Most mental health practitioners report high overall satisfaction and most say their practices are either stable or growing.
The findings were part of the latest annual state of private practice report from SimplePractice, an EHR and practice management platform for mental health professionals. It draws on survey insights from over 2,200 clinicians and aggregated data on over 245,000 practitioners using the platform. Nearly half of clinicians using SimplePractice are solo practitioners.
In total, about 7% of clinicians were located in rural regions, the report found. This finding “establishes a critical baseline for the typically overlooked contribution of independent clinicians who are embedded within those communities,” Lindsay Oberleitner, Ph.D., head of clinical strategy at SimplePractice, told Fierce Healthcare in an emailed comment. “Their reach is substantial as they provided nearly 7.8 million sessions in 2025.”
Though 88% of clinicians report strong intent to stay in the field through 2026, the biggest daily challenges reported were burnout, admin burden and hurdles with insurance.
Oberleitner highlighted two areas of need across mental health roles: a reduction in geographic inconsistencies in licensure, and formal business education in clinical training programs. “By reducing the ‘administrative tax’ on clinicians, we can ensure they spend less time on paperwork and more time helping their clients,” Oberleitner wrote.
More than 60% of clinicians have appointment availability in the next seven days, the survey found, and 80% are taking new clients. This speaks to consumer preferences. A complementary consumer survey conducted by Dynata on behalf of SimplePractice, which reached 1,000 consumers, found the top-ranked frustrations of navigating mental healthcare are knowing first steps (23%) and finding availability (19%).
Aggregated SimplePractice data revealed a $40 gap between the average self-pay rate ($139.75) and the average insurance reimbursement rate ($99.75). For those accepting both self-pay and insurance, private pay was, on average, over $60 higher than reimbursement.
Additionally, aggregated data showed that the share of insurance-based sessions nationwide rose from 56% to 59% between 2024 and 2025. “This three percentage point increase suggests a growing commitment to care accessibility despite the broader economic climate,” Oberleitner wrote in her email. Though most providers surveyed accept cash pay and private pay, only a quarter take Medicaid and a fifth take Medicare.
The report also looked at how artificial intelligence is being used. Half of clinicians reported not yet incorporating AI into their practices. Among those who have, use cases include marketing, email writing and other non-clinical work. In terms of consumer preference, the Dynata survey found that while half of consumers are somewhat or extremely open to clinicians using AI in sessions, 45% express caution and 38% express skepticism.
“We continue to be an advocate for responsible AI use,” Oberleitner wrote in her emailed comment, adding she recently offered a public comment to HHS on accelerating AI adoption in clinical care. “We advocated for direct engagement with mental health practitioners in setting policies, and ensuring that any regulations or frameworks center [on] both safety and burdens for independent clinicians.”