With Covid-19 showing no sign of abating, mental health care (from ongoing therapy to helplines) continues to be an important site of treatment for many Americans. While traditional therapy has continued to be prohibitively expensive for most, teletherapy has been covered by most major health insurance companies since the early days of the pandemic and is currently free for upwards of 130 million Americans. 2020 has seen the most widespread offering of fee-less teletherapy in the U.S., but the fact of teletherapy’s financial accessibility is not quite new: most forms of tele-mental health care have been free or low-fee across their long history.
Across the 20th century and into our present, new modes of relating at a distance have given individuals in crisis an ever-expanding set of tools for accessing mental health care. From World War II psychotherapeutic broadcasts to Instant Relay Chats, letter writing to e-therapy, psychiatrists, psychoanalysts, and peer-activists have attempted to send therapeutic care beyond the consulting room by harnessing quotidian, habitual media to connect would-be patients to the help that they need wherever they are, whenever they need it. The suicide hotline is one such form of teletherapy, premised on reaching users who otherwise couldn’t access traditional therapy as well as those in extremis: it’s nearly ubiquitously available, free, and comes in over a household utility or, now, a cellphone. It was designed to provide great flexibility and control to users, and to circumvent traditional modes for seeking care in while in crisis: namely, it has sought to create a space of care outside the jurisdiction of psychiatry and policing and the threats their forms of intervention carry.