What Does a Licensed Mental Health Counselor Do?

Mental health counseling is the practice of providing mental and emotional support to people suffering from mental health issues or navigating difficult life situations. So, what is a licensed mental health counselor (LMHC)? They’re the professionals who make it happen. Licensed mental health counselors work with other healthcare providers to determine the best course of action for treating a client. It’s important to note that the LMHC license title may vary depending on the state.

LMHC Licensure Requirements

The primary function of a licensed mental health counselor is to treat people who have mental and emotional disorders or other behavioral challenges. Counselors may coordinate with psychiatrists and social workers to determine a comprehensive treatment plan for clients. Those in this line of work combine their educational training with qualities like compassion and strong communication to support their patients. 

Can an LMHC Prescribe Medication?   

There are a few types of mental health professions that can prescribe medications, including psychiatrists and psychiatric or mental health nurse practitioners. Other mental health professionals may collaborate with these prescribing professionals or a primary physician to prescribe medication. Prescriptive authority may vary by state, however. In Idaho, Illinois, Iowa, Louisiana and New Mexico, clinical psychologists may be permitted to prescribe medications

Although LMHCs cannot prescribe medication, they may be able to collaborate with other medical professionals to support their clients. Licensure for LMHC allows these professionals to provide individual and group counseling as well as help provide diagnoses to clients, depending on the state.

There are also a few differences between a licensed mental health counselor and licensed clinical social worker (LCSW), including what they study in school. LMHCs may complete a master’s degree program in mental health counseling. LCSWs, on the other hand, typically pursue a social work master’s degree program with a clinical focus. 

Licensed Mental Health Counselor Job Settings

With a vast array of skills and patients to see, you might be wondering, where do LMHCs work? There’s no single work environment for LMHCs. Depending on the type of counseling you specialize in, you may find yourself in a variety of settings. 

Where Do Licensed Mental Health Counselors Work?

There’s a range of work settings for licensed mental health counselors. Depending on the type of counseling you decide to practice, you could end up in a rehabilitation center, a healthcare practitioner’s office, or even a residential mental health facility. 

Marriage and family counselors may work in individual and family service centers. Mental health counselors specializing in substance abuse or behavioral disorders may work in outpatient mental health and substance abuse centers, individual and family services, hospitals and other settings. 

Mental Health Counselor vs. Mental Health Therapist

At their core, both mental health counselors and therapists help people make sense of and cope with tragedy, disabilities, mental health disorders, trauma, anxiety and similar emotions. Some mental health professionals go by the titles “counselor” or “therapist,” which may be used interchangeably. For instance, states that license marriage and family therapists may also utilize the title of “mental health therapist,” but the title of a mental health professional may be subjective to the practitioner. The difference between these professions lies in the day-to-day responsibilities and types of treatment and approaches to clients presenting concerns. Education and licensure requirements will vary by state. 

LMHC Job Outlook

The Bureau of Labor Statistics (BLS) reported in 2020 that 327,500 people were employed as substance abuse, behavioral disorder or mental health counselors. These jobs are projected to grow 23 percent between 2020 and 2030. Demand for all three professions is fueled in part by the development of alternative sentencing policies. Several studies have shown that counseling programs are more effective than incarceration in curbing repeated drug use and crimes among drug offenders. 

What Can Affect LMHC Salary?

Various factors can impact LMHC salaries, including level of education, specialization and location. Depending on your certifications and educational training, you could be placed in a position that pays more or less than others. 

The BLS reports that substance abuse, behavioral disorder and mental health counselors working in business, professional, labor, political or similar organizations earn the highest annual mean salaries at $78,570. Outpatient care centers employ the most people in these roles, 72,820 professionals earning a mean annual salary of $51,980. 

Licensed mental health counselor salaries also depend on geographic location. The top-paying states for these roles include Utah, Alaska, Rhode Island, New Jersey and the District of Columbia. Mean annual salaries in these states range from $66,190 to $63,430, according to 2021 BLS data. 

What Is the Average Salary for a Licensed Mental Health Counselor?

LMHC salary can vary significantly from state to state, employer to employer and by level of education. Referencing BLS averages and speaking with professionals in the field may prove useful as you research licensed mental health counselor salary.

The median annual salary for substance abuse, behavioral disorder and mental health counselors was $48,520 in May 2021, according to the BLS. The highest 10% earned more than $77,980 while the lowest 10% earned less than $30,870.

Cities Where Mental Health Counselors May Be in Demand 

Some cities may experience higher employment in mental health counseling jobs due to a variety of factors, such as living conditions and population size. As you search for an LMHC job, you may want to consider working in cities where LHMC careers are in high demand. Here is a list of metro areas with the highest employment of substance abuse, behavioral disorder and mental health counselors, according to 2021 BLS data.

Metropolitan AreaTotal Employment

New York-Newark-Jersey City, NY-NJ-PA
Los Angeles-Long Beach-Anaheim, CA
Boston-Cambridge-Nashua, MA-NH
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
Chicago-Naperville-Elgin, IL-IN-WI
Seattle-Tacoma-Bellevue, WA
Washington-Arlington-Alexandria, DC-VA-MD-WV
Minneapolis-St. Paul-Bloomington, MNN-WI
Denver-Aurora-Lakewood, CO
San Francisco-Oakland-Hayward, CA

Explore These States for Mental Health Counseling Careers

Certain states also have more LMHC jobs than others. Mental health counseling careers in these areas are in greater demand for different reasons. The following states employ the most substance abuse, behavioral disorder and mental health counselors, according to 2021 BLS data.

StateTotal Employment
New York

Is an LMHC Career Worth It?

Whether or not an LMHC career is worth it depends on your goals and passions. Although becoming an LMHC requires completion of at least a master’s degree program and continued learning based on the specialization, according to the BLS, the personal gratification may be what makes it worthwhile for you. Being an LMHC may be fulfilling if you enjoy helping people achieve their mental health goals. Depending on your specialization, you can help people through addiction, tragedy, marital issues, mental health disorders and more. 

As you think through your decision to become an LMHC, consider factors like salary, job outlook and opportunities for professional growth.

If you’re seeking a career that allows you to use your skills and education to improve the lives of others, then becoming an LMHC is probably worth your time, money and effort. 

Alternative Careers for Licensed Mental Health Counselors

Not sure if an LMHC career is right for you? Explore other types of therapy, counseling and psychology degrees and careers.

  • Social Work: To become a social worker, sometimes all you need is a bachelor’s degree, although clinical positions require a Master of Social Work. As a social worker, you can help patients solve and cope with life’s challenges. And with a master’s in this discipline, you can help treat disorders and mental health issues.  
  • Clinical Psychology: In most states, in order to become a clinical psychologist, you need a doctoral degree in psychology. But before that, you may earn a Master of Clinical Psychology. You’ll also need a license. Clinical psychologists work with patients and study cognitive, emotional and social behavior. 
  • Applied Behavior Analysis: People who receive a Master of Applied Behavior Analysis may work with people who have behavioral disorders or developmental disabilities, such as autism. They can detect, diagnose and treat behavioral disorders by collaborating with other healthcare workers to determine the best course of treatment. 
  • Marriage and Family Therapy: If you’re interested in pursuing this career path, you may choose to earn a master’s in marriage and family therapy, a master’s in psychology degree or other related degree. Your degree program will prepare you to guide patients through struggles relating to marriage, family, relationships, etc. All states also require a license to practice as well as clinical experience. 
  • Psychology Degree: With a degree in psychology, you can work in various settings and with diverse patients. You can study psychology at the undergraduate and postgraduate level. However, most clinical, counseling and research psychologists need to have a doctoral degree.
  • Counseling Degree: A counseling degree may open up doors to a number of career opportunities, from working as a school counselor to working as a rehabilitation counselor. 

The mental health field offers numerous career paths that all share the same goal—to help others. If you’re not sold on a career as an LMHC, there are more possibilities to specialize in mental health. 

Last updated July 2022.