Therapists warn therapy could become a class issue

Many people with depression and anxiety do not receive psychological treatment, despite recommendations that more patients should be offered it, SVT reports. The Psychotherapy Association within SSR warns that access to therapy risks becoming a class issue.

In SVT’s news documentary Antidepressants and sex drive, patients describe sexual side effects from antidepressants and their effects on relationships and daily life. Several people told SVT that getting medication was easier than getting psychological treatment. One said seeing a doctor could happen relatively quickly, while an appointment with a psychologist might take months. Another said they were not offered someone to talk to when prescribed antidepressants.

Aron Branner, a board member of the association, says patients are not always given the chance to discuss different treatment options. He says some people need antidepressants, but many should be able to choose between medication and psychotherapy.

The National Board of Health and Welfare has previously identified a shortage of suitably qualified staff as the main reason more people do not receive psychological treatment. Branner says the shortage of psychotherapists has worsened in recent years, and that therapy can also be time-consuming and costly.

“Antidepressants become a cheap way to make patients feel seen and heard,” Branner says. He warns that unequal access can result: people who can afford it may seek private psychotherapy, while others depend on regional services, which vary across the country.

Andreas Stomby, a general practitioner and chair of the Swedish Society of General Practice, also believes antidepressants are prescribed too often. He says the society has sought to encourage doctors not to prescribe medication as the first option for mild to moderate worry, anxiety and low mood. Conversation-based treatment, physical activity and self-help can be at least as effective, he says.

Stomby adds that mental illness should be distinguished from normal reactions to difficult periods in life. Not everyone experiencing worry or low mood needs psychotherapy, he says; in many cases, talking with a doctor at a primary care centre may be enough.

Most adults with depression or anxiety disorders receive care in primary care. The National Board of Health and Welfare says psychological treatment should in principle be available to almost everyone with mild or moderate depression or anxiety disorders. Its national guidelines give cognitive behavioural therapy the highest priority for mild to moderate depression.

The board’s 2025 review of healthcare staffing found that the number of employed licensed psychotherapists per 100,000 residents fell by 7.2 percent between 2020 and 2024.