I've seen a couple of so called mega churches on TV.
The issue I think they have is ,with thousands of members pastoral counseling is impossible.
It's not impossible, if you have enought qualified elders/pastors for counseling and study/advice.
The problem is that many churches think that it is the "preaching pastor/preacher"'s job to minister to everyone. That is simply not true. Timothy was told to appoint "elders" and "deacons" to tend to the flock.... how many you need is based on how many are in your flock. The role of elder or deacon should never be just a "title" for recognition.... there are responsibilities involved, and jobs to be done.
I was asked to be, and then appointed as a deacon in a church I used to attend... about 700-800 members at our "peak".... I told them that I would not accept it just as a "title", but if there was a specific work that needed doing, I would gladly accept it. I took on the benevolence ministry of our church... we had an annual donation of $60-70,000 that we used to help our members, and members of our community. We never had money left over.... the need was great, even in as affluent a town as we lived in.
I did that for about 6 or 7 years before I had to step away from it, to regroup.... working with people and their financial problems will take a toll, given time.
The point of that is to say that there are specific jobs to do, and spiritual counseling is a big part of that, and should be done by elders.