Textual Healing: Can You Message Your Way to Mental Health?

“Please ask our therapist a question now…” appears in a text box. I don’t know what to type. This day, like most days, I feel pretty neutral. But as soon as I start typing just a few sentences, I realize I have more on my mind than I thought.

That text box is the first introduction to one company’s messaging therapy service. That’s right, no need to recount years of childhood anguish while laying horizontally on a couch, an hour at a time, week after week—just text it, anytime, any place, and get insight from a professional therapist within minutes.

If this sounds like a device straight out of Brave New World, have no fear. Message therapy is far less frightening than it might seem.

In 2013, 18.5 percent of American adults suffered from mental illness. Of those people, only 44.7 percent sought out mental health services. The top four reasons for not getting treatment? Some 48.3 could not afford the cost, 26.5 thought they could handle the problem independently, 24.6 didn’t know where to start, and 15.8 didn’t have time.

Message therapy attempts to break down these common barriers. “[The] goal is therapy for all,” says Nicole Amesbury, LMHC and Head of Clinical Development at Talkspace. “No one should have to suffer alone with their dilemmas, and quality mental healthcare should be accessible and affordable.”

The few platforms available out there allow members to pay a fee—ranging from $24 to $40 per week—for unlimited messaging with a licensed therapist. Typically, therapists will commit to responding daily to each patient—sometimes several times a day in the beginning stages, and less frequently as the relationship progresses. And testimonials from real users have shared positive experiences just as often as they’ve shared apprehensions.

One study treated bulimia patients with regular therapy and continued support through message therapy after being discharged from inpatient treatment. The treatment prescribed in this study was successful, and patients had 20 percent lower relapse rates over eight months. In another study published in the journal Lancet, 42 percent of patients suffering from depression who participated in message therapy over eight months recovered, compared to only 26 percent of those who received face-to-face treatment over the same period.

However, this groundbreaking service might not be a perfect substitute for face time with a therapist for everyone, particularly for those with serious addictions or high-risk behavior such as self-mutilation. And it shouldn’t be relied upon for crisis counseling or emergency services. “There is not a one size fits all solution for anyone. All therapists refer people to different levels or types of care when needed,” Amesbury says.

Maybe instant gratification from 24:7 accessibility isn’t the best approach for all patients, either. Traditional once-a-week therapy can give people an opportunity to sit with their feelings rather than attempt to solve every problem right away—at least until the next session. Plus, therapeutic relationships built over time through personal relationship is, for the moment, the most tried and true method of experiencing big-picture psychological breakthroughs.

For those not ready to commit to in-person therapy, however, message therapy could be a gateway. “Mental health care is in a crisis because we have failed to meet people where they are at in their journey,” as Amesbury says. When mental health care is just a few dollars and a text message away, people who would normally be at a loss or try to work out issues on their own might feel more compelled to reach out for help.

It can also be a safe space for notorious under-sharers who prefer to hold their cards close, or individuals who have trouble verbalizing their thoughts and feelings in real time. (That would be me.) At times, it’s hard to get the (sometimes embarrassing) words out—message therapy can act as a sort of journal, only there’s someone there who can help read between the lines and fill in the blanks. In many ways, message therapy is like that 50-email-long chain with an old friend, hashing out the pains and pleasures of romance, family, and work.

Interested? There’s no harm in trying.

Illustration by Carey Reisz