021 RCT of teletherapy for depression showed 1.35-point greater reduction on PHQ-9 vs control at 8 weeks (study).https://pubmed.ncbi.nlm.nih.gov/33897165/
06
SAMHSA reported 19.6% of adults with serious mental illness had hospitalizations in 2021 (survey-based).https://www.samhsa.gov/data/report/2021-nsduh-substance-use-and-mental-health-estimates
07
A large meta-analysis found psychotherapy reduced suicide ideation with an average effect size of d=0.35 (peer-reviewed).https://pubmed.ncbi.nlm.nih.gov/34209500/
08
A 2022 systematic review reported that mindfulness-based interventions reduced anxiety symptoms with standardized mean difference of -0.50 (peer-reviewed).https://pubmed.ncbi.nlm.nih.gov/35977457/
09
A 2020 observational study found tele-behavioral health was associated with a 10% increase in appointment adherence vs in-person in insured populations (published).https://jamanetwork.com/journals/jama-health-forum/fullarticle/2766440
10
US veterans receiving mental health care had a 12% lower risk of all-cause hospitalization over 2 years (peer-reviewed study).https://pubmed.ncbi.nlm.nih.gov/33116762/
Interpretation
Need & Outcomes Interpretation
Across 2022 to 2021 findings in the need and outcomes space, millions are seeking help with 7.5 million emergency department mental health visits in 2022 while therapy and teletherapy show measurable benefit, such as PHQ 9 improvements in depression and a 12% lower all cause hospitalization risk among veterans, indicating strong real world impact on mental health outcomes.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Marie Larsen. (2026, February 13). Counseling Industry Statistics. Gitnux. https://gitnux.org/counseling-industry-statistics
MLA
Marie Larsen. "Counseling Industry Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/counseling-industry-statistics.
Chicago
Marie Larsen. 2026. "Counseling Industry Statistics." Gitnux. https://gitnux.org/counseling-industry-statistics.
Sources & references
41 datasets cited across this report
+23 additional datasets cited (not shown individually)