Funding for talk therapy is drying up just as increasing numbers of New Zealanders are feeling comfortable talking about their problems.
The country's biggest income protection insurer, Sovereign, says claims for depression have reached a crippling 40 per cent and the cost of counsellors it sends clients to "out of the goodness of our hearts" can't be sustained.
It will recommend more clients do exercise and take medication.
Government departments have also reduced the counselling services they have offered for years.
Free relationship counselling services offered by the Family Court are about to be axed; the Ministry of Social Development is tightening up on the extensive counselling it offers the mentally ill on the disability allowance.
The ceiling on therapy sessions may be cut from 16 to as low as four.
Some of the cutbacks, particularly Sovereign's, have alarmed the Association of Psychotherapists' chair of public issues, Kyle MacDonald.
He says they are being done simply to save money.
"We are up against the massively funded model of the drug companies who convince people that medication is the best treatment, despite evidence to the contrary for mild to moderate depression."
Sovereign's chief medical officer, John Mayhew, says it has decided that where antidepressants have been proven to work well, it is "efficacious" for them to be used.
"In the past we've had, say, a 50-year-old stockbroker with an income protection product who's become severely depressed.
"The first thing we'd do is get him seen by a psychiatrist, get a diagnosis and then start treatment. That might be a mixture of psychotherapy, medication and an exercise programme. But now we've decided a talk therapist isn't necessary for everyone.
"A guy whose wife has just left him might be depressed and struggling to cope but it doesn't mean he necessarily has to see a counsellor.
"Anti-depressants like SSRIs (selective serotonin re-uptake inhibitors) are proven to work."
The Ministry of Justice is gutting its free relationship counselling. The Court Proceedings Reform Bill before Parliament will kill off the remaining three hours' free relationship counselling for couples. That was halved from six in 2012.
Justice Minister Judith Collins says the ministry has no idea of the outcomes of counselling sessions.
These will be replaced with six separation mediation sessions, free to 60 per cent of users who fall under the civil legal aid threshold. Those above it will pay about $780 + GST a couple, or $390 a person. Those talking separation will be advised to pay for their own counselling, though judges can still order it be paid for if things get as far as the Family Court.
The squeeze on therapy has angered comedian and Nutters Club founder Mike King, who has had well-documented battles with addiction and mental illness.
"The reason I had talk therapy was because I was overwhelmed with suicidal thoughts.
"As much as the whole therapy thing went against everything I stood for, I was faced with death as the only option - I had to try it for my family's sake.
"I can say from experience that talk therapy absolutely works. But few people can afford it.
"We don't need less talk therapy. We need to be working with the Government and insurance companies to find ways for more people to get affordable or free therapy."
MacDonald of the psychotherapists association says that at its most basic, the choice is coming down to the cost of a pill versus $120-plus for a session of talk therapy.
"People are given medication as the frontline treatment - usually SSRIs - after just 15 minutes of consultation," MacDonald says.
"It is often not an effective form of treatment but people are getting this as the only option.
"We must find the reasons people are depressed and this is what therapy is for, otherwise it is likely to recur."