In uncertain times, the safe choice often feels like clinging to a steady paycheck. But in Episode 48 of the Sit and Stay podcast, we explore why self-employment—specifically in private mental health practice—can actually be a more stable path for providers during economic downturns. This episode breaks down the hidden advantages of being your own boss when the economy gets shaky and highlights why traditional employment may not offer the security many assume it does.

Why Self-Employed Mental Health Providers May Be More Recession-Proof

While employment at a large clinic or healthcare system is traditionally seen as more secure, private practice offers a different kind of safety. Here's why:

Mental health demand increases in tough times.

Economic stress can trigger a surge in anxiety, depression, and relationship issues. Private practitioners often find that demand for care increases rather than declines during a recession.

You control your income.

Self-employed providers have the freedom to adjust session rates, panel with insurance companies, or explore new service offerings. This agility makes it easier to adapt when client behavior or spending shifts.

You’re not dependent on a single paycheck.

Many providers operate hybrid models, combining private practice with part-time work, contract gigs, or consulting. This diversification creates a financial cushion that employed roles often can’t provide.

Clinicians still get laid off.

Even though clinicians may be the last to go, layoffs still happen—especially in organizations impacted by private equity ownership, where financial targets often drive decision-making.

The Risks of Being Employed by a Large Mental Health Organization

Employment can seem stable—until it isn’t. Many large mental health agencies have been acquired by private equity, which introduces instability through cost-cutting and restructuring. In economic slumps, companies may reduce staff, freeze raises, or even shut down entirely.

Additionally, employed clinicians don’t retain the full value of what they earn. Organizations typically keep 30% to 50% of a provider’s revenue, which may be worthwhile when benefits are strong—but becomes harder to justify if salaries are frozen or workloads increase. That trade-off, in a downturn, can feel increasingly lopsided.

How Private Practice Offers Income Control in Economic Downturns

In private practice, providers have far more control over their financial outcomes. This flexibility becomes even more valuable when the economy is unpredictable:

Providers can trim or scale expenses strategically, such as adjusting office space or telehealth use.
Negotiating insurance contracts offers a way to stabilize income and expand access for clients.
Practitioners can adjust caseloads, take on new clients, or introduce supplementary offerings like workshops or group therapy.
Multiple income streams—such as supervising interns or contracting with local agencies—help mitigate financial risk.

When you own your practice, you decide what stays, what changes, and how to grow. That level of control is a major asset when the economic landscape is shifting.

What Happens to Client Demand During a Recession?

Mental health needs don’t shrink during a downturn—they grow. Recessions create uncertainty, and that uncertainty fuels stress, anxiety, and conflict in both individuals and families.

Clinicians frequently report seeing more clients experiencing economic-related stress. Even young children express concerns influenced by the financial struggles of their families. Importantly, many families continue to prioritize therapy—especially for children—placing it just after essential expenses like housing.

As out-of-pocket costs become harder to manage, many clients shift to using insurance. This creates more demand for in-network providers and puts clinicians in a strong position to negotiate better reimbursement rates. In this way, downturns can actually strengthen a provider’s leverage.

Is Now a Good Time to Start or Grow a Private Practice?

If you're hesitant to take the leap into private practice during economic turbulence, you're not alone. But uncertainty can also be a strategic opportunity. Mental health services remain in high demand, and private practice can be built slowly and sustainably.

For those concerned about the unpredictability of cash-pay clients, accepting insurance is a powerful way to protect your caseload. You don’t need to scale overnight—many providers begin with a part-time private caseload while maintaining existing employment or contracts. And for clinicians working with kids or teens, the stability is often even stronger, as parents are less likely to cut back on their children's care.

Rather than waiting for the "perfect time," now may be the best time to take steps toward greater autonomy and income stability.

In this week’s mental health business moment…

We focused on the art of negotiating office space during practice growth. With many commercial properties sitting empty, providers may have more leverage than they think.

A savvy leasing approach involves starting early, showing low urgency, and allowing property managers to return with better offers. Even before touring, it’s possible to reduce asking rents significantly just by slow-playing the process and questioning “high demand” claims. The takeaway: don’t rush. The commercial real estate market may be more flexible than it appears, and thoughtful negotiation can significantly reduce long-term overhead.

In Uncertain Times, Private Practice Offers Control and Opportunity

Economic turmoil may feel like a reason to hunker down, but for many mental health providers, it can actually be the perfect time to take control. Private practice offers flexibility, financial resilience, and opportunities to grow—even when the broader economy looks uncertain. As this episode of Sit and Stay explores, the safest option may not be employment—it may be the freedom and adaptability that come with running your own practice.

Have a question or topic you’d like us to explore? Contact us at sitandstay@ripsytech.com.

And don’t forget to subscribe to the Sit and Stay Podcast for more insights on running a thriving mental health practice.

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Why Private Practice Can Be Safer in a Recession