Mental health policy reform

Therapy without borders

Every year, thousands of people lose access to their therapist — not because they stopped needing help, but because they crossed a state line. A college student moves for school. A military family relocates. A remote worker changes addresses. And the therapeutic relationship ends.

Therapy Without Borders works to change the laws that make this happen. We research state-level barriers, build advocacy tools, and push for policies that let care follow people — not zip codes.

Person in a telehealth therapy session
160M+
Americans live in states with zero mental health compacts
8
States received a failing grade on mental health access
90+
Days average wait for licensure in the slowest states
3
Interstate compacts now exist for mental health providers
The Easy Score

How does your state stack up?

We graded all 51 U.S. jurisdictions on 35 points across four categories. Pick your state and see what's working — and what needs to change.

What We Do

A simple mission with two priorities

Remove state lines from mental health care. Every young person in America should be able to find and keep a therapist without worrying about invisible borders.

PRIORITY 01

Universal Compact Participation

Every state should join every mental health compact. When all states participate, a college student can keep her therapist after moving across the country. A military spouse doesn't restart care after relocation. A family doesn't start over in a crisis.

Learn about compacts
PRIORITY 02

Modernize Telehealth Laws

Compacts solve interstate licensing, but insurance rules and outdated telehealth restrictions still block access. We're evaluating telehealth laws in every state to identify what works and push legislatures toward best-practice policies.

See how your state scores
Get Involved

Are you a therapist? We need your voice.

Take the Therapist Reality Check — a quick survey about the real barriers you face practicing across state lines. Your responses fuel our policy advocacy and legislative briefings.

Take the survey
⏱️
Takes 3–5 minutes
Quick, focused questions about your licensing experience
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Aggregate data powers advocacy
We use responses in legislative briefings and one-pagers for state lawmakers
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Real stories drive real change
Legislators respond to people, not data points — your experience is powerful