New Report Highlights Independent Mental Health Practice, Access to Care, and Evolving Role of AI

SimplePractice, a practice management platform, has released their Annual State of Private Practice Report, which draws on data from more than 245,000 practitioners and survey responses from over 2200 clinicians.^1,2 According to the report, independent clinicians collectively delivered 113.6 million sessions of mental health care over the course of the year. Furthermore, 87.9% of clinicians surveyed indicated they intend to remain in the field of mental health through 2026.

“I hope this report, a snapshot of current practice, shows clinicians that (1) they are not alone, and (2) there are a whole lot of ways to make independent practice successful,” Lindsay Oberleitner, PhD, a full-time faculty member at the Yale University School of Medicine and head of clinical strategy at SimplePractice, told Psychiatric Times. “Together, we can work toward making our communities healthy and making mental health care accessible. Independent practice is the core of much of that.”

Independent Clinicians Dominate Outpatient Care

Independent clinicians make up the majority of outpatient mental health care, according to the report, with solo practitioners accounting for 49.8% of clinicians and 85.3% of practices. Furthermore, patient preference data align with this reality: 50% of patients prefer independent clinicians over large hospital systems or online-only platforms, with that preference rising to 56% among women, 54% among Baby Boomers, and 54% among Gen X respondents.

The states in which clinicians were most likely to be in solo practice as of December 2025 were:

• Vermont: 72.8%
• Maine: 71.9%
• Montana: 71.0%
• Washington: 63.3%
• Massachusetts: 62.1%

The top mental health disorders treated by independent clinicians are:

• Generalized anxiety disorder: 24.1%
• Adjustment disorders: 22.9%
• Major depressive disorders: 15.7%
• Posttraumatic stress disorder: 8.9%
• Attention-deficit/hyperactivity disorder: 8.1%

Cognitive behavioral therapy is the most common therapeutic modality, with approximately 80.1% of clinicians utilizing it. Practices also show a strong commitment to specialized care, with 32.5% focusing on LGBTQ+ patients and 19.6% treating military/veterans patients.

Slow Adoption of AI

Despite the rapid proliferation of AI-powered tools across health care, adoption among mental health clinicians remains cautious. Approximately 53% of clinicians have not yet incorporated AI into their workflows. Among those who have, use is concentrated in nonclinical domains such as marketing, email drafting, and administrative communication. Tools designed specifically for clinical efficiency offer measurable time savings of up to 5 hours per week, yet uptake remains limited. Patient attitudes toward AI in the clinical encounter are similarly mixed: 49% report being somewhat or extremely open to AI use during sessions, while 45% express caution, and 38% express outright skepticism. For clinicians navigating these conversations with patients, the data suggest that transparency and individualized discussion around AI use will be essential as the technology matures.

Online appointment requests (62.7%) and automated measurement-based care (55.3%) show much higher rates of adoption.

Access to Care

Access to care, a long-time structural challenge in mental health, shows meaningful signs of improvement within the independent practice sector. More than 60% of clinicians report appointment availability within the next 7 days, a figure that compares favorably with the access timelines often associated with larger institutional settings. Notably, more than 16,000 clinicians practice in communities with populations below 49,000, and nearly 6000 serve areas with populations below 10,000. Rural clinicians alone delivered nearly 7.8 million mental health care sessions in 2025.

However, patient-reported barriers to care persist: 23% of patients identify navigating the first steps of seeking care as the most frustrating aspect of the process, and 19% cite difficulty finding a provider with availability.

Telehealth plays an important role in expanding access to patients in need.³ The locations with the highest average proportion of telehealth appointments in 2025 were:

• Maryland: 65.7%
• Washington D.C.: 63.5%
• Hawaii: 60.9%
• Massachusetts: 59.2%
• Rhode Island: 58.4%

Affordability remains one of the most consequential pressures facing independent practice. The average self-pay rate is $40 higher than the average insurance reimbursement rate, a gap that creates real tension for clinicians attempting to sustain viable practices while keeping care accessible. Insurance-based sessions account for 58.8% of all sessions, and 49% of patients indicate they would pay for mental health services through private insurance if given the option. Adding complexity to the financial picture, 43% of clinicians reported having no formal business training when they established their practices, a finding that points to a persistent gap between clinical preparation and the operational demands of running an independent business.

Concluding Thoughts

All together, these data paint a picture of an industry that is both indispensable and under pressure. Independent clinicians continue to serve as the dominating force of US outpatient mental health care, reaching patients in rural communities, maintaining strong patient preference, and delivering care at a scale that rivals any single institutional system. The challenges ahead, including AI integration, reimbursement equity, and reducing first-contact friction for patients, will require both individual adaptation and systemic support.

References

1. SimplePractice releases first-of-its-kind report on independent mental health practice. News release. May 13, 2026. Accessed May 13, 2026. https://www.businesswire.com/news/home/20260513758800/en/SimplePractice-Releases-First-of-Its-Kind-Report-on-Independent-Mental-Health-Practice

2. Annual State of Private Practice Report: 2025 in Review. SimplePractice. May 13, 2026. Accessed May 13, 2026. https://www.simplepractice.com/resource/state-of-private-practice-2025-report/?utm_source=press-release&utm_medium=organic&utm_campaign=private-practice-report-25&utm_content=announcement

3. Ezeamii VC, Okobi OE, Wambai-Sani H, et al. Revolutionizing healthcare: how telemedicine is improving patient outcomes and expanding access to care. Cureus. 2024;16(7):e63881.