Here’s What You Need to Know About Accessing Affordable Therapy
Depression and anxiety are two very common mental illnesses that are even more common among women. Often, professionals will recommend therapy to help people cope with these and a host of other mental illnesses, like PTSD and personality disorders. Some people, like Mandy Moore, will even advise people attend therapy as a means of preventative mental health maintenance. But of course, therapy can be really expensive, and not accessible to everyone who needs professional help with mental illness.
The problem of access to therapy only compounds when race and class are factored in. According to a 2016 study titled “‘Sorry, I’m Not Accepting New Patients’: An Audit Study of Access to Mental Health Care,” Heather Kugelmass, a sociology PhD candidate at Princeton University, found that therapists were significantly less likely to return the calls of prospective patients who they perceived to be low-income, and particularly people of color. The study found that therapists were 30 percent less likely to return the calls of middle-class Black women and 60 (!) percent less likely to call back Black men, compared to white, middle-class would-be patients. Only eight percent of working-class people of any race got a callback and offer for an appointment.
Not only do people of color and working-class people have a harder time even getting a therapy appointment, but the cost of therapy becomes an issue even when a therapist is willing to take on these new patients. On average, therapy costs between $75 and $150 per session (sessions usually run 45 or 50 minutes) without insurance, and that cost is much higher in certain cities. For example, in New York, therapy can cost upwards of $200 to $300 per session.
Of course, therapy can be cheaper with insurance, but insurance is also costly, and 28 million people in the United States did not have insurance at the end of 2016, according to the Kaiser Family Foundation. The vast majority of the millions of people who don’t have insurance found that plans available through the Affordable Care Act were not affordable.
There are significant and real obstacles facing lower-income people who need therapy, and in some cases, it’s largely a broader issue of unaffordable care and inaccessible health insurance in general. However, there are ways to mitigate the costs of therapy. Here are some options worth looking into if you need therapy, but are worried that it will be too expensive.
check your insurance
If you have insurance, do some research to find therapists in your network and see what your sessions will cost through your insurance plan. Medical insurance covers mental health services including therapy, and if a therapist is in your network, the cost of each session will be less expensive than the out-of-pocket rate.
try a mental health clinic
Especially in big cities, there are often mental health clinics that offer therapy services on a sliding scale for individuals and families. In these clinics and health centers, the cost of therapy is determined based on income. Some universities also have training clinics, where students finishing up their graduate degrees in psychotherapy can treat patients with supervision from faculty. Here’s a list of training clinics that range from Boston to Boone, North Carolina, and Palo Alto, California.
check out web-based therapy
Web-based therapy, offered through companies such as TalkSpace and BetterHelp (to name just two!), is often less expensive than in-person therapy. It’s also likely going to be easier to find a therapist more quickly. Online therapy models usually offer a range of services, from weekly chat-based sessions to video appointments, and prices will vary based on the therapy package a patient chooses.
Though it can be cheaper and more convenient, some experts caution that online therapy is insufficient to treat some patients and conditions. According to the American Psychological Association, “research hasn’t yet shown that stand-alone therapy online or via texting is effective for everyone in every situation.” Web-based therapy might not work for everyone, or at least not work as well as in-person therapy might, but it’s an option to consider if cost or ease of access to therapists offices is an issue.
seek recommendations from larger health care providers
Some therapists who have their own practice, and even those who are part of larger offices, offer their services on a sliding scale. It can be challenging to find therapists who offer therapy on a sliding scale, but larger mental health organizations often have resources to help find a sliding-scale therapist. The Anxiety and Depression Association of America has a search tool to help patients find sliding-scale therapists in their state.
check out group therapy
While it might not work for everyone’s specific mental health needs, group therapy can be just as effective as individual therapy in treating some conditions. Further, group therapy is usually much less expensive compared to individual therapy, sometimes as much as half the cost.
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(Photos via Getty)
Welcome to Selfmade Finance School, our new money series with Block Advisors to help small business owners with their tax, bookkeeping, and payroll needs year-round. This week, we explore the tax implications of bringing family members into your business.
The question for today is this: Does hiring your family members make sense for your business? Let me be clear. This is not a piece about whether hiring your family members makes sense for your relationships with those family members. As someone who is part of a family business, I could fill up a lot more than 600 words on my opinions about that. For today's purposes, we focus on whether it makes sense from an overall "good business and tax implication" perspective. As it turns out, there is a decent amount of tax nuance when it comes to employing your family. Let's break it down based on relationship to the employee:
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Spouses Who Are In Business Together
Personally, if I had to be in business with my husband, it would not go well. However, many couples build viable, strong businesses together and I say, good for them! Depending on how you have your business entity structured, it will make a big difference on the tax treatment of you and your spouse working as partners. Because a business jointly owned and operated by a married couple is generally treated as a partnership for Federal tax purposes, the spouses must comply with filing and record keeping requirements imposed on partnerships and their partners. The election to file two Schedule C (Form 1040) forms, (one for each spouse) permits certain married co-owners to avoid filing partnership returns, provided that each spouse separately reports a share of all the businesses' items of income, gain, loss, deduction, and credit. Under the election, both spouses will be subject to self-employment tax and on net earnings from self-employment and receive credit for Social Security earnings.
One Spouse Employs Another
If you have a dynamic where your spouse is an employee of your business, then your spouse's wages are subject to income tax withholding, Social Security and Medicare taxes. If you are self-employed (not a corporation or a partnership), your spouse's pay does not have to be included in your federal unemployment tax account (FUTA) contributions and payments. However, if your business is a corporation or a partnership you must include that spouse's pay in your unemployment tax contribution calculation.
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You Employ Your Child
First, let's be clear. I work in my family business, but I am an adult, so I am treated just like a normal employee. However, if you, for example, run a family restaurant and want to hire your children under 18 to work for you, there are some tax benefits. But first, you should check with your state for rules on how many hours minors can work (in non-agricultural jobs) and reference the Fair Labor Standards Act for information on limitations on the kinds of work children can perform.
"This is an often overlooked or under-utilized strategy. Paying your children for true services they provide in your business can be a powerful tax-saving tool," says Cathi Reed, Block Advisors Regional Director. "If you are a sole-proprietorship or single member LLC, and the child is less than 18 years of age, the business is not required to withhold FICA or payroll taxes. The child can use his or her standard deduction against income you pay."
You Hire Your Parent
Oh dear. If you are brave enough to do this, know that you will need to pay Social Security and Medicare taxes on your parent's wages and make the appropriate withholdings, but you don't have to pay unemployment taxes. Now all you have to do is convince your parent that you are the boss. Have fun with that!
Is Hiring Family Members Worth It For The Tax Benefits?
"There are some positive tax advantages to hiring family members. It's important to treat a family member like any other employee. Hiring your children can result in substantial savings for businesses. Make sure your child has real, age-appropriate work to do and a reasonable pay rate, comparable to other employees. Consult with a Block Advisors small business certified tax pro to ensure that you are complying with all requirements," advises Reed. "Block Advisors, a team within H&R Block, is dedicated to meeting the tax, bookkeeping and payroll needs of small business owners year-round. To start working with the tax experts at Block Advisors, visit blockadvisors.com."
In my opinion, you should not hire a family member solely because of the tax benefits. You should always hire based on whether that person is right for the job and keep in mind how this hire could materially impact your relationship with that person and others in your family. Finally, as I mentioned, make sure you have a tax professional on your team when making these determinations. As you can see, things can get a little tricky!
*All details were sourced from IRS.gov and blockadvisors.com