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The Short Version: Paul Fugelsang founded Open Path Psychotherapy Collective because he recognized that not all couples and individuals who may benefit from therapy can afford treatment. Some people lack insurance and can’t pay the high out-of-pocket rates for the critical service. Open Path aims to fill that void by connecting therapists with clients who can only pay $30 to $80 per session. Now, more than 7,000 therapists in the United States and Canada are registered with Open Path and provide affordable psychotherapy to more than 25,000 people.
According to a recent study, more than 56% of Americans who struggle with mental health issues can’t afford treatment. That number includes those suffering from problems with self-esteem, sexuality, and relationships.
Many factors contribute to that gap. For one, hourly rates for therapy are too high for some to pay, with the average session ranging from $60 to $120. Further, although more Americans have insurance, many plans do not cover mental health services. The number of uncovered Americans actually increased from 4.6% in 2012 to 8.1% in 2017.
Around 9% of the population has no insurance. All of that data indicates that a large portion of Americans could benefit from low-cost therapy.
Luckily, many therapists are willing to take on those clients who can’t afford to pay the full fee. That was the case for Paul Fugelsang, a long-time therapist in North Carolina and the Founder and Executive Director of Open Path Psychotherapy Collective.
“When I was in private practice, I would also take on a few lower-fee clients — maybe two or three at a time,” he told us.
However, when those limited spots filled, Paul didn’t have a system to refer interested clients to therapists with slots available.
“I thought it would be nice to have a service out there that would let me tell a client that I couldn’t see them, but someone else could,” he said.
Out of that desire, Open Path was born. The platform connects people interested in low-cost therapy with psychotherapists in their areas. Session fees for individuals range from $30 to $60, and session fees for couples and families range from $30 to $80.
Since its launch in 2013, Open Path has helped 25,000 people find the mental health services they need.
Open Path targets potential clients who make too much to qualify for government assistance programs but don’t make enough to pay full price for therapy. Specifically, Open Path serves uninsured as well as underinsured individuals with either a very high deductible or a high co-pay for mental health appointments.
As a benchmark, if clients have an insurance plan that asks them to pay more than $60 as an individual or $80 as a couple per session — which they can’t afford — those clients are eligible to use Open Path.
If someone can afford to pay more than $60, the collective asks them to find a provider through their insurance plan. Many therapists, like Paul, can only afford to take on a limited number of clients who can’t pay the full hourly rate.
“Open Path is not for people who can pay out of pocket or for people who have good mental health benefits,” Paul said. “I started Open Path to meet the needs of those people who were falling through the cracks.”
Despite sharing a similar socioeconomic status, Open Path users come from a variety of demographics and backgrounds. Therapists work with young clients and seniors alike.
To begin using the Open Path platform, clients pay a small fee that goes toward operating the collective. After the initial fee, users have a lifetime membership to the service — if they need it. If a user’s circumstances change — for instance, if they get better mental health benefits — then the collective asks that they pay their therapist’s regular rates and no longer use the low-fee service.
More than 7,000 therapists from around the United States and Canada list their services on Open Path. The platform includes listings for therapists in large cities, the suburbs, and everywhere in between, and the collective hopes that more therapists from rural areas will continue to sign up.
All of these therapists are licensed, masters-level practitioners who are committed to the idea that everyone should have access to mental health services. They also come from a variety of specializations — offering everything from treatment for relationship issues to couples therapy. Whatever struggles a person or a couple is having, they can find a local therapist that can help them work through their problems.
If users are looking for affordable couples therapy, they would first type in their zip code. Next, they would decide if they wanted to pursue remote therapy — an option that most of the collective’s members said they don’t prefer.
“Each therapist will list on their profile if they do sessions online, but we’re big believers of face-to-face therapy,” Paul said.
After filtering by therapists who are currently taking clients, users navigate to those who offer couples therapy through the “Specialties” drop-down menu. Users can even indicate whether they’d prefer a therapist who speaks a particular language or has experience working with people in a particular ethnic group or age range.
Once they’ve chosen a therapist, users can see the per-session charges and email the therapist to set up an appointment.
In its six years of operation, Open Path has made great strides in closing the gap for underinsured people seeking mental health treatment. Clients note in testimonials how critical the service was for them in finding the help they needed — at a price they could afford.
“In this time of escalating rents and increasing difficulties just with making ends meet, the service that Open Path provides is priceless,” one client said in an online testimonial.
Another client agreed, saying: “Dealing with mental health issues is already stressful enough, and can feel insurmountable if you cannot afford access to services intended to help.”
Paul said he is grateful that the collective he created helps people as he intended, but he said he’s even more appreciative to the therapists who are willing to offer their services.
“They’re out there doing the work every day. They also hold our mission in high regard, and want everyone to get the care that they deserve,” he told us.
With such a positive reception, Paul and the Open Path team have big plans to expand and reach even more people in need. Each month, the service connects more clients than it did the month before.
To meet that demand, Open Path is putting its resources toward spreading the word about the platform. The intention is not only to encourage therapists to sign up for the site but also to let them know that they can refer low-fee clients to other therapists in their area.
“We’re growing by leaps and bounds,” Paul said. “We want every therapist in this country to at least know about Open Path. That’s our goal.”