> Is your only distinction that depression would be harder to obtain?
Yes. You seem to be taking chagrin with the fact that therapists have to attach a diagnosis code in order to bill insurance, and then conflating that with inflated diagnoses of mental disorders that qualify as disabilities.
My issue with your comment is that I think you're taking a systemic issue (which I acknowledge, btw) and framing it as therapists' misconduct. If your claim that therapists are categorically diagnosing anyone who shows up for the purposes of billing were true, we'd expect to see very high diagnosis rates specifically among therapists who rely heavily on insurance, relative to those who are mostly private-pay. I don't have that data, but I'd be surprised if the difference were as extreme as your framing implies.
What did change in a clear, documented way was the DSM-5 criteria in 2013, which lowered thresholds for several conditions and broadened who qualifies for a diagnosis. That is diagnostic classification problem, not a "therapists are gaming the system for billing" problem.
I don't think this is a complete picture? Sure, they have to provide a diagnosis in order to bill insurance, but that can be something like F43.2/adjustment disorder, which is not a clinical diagnosis of depression or anxiety. Your comment makes it sound the typical experience is that you can just waltz into a talk therapist's office and be handed a slip of paper that says "I'm depressed." Which I'm sure exists, but I don't conflate pill-mills with responsible MDs, either.
Regardless, depending on the state, licensed counselors are qualified to diagnose mental health disorders, so not sure what your comment is getting at.