Interesting guest post by Matthew Mintz on Kevin MD entitled As psychiatry goes, so will primary care. His basic point: That despite the fact that "psychotherapy has been found to be effective for many mental health disorders", it isn't reimbursed as highly as "diagnostic" or "medication management" visits. Therefore, you guessed it, the number of patients actually receiving therapy is going down.
Almost everyone I know who can afford it, including my own self and those close to me, have chosen to go privately for therapy and pay out of pocket when they've availed themselves of it. Why? Well, first of all the benefits on most insurance programs are so limited it hardly seems worth the hassle, but also, clearly, there is still a stigma associated with it. Going through your insurance increases the chance you might have something come up with the service and then have to check in with your company's benefits administrator.
People who have a choice tend to opt out of the whole loop. (Anecdotally speaking of course.)
So the post is interesting and worrisome, but this talk of heading towards a tiered system of care is a bit out of date...in real life, we're already there.