What medical settings can a mental health counselor work in?

Working as a mental health counselor is a rewarding career path, offering the satisfaction that comes with helping people in need and seeing their lives turn around. Mental health counseling is a sought-after sector too. The US Bureau of Labor Statistics states that mental health counselors earn higher than average wages and that the profession is set to expand by 22% between 2021 and 2031 — a rate of growth that’s considered much faster than average.

What’s also appealing about this career path is the variety of employment settings it offers. Mental health counselors work in a wide range of establishments and environments, from hospitals to commercial organizations. This opens a world of choice when it comes to applying for jobs and finding a niche.

This article will explore the types of teams and settings counselors could find themselves in when they embark on a career in mental health counseling. It will help them understand the available options and map out a career path for anyone considering this exciting employment sector.

What is mental health counseling?

Before looking at where individuals could work as a mental health counselor, let’s understand precisely what the role involves.

In short, a mental health counselor helps people manage their emotions, behavior, and mental health issues in a safe and supported environment. The core areas of their work are to understand issues and patterns of behavior affecting a person’s emotional well-being and, working with the client to offer therapies and treatments to address these concerns.

The types of mental health issues or situations a mental health counselor works with include:

  • Addiction
  • Anger
  • Anxiety
  • Bereavement
  • Bipolar disorder
  • Borderline personality disorder
  • Depression
  • Eating disorders
  • Family and relationship issues
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Social phobia

The end goal is to empower the individual to manage their issues and resolve them where possible, freeing them to pursue their best and happiest life.

This sector also offers lots of different specializations. For example, substance abuse counselors and addiction counselors work with clients dependent on alcohol, drugs, or other addictions like gambling or shopping.

Behavior disorder counselors work with people living with conditions such as attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD), helping them navigate their emotions and everyday life.

And licensed clinical mental health counselors work in a wide variety of settings to help people address and live with diagnosed mental health conditions. To work in this specialty, individuals will need to pass licensing exams to show that they have a full grasp of the subject area and the requirements of the profession. Next section, this article will explore some of the many different settings where mental health counselors may work.

Inpatient facilities

Many mental health counselors work in inpatient settings, such as mental health hospitals, wellness facilities, and retreats. 

Working as part of a team of clinicians, therapists, and providers of holistic therapies, mental health counselors devise and deliver counseling programs for individuals or groups. Their role also involves assessing clients’ progress and their discharge from the facility.

The term ‘inpatient facilities’ covers quite a wide spectrum of settings, from psychiatric wards with a minimalist feel as well as wellness retreats with a homely atmosphere offering a range of leisure-based therapies in addition to any clinical or counseling treatment.

It also covers different mental health symptom severities. So, for example, in secure psychiatric wards counselors could be working with the most challenged clients with distressing symptoms who need round-the-clock monitoring and care. Meanwhile, the clients counselors encounter in wellness retreats may have a greater awareness of their issues and are not at risk of harming themselves or others.

Whichever type of facility counselors choose to work in, the end goal will be the same — support clients to restore or manage their mental health to the extent that they can safely and confidently return to the community.

Outpatient facilities

Working as a mental health counselor in an outpatient facility involves seeing clients who are not so severely affected by their mental health that they require inpatient treatment. However, counselors are still likely to see a range of mental health issues and meet a wide variety of clients, making this a rewarding pathway for a career in counseling.

Outpatient mental health counseling is offered in hospitals, clinics, and health centers and can take a variety of forms, such as one-to-one counseling or group therapy.

From a client’s perspective, outpatient mental health counseling is a great option to enable them to continue with their day-to-day lives in between sessions. It is ideal for mild to moderate mental health issues including anxiety, depression, and phobias.

It’s also good for clients who have previously received inpatient care as it supports the progress they have made and reduces the likelihood of subsequent hospitalization.

Hospices and palliative care

While palliative care generally alleviates the physical symptoms of terminal diseases and conditions, working with patients on their mental health at the end of their lives is a relatively new — but just as relevant — concept in this field.

Individuals working in hospices and palliative care settings as mental health counselors enhance their clients’ quality of life, right to the end. This makes it a special and much-needed area for mental health practitioners to work in.

In this role, counselors may work in a hospital setting or in a hospice, a facility that gives specialized support and care to people at the end of their lives.

Their work will involve supporting patients as they complete the final chapters of their lives, helping them to express their feelings and address their fears. It also involves working with them to offset symptoms like anxiety so that they experience good quality of life to the end.

Hospices and palliative care settings are far from depressing and can be vibrant places to work, where compassion is key. They can feel less formal than traditional inpatient facilities as loved ones are often free to visit when they like, creating a real family atmosphere and providing an uplifting place to work.


Working as a mental health counselor in pediatric settings is another specialized area that can make a huge difference to children’s lives. These counselors may work in an inpatient or outpatient facility, or at a private practice or health center in this capacity.

In a pediatric setting, the aim will be to provide a safe space for children to express their issues and work towards regaining control of their mental health now, and for the future. Counselors will work with them on techniques and therapies that they can use as they grow towards adulthood.

The types of issues a mental health counselor may work with in pediatrics include bereavement, for example the loss of a parent or sibling, abuse, eating disorders, bullying, and childhood illness. However, this list is not exhaustive, and counselors are likely to encounter a wide range of topics in this satisfying role.

Private practices

Working as a mental health counselor in a private practice setting opens up a number of options. Counselors may start their own private practices working alone or in a partnership with other counselors or therapists. This gives them the freedom to set their own schedule and have control over the working environment — for example, a counselor may wish to operate from a private space in their own home for convenience or hire premises in a locality close by.

Naturally, the core work of a mental health counselor will be to support clients and offer strategies and treatments to help them take control of their mental health.

Another key part of a private practitioner’s work is running the business, so counselors will need a sound grasp of business practices from securing finance to keeping records and turning a profit. Private practice is an excellent choice for mental health counselors who enjoy the freedom of managing their own workload and the challenge of running their own business.


These days, more and more companies understand the value of good mental health in the workplace and are running employee health and well-being programs, which include mental health counseling.

This is great news for both workers and counselors as it recognizes the value of employees as ‘whole’ people while providing a rewarding career niche for mental health professionals.

The role of a mental health counselor in the corporate sector will include providing support to employees, and sometimes their families, for a variety of issues linked to their mental health, including work-life balance and burnout. The goal is to help them manage their challenges to enhance their well-being, and ultimately support them to be happy and productive employees.

Counseling may take place in person, by telephone, or online and may not be limited to work-related issues. Counselors are likely to encounter a wide range of topics, just as they would in any other area of practice.

Counselor support could be on an ongoing basis or may be called upon to offer counseling to help employees come to terms with a traumatic incident in the workplace, for example an accident or the death of a colleague. Either way, helping clients thrive in the workplace and beyond offers a rewarding career path for mental health counselors.


Most colleges have an in-house counseling service to ensure the emotional well-being of their students. This could involve counseling them for existing mental health challenges or helping them through numerous issues. For example, the pressures of academic success or being in an unfamiliar environment result in anxiety and depression.

Typically, a mental health counselor working in a college will practice from a student health and wellness center. They offer individual or group therapy and both planned and emergency therapy. Working with young people and supporting them through this important transition in their lives is a satisfying pathway for mental health counselors. 

Correctional facilities

Correctional facilities, such as jails that accommodate inmates awaiting trial or longer-term facilities such as prisons, can provide a challenging yet rewarding environment for mental health counselors.

In this role, counselors may work with inmates either on a one-to-one basis or in groups to explore their mental health issues, behavioral patterns, and emotions. There is a focus on understanding the path that led them to criminality.

This is a specialized role that aims to support clients through their incarceration. It will help them to respond in a more positive way to mental health challenges, reducing the risk of them returning to prison in the future.

Counselors in correctional facilities will also work closely with other staff, for example doctors, nurses and psychiatrists, depending on the care needs of the clients. Working in correctional facilities can be challenging and sometimes even dangerous. For example counselors may be called upon to assist inmates in crisis or who exhibit violent behavior. However, it can also bring unique rewards, seeing inmates work through challenging issues to change their behavior for the better.

Residential care facilities

The term ‘residential care facilities’ includes permanent or temporary accommodation for people who need help with their day-to-day lives. This includes people with learning disabilities such as Down’s syndrome, the elderly, and people with complex medical needs.

Sometimes the care is all-encompassing and in other cases, for example in retirement communities, residents can take care of their own daily needs but have support on-site if required.

Working as a mental health counselor in residential care is a rewarding role, which makes a real difference to residents’ lives. Guiding them to take ownership of their mental health issues can help them thrive in their care environment and live as independently as possible.

Like many other settings, work as a mental health counselor may take the form of one-to-one, group, or emergency therapy. Clients will also be supported by other staff in diverse roles, so this type of setting will help counselors feel part of a cohesive team.

How to become a mental health counselor

Individuals who think that mental health counseling sounds like a rewarding and varied career choice may be wondering the best route to get there. A typical journey to becoming a mental health counselor starts with a bachelor’s degree in a related field, such as psychology, social work, or sociology. 

Students will then need to undertake a Master’s in Counseling — the exact title of the course may vary according to the educational establishment. They should choose a course accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) to ensure it meets the high standards demanded by this field.

This will give them a solid grounding in counseling as a subject area, therapies, cultural issues, critical thinking, and the business side of a counselor’s role. Together, these topics will enable students to work as mental health counselors in a wide range of settings.

A good master’s program will also prepare students for the licensed professional counselor exam, which is a requirement before practice. An important step towards licensure is hands-on experience through the practical component of the course and internships. Graduates can then apply for licensure and embark on this exciting and rewarding career.

Studying online is the perfect option for anyone with a busy lifestyle, allowing students to work at their own pace and from their preferred location. The course will equip students with all the necessary competencies to practice nursing in society. 

For individuals looking for a course in counseling that prepares them for this journey and fits in around existing commitments, consider a Mental Health Counseling Online Masters from a reputable university such as St. Bonaventure University Online. Students will have access to a range of materials including videos, live sessions, and discussion boards and will be supported by faculty staff throughout. 

This dynamic course will prepare students to meet the requirements of a licensed counselor, with 2021-22 candidates achieving a 100% pass rate on the exam. Staff can even help students find internships in their local area to make the transition to qualifying as a mental health counselor as smooth as possible.

Learn the smart way with an online master’s

A career as a mental health counselor offers variety, satisfaction, financial reward, and a career path that can flex according to areas of special interest.

This article has touched on many — but by no means all — of the settings mental health counselors may work in. As it is a growing sector with the profession in constant demand, graduates can expect the range of workplaces for this career to expand too.

So, interested individuals can start planning their journey to their dream career with an online master’s today. It’s the smart way to a career that has everything to offer, from the satisfaction of seeing clients grow and thrive to the numerous options for a diverse and vibrant workplace where counselors can really make a difference.