I’m Paying Hundreds For Therapy and I’d Do It Again If I Had To

I’ve spent over $600 on therapy in the last two months.

That’s $600 that could be better spent elsewhere — two (2) pairs of Ultraboost sneakers, the new PlayStation 5 next month… or, you know, a hundred $6 meals.

Why pay for therapy at all, considering the high cost of each session? We all know how expensive mental health services like therapy and counselling can be in Singapore. Why not just do a bunch of push-ups a day for that sweet endorphin hit and call it a day?

As I’ve learned this year — especially this year — there are some things you can’t be stingy about. One of the biggest things for me was (and is!) my mental health, which started deteriorating faster than I could keep track after the circuit breaker period began; I was having numerous meltdowns at least once a week, losing sleep, and generally approaching an all-time low.

Push eventually came to shove; I wasn’t able to “fight it off” or simply “get over it” (and, if you can believe it, I did push-ups everyday before ministers began endorsing it and they only helped minimally, thank you very much).

So, on a friend’s recommendation, I called up a therapist and arranged for a session.

The Price You Pay For Mental Health

About two weeks into the circuit breaker, I began to notice something about myself: that I couldn’t quite keep my anxiety under control. It was leading to panic attacks out of nowhere, over the littlest things — and I figured that soon, my work was going to suffer on top of my mental and emotional health.

That was what I told my therapist in our first conversation over the phone. We scheduled my first session that same week.

At first, the arrangement was that I would only see her once a fortnight. That would give me space in my schedule to spend time with friends or finish schoolwork for my degree over the weekends. I got by reasonably well for the first two or three sessions, but then I began to realise that it wasn’t sustainable.

I was still having a hard time, mentally, and while the bi-weekly sessions slowed down the frequency of my episodes, the frequency couldn’t quite meet my needs at the time.

So, I began scheduling weekly sessions. I was prepared to foot the bill, despite some friends expressing concern over the health of my wallet in the coming weeks.

On average, based on the numbers from various counselling centres in Singapore, therapy sessions can cost around $150 per hour. For someone to require weekly sessions to adequately take care of and manage their mental health, the total bill would come up to $600 per month.

While that figure doesn’t even cut close to the average amount one would have to pay for rent in Singapore, it’s still a hefty sum — and not a lot of younger millennials or Gen Zs would be able to afford therapy on a regular basis without draining their budget dry.

But to me, it was really quite simple: my mental health took precedence over everything — even my bank account.

Mental Health Isn’t Secondary

The way I framed it to myself was like this: if I had a bad fever, what would be the most logical course of action? Go to a doctor, obviously — unless I already had fever medication stocked up at home.

But that’s the thing — you wouldn’t do nothing about a fever. You wouldn’t think, I’ll just sit at home and wait it out, maybe it’s just temporary and I’ll get over it soon.

If we wouldn’t do that for our physical health, what more for our mental health? Sure, we feel sadness on occasion when things don’t go our way, but it’s not just about feeling sad or getting upset because of a bad situation.

Mental instability or mental health conditions like anxiety, depression and borderline personality disorder are often things that won’t “fade away” once given enough time. And oftentimes, we don’t have a say in when these episodes occur, or the severity of them.

These aren’t just regular “bad feelings” you have once in a while. Even things like anxiety can get in the way of work and mess up your productivity; there were days where I couldn’t function like a normal person, all frozen over with an anxious feeling that I couldn’t explain, and that threatened my productivity.

That meant risking my job, my income — things I needed to survive on a month-to-month basis. Therapy, then, was an investment that could get me the returns I wanted: my productivity, my capabilities, and being able to function.

We don’t talk about this often enough in Singapore, and perhaps that’s a consequence of how expensive mental health services are — or how we still haven’t gotten rid of the stigma surrounding mental health issues.

And on that note, let’s talk about insurance coverage for a moment — why were people, at one point, keeping their mental health disorders a secret to “stay insured”? Only recently, insurers have started providing plans that cover mental illnesses and diagnoses, even if it’s lumping them together with critical illness plans. It’s better than nothing — but why did we have to wait till 2019 for that to happen?

When the fever is hitting 40 degrees, what would anyone do?

When I started going for regular, more frequent sessions, I had only one constant refrain: I needed to take care of my mental health the same way I would for my physical health. That was non-negotiable.

Yes, the Sentiment Is Shifting; Yes, There Are Resources For Therapy

Early last year, it was reported that Parliament was aware that mental health needed to be brought to the forefront of our national discourse to better inform policy making in education and employment.

Mental health needed to become a “national priority” and a “basic need”. The way we talk about mental health today is probably vastly different from how we would have approached it ten years ago — and that’s a good thing.

Here’s some more good news: there’s more than one insurance plan on the market now that covers mental wellness and mental health. There’s even a “work from home” plan for employers that provide the following:

• Mental health support ($500 per employee);
• Coverage for ergonomic-related injuries (or “domestic perils”) like falling at home.

It’s worth highlighting that Singaporeans can use MediSave and MediShield Life to cover or offload costs for inpatient psychiatric treatment as well. MediSave can also be used for outpatient treatment for the following disorders, under the Chronic Disease Management Programme (CDMP):

• Schizophrenia
• Major depression
• Bipolar disorder
• Anxiety
• Dementia

Take note, though: MediShield Life will not cover post-hospitalisation treatment or outpatient treatment!

For those who are still concerned about the high cost of getting a counsellor or therapist (and they are not one and the same), I need to highlight that there are therapists and counselling centres out there that provide reasonable rates, and even subsidies.

For example, AWARE takes into account the working status of a person seeking therapy, and will adjust the charges accordingly — especially if they’re unemployed. Rates for counselling there can go as low as $20 per session.

My therapist, too, is flexible with her rates and was able to provide a rate that worked for me without putting my budget at risk. So affordable mental healthcare isn’t actually non-existent.

Therapy Is Not a Permanent Fixture in My Budget

While I’ve factored in therapy costs into my monthly budget, I’m aware that it’s not going to be there forever.

For my case at the very least, I might not have to depend on therapy sessions for the rest of my life. But that’s only because I don’t have more seriously debilitating disorders that require constant care and attention.

Just the other week, my therapist and I agreed that we were in a good enough place to space out my sessions to twice a month, or even only once a month.

Since attending my sessions (almost religiously), I’ve definitely come to be in a much better place. The occasional panic attack aside, my mental episodes are now few and far between.

If nothing else, I’ve gotten my regular sleep hours back. While I’m still in the process of getting a grip on things, I won’t discount that I’ve made quite a lot of progress in what I consider to be a short amount of time.

Going to therapy has opened me up to a lot of things I used to disregard: the importance of being still, learning how to process complex emotions and situations, and understanding my personal triggers. These things sound “easy”, but as with most things in real life, they’re often not when you actually get down to it.

So even though I’m $600 poorer, that self-knowledge is worth paying for. I would pay for it again if I had to — if I needed to — because it’s the only sensible thing to do when you’re running a psychological 40-degree fever.

Here are some free resources:

• Family Life Society (FLS), a non-profit charity whose patron is the Catholic Archbishop of Singapore, though its services are not “religious” in nature.
• Most churches in Singapore offer pro bono counselling services, and churches like Wesley Methodist Church may also state that they have non-religious counselling available.
• Helplines from organisations like the Singapore Association for Mental Health (SAMH) are usually toll-free and don’t require commitment to face-to-face sessions.