Dak
mentat
The people occupying that niche tend to leave it or stop it and find what they deem to (probably) be less restrictive niches because modern psychiatric practice is almost entirely pill-pushing after a certain amount of visits/etc. due to insurance companies being dumb. Not saying don't try to, just saying it'll be less than optimal for you, I imagine.
I agree in a rear facing view of the future economy it would be completely sub-optimal. However, mental health issues are skyrocketing, and I expect the trend to continue/grow. When cultural foundations get shaken, it affects even the best of us. Not only that, but insurance companies are becoming as insolvent as all other financial institutions due to mismanagement and excessive risk taking to insure increasing profits, so insurance coverage is less of a concern in the future than it might be now.
People won't be able to afford the insurance, prescriptions, or the copayments even if they wanted to, and many reject the pills already (as you personally know).
The current western popular lifestyle feeds mental instability, both through action and diet. It is systemic. It is not something that pills can fix, only potentially, temporarily mask.
Edit: I'm also not expecting the economic landscape in general to look anything like it does now, in 8-10 years (at the latest), so doing a small practice without insurance payments wouldn't be an issue, relatively speaking.