How a US mental health clinic got a 13.7× return on ad spend from Google Ads

The client is a mental health clinic in the United States that offers in-person and online care.

We describe the clinic by type and market rather than by name. We publish a client's name only with written permission, and in mental health, discretion matters to patients as much as to the practice.

Why mental health advertising is different

• Health audiences are off limits

  Ads about physical or mental health conditions can't use advertiser-built audiences such as Customer Match, your data segments or lookalike segments.

  Google Ads policy
• Clicks and leads cost more

  Median mental health search campaigns paid $4.22 a click and $141.17 a lead (US, Oct 2024 to Sep 2025).

  LocaliQ benchmarks
• Care is local, or licensed

  In-person patients look for care within reach, and online sessions can only be offered in states where clinicians are licensed.

Our work on the account began in February 2023, the first month in the results below. This is how the account was set up from that point.

How we measured it

Conversions

Patient inquiries and appointment requests, counted in Google Ads.

Cost per conversion

Ad spend divided by conversions.

Return on ad spend

Conversion value recorded in the account, divided by ad spend.

Agreeing what counts before launch matters, because automated bidding learns from whatever the account records as a conversion.

The campaign was built on three parts. Each follows from the limits on mental health advertising above.

1. Behavioral health keyword targeting

   We built campaigns around the searches people make when they look for care, such as a type of therapy or a "therapist near me" search.

   Why it matters here. With health audiences restricted, the search itself is the clearest sign someone is looking for care now. Copy that names the service, not the reader's condition, reads as more respectful.

2. Geo-optimized campaigns

   We focused the budget on the areas the clinic serves, with bids and budgets adjusted by location.

   Why it matters here. Clicks from outside the service area are unlikely to become patients, and online sessions have to stay within the states where clinicians are licensed.

3. Conversion tracking with values

   We counted inquiries and appointment requests as conversions and gave them values, so bidding and reports followed patient demand instead of clicks.

   Why it matters here. Values are what make return on ad spend possible. Condition details stay out of what is sent to Google: no diagnoses in page URLs, form fields or conversion names.

All figures come from the clinic's Google Ads account for February 2023 to June 2025. Figures marked Calculated are worked out from those totals and are approximate, because the account summary rounds them.

• 13.7×return on ad spendAccount
• 5.28KconversionsAccount
• $3.85cost per conversionAccount
• 31.8KclicksAccount

Where the $20.3K went

1. $20.3Kad spendFeb 2023 – Jun 2025Account
3. 31.8Kclicksabout $0.64 eachAccount
5. 5.28Kconversions16.6% of clicksAccount
7. about $278Krecorded conversion value13.7× ad spendCalculated

The pace over 29 months

Against the category

Account results summaryGoogle Ads · mental health clinic

1. Let search intent do the targeting

   When health audiences are off limits, the search and the location are your targeting. This account was built on those two settings and kept its cost per click and per conversion well below the category medians above.

2. A focused budget can go a long way

   Spend averaged about $700 a month. With a defined service area and relevant searches, that budget produced about 182 conversions a month on average.

3. Set conversion values from real fees

   Return on ad spend is only as reliable as the values behind it. For your practice, we'd base them on booked first sessions and your real session fees.