Mental health professionals cannot keep up with demand

JTwo and a half years into a pandemic that has left tens of millions of Americans more anxious and depressed, mental health professionals cannot meet an unprecedented demand for services.

Bayville psychologist Robert Motta said he was seeing twice as many clients as before COVID-19 and his six-month waiting list was the longest in his 46-year career.

“I have people calling all the time and I wish I could help them, but I can’t help them,” Motta said. “Every practitioner I talk to is overwhelmed with cases related in some way to COVID.”

Mental health professionals have said the psychological effects of COVID-19 will linger long into the future and – combined with a shortage of counselors, therapists, psychiatrists and psychologists – will continue to strain the mental health system. It was also sometimes difficult to find help before the pandemic, medical professionals said.

WHAT THERE IS TO KNOW

  • Request for mental health services is unprecedented amid levels of anxiety and depression that federal surveys show remain much higher than before COVID-19.
  • Many people are still afraid of contracting COVID-19, and some are still grappling with the grief of losing loved ones to the disease or with mental health issues that surfaced during the pandemic.
  • Many Long Island mental health professionals are not accepting new clients and have instituted waiting lists because they are seeing many more clients than a few years ago.

Federal health surveys reveal the mental health toll the pandemic has taken.

Nationally, 32.3% of Americans reported symptoms of anxiety or depression between July 27 and August 8, according to the latest household survey from the National Center for Health Statistics and the Census Bureau. That’s nearly triple the 10.8% rate in 2019 federal surveys, though down from a peak of 42.6% in November 2020.

The growing number of Americans with anxiety, depression and other mental health issues has led more people to seek psychological help, exacerbating the shortage of mental health professionals before the pandemic, Vaile Wright said. Senior Director of Healthcare Innovation for the American Psychological Association.

Almost two-thirds of psychologists who responded to an association survey this time last year said they were unable to accept new clients.

Deborah DeJean, a therapist whose office is in Valley Stream, tripled the number of clients than before COVID-19 and stopped accepting new ones last year.

“I feel really bad when I have to turn people down, but I can’t stand it physically,” she said. “You know what they say when they call? ‘Everyone is full. I do not know what to do.'”

A 2021 survey of psychologists found:

65% say they have no capacity for new patients

68% reported a longer waiting list

46% said they felt burned

Source: American Psychological Association

The frustration of not being able to find help can make mental health issues worse, said DeJean, who refers people to other therapists who may have openings or to phone helplines.

Motta said that while he still receives more calls for help than before the pandemic, the number has dropped somewhat in recent months.

“I attribute that to less fear,” he said.

The percentage of Americans who say they are “very concerned” about the pandemic fell from a peak of 65% in April 2020 to 28% on August 25 and 26, according to weekly Morning Consult polls.

Some — especially those who are older or have health conditions that make them more vulnerable to severe COVID-19 — remain extremely anxious, Motta said.

“A phenomenon like COVID produces within a population a high sense of vulnerability and threat,” Motta said. “And that’s what we’re really dealing with. That sense of security and predictability is gone. Suddenly, the environment becomes unpredictable. You don’t know when you’re going to get it, and if you get it, are you going to get impaired? »

Many worry about the long-term effects of the disease, he said. Nearly one in five Americans who have contracted the virus are still showing symptoms three months or more later, according to the Household Pulse Survey.

For people weakened by long severe COVID, “it can incredibly demoralize and depress them to the point where there is an elevation in suicide. [risk] for these people,” Motta said. “They feel their life is over.”

There’s also the lingering grief of those who have lost loved ones to the virus, some of whom don’t seek help until long after death, said Jeff McQueen, executive director of the Mental Health Association at Nassau County nonprofit, based in Hempstead.

Although the pandemic death rate has declined, an average of about 400 people die each day from COVID-19 nationwide, according to data from the Centers for Disease Control and Prevention.

Tatiana McLean, a therapist at Huntington, said three of her clients blame themselves for hosting social gatherings where someone apparently contracted the virus and later died.

“They can’t get over the guilt, the shame, the feeling that they should have known better…having intense sadness, feeling like it was their fault,” she said.

Jeffrey Steigman, a psychologist at Port Jefferson Station and director of strategy for the Huntington-based Family Service League, which has 10 nonprofit mental health and addiction clinics in Suffolk County, said the time families spent locked down earlier in the pandemic has caused tensions to surface that have still not been resolved, in addition to leading some to develop alcohol addictions.

“We are going to feel the effects of the pandemic for years to come,” he said.

McLean said some children are particularly struggling to rehabilitate, including those with social anxiety who have been thrown back into uncomfortable social situations at school after remote learning.

DeJean said some of her new clients might not have asked for help if it weren’t for the convenience of the virtual sessions she started conducting from her Brooklyn home because of COVID-19. Some also prefer virtual sessions due to the perceived stigma of going to a mental health office, she said.

Steigman said the popularity of virtual sessions has allowed his organization to better distribute services. If, for example, the Riverhead Clinic has no availability, the client can have a telehealth session with a therapist elsewhere, he said.

McQueen said COVID-19 isn’t the only issue causing increased need. There are also the strong political divisions in the country, as well as the racism and social injustice that have always existed, but which have been increasingly highlighted in recent years, he said. The spotlight on issues as such increases awareness and anxiety for people of color, said McQueen, whose agency has mostly black and Latino clients and mental health professionals.

McQueen’s organization has responded to the increased need in part by hiring more peer advocates — people with mental health issues who are trained to help others.

Wright said peer advocates are one way to address the shortage of mental health professionals.

“We will never have a large enough workforce to provide the traditional model of mental health care, which is a weekly 45-minute psychotherapy session,” she said.

Other potential solutions include more group therapy and expanded youth mental health programs to catch problems early, she said.

The roots of the shortage go back to long before COVID-19, Wright said. A 2018 analysis in the journal Psychiatric Services predicted that there would be fewer than 39,000 psychiatrists by 2024, although the need could reach 70,000. One reason: more than half of psychiatrists were due to retire by the.

Some young people are deterred from pursuing careers in mental health because mental health professionals with advanced degrees don’t make as much money on average as their counterparts in other fields, Steigman said. Insurance reimbursement for mental health services is generally low, he said.

Additionally, Wright said, “burnout can be very high” due to the “emotional burden of helping people who have experienced trauma, bereavement, etc.”

There’s a particular shortage of Spanish-speaking psychologists and those from “historically marginalized populations,” she said.

McQueen said the number of cases would have increased even more during the pandemic if there had been more black and Latino mental health professionals.

“I think black people and Latinos, when they go for help, they want to get help from other black people and Latinos,” he said. “They don’t feel comfortable going to see a doctor to discuss their issues if their doctor doesn’t feel like-minded or understand where they’re coming from, what their traumas are and what their issues are.”

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