Here are just some of the challenges therapists have been facing as they try to keep up with patients’ needs during the pandemic, along with ways you can get mental health support if you’re struggling to find help.
Heavier Caseloads and Long Waitlists
Adults across the United States have faced real mental health challenges during the pandemic. According to a survey conducted by the Centers for Disease Control and Prevention (CDC) in June 2020, more than 40% of adults were struggling with substance use or a mental health issue like depression, anxiety, trauma, or serious thoughts of suicide. As a result, many people have been turning to mental health professionals for support. According to data released by the American Psychological Association, nearly 1 in 3 psychologists say they’re seeing more patients during the pandemic. “My practice and demand in general for therapy has surged since the pandemic started. At this time last year and in 2019, I was seeing about 23 clients a week. I now see an average of 33 clients a week—an increase of 43%,” says Andrea Dindinger, LMFT, a San Francisco-based individual and couples therapist. Besides the influx of new patients, some 44% of psychologists say they’ve also seen a drop in cancellations and no-shows. That has left many mental health professionals with packed schedules—but the calls from new patients keep coming. As a result, they’re forced to put prospective patients on months-long waitlists before they can be seen. “I have been getting booked out of appointments months in advance, with a wait time of two to three months for new patients,” says Rashmi Parmar, MD, a psychiatrist at Community Psychiatry. Likewise, Massachusetts General Hospital’s Child Cognitive-Behavioral Therapy Program has seen its waitlist grow from two to three months to seven months, despite having recently hired a new full-time clinician, adds the program’s founding co-director Dina Hirshfeld-Becker, PhD. “Since the pandemic, we have continued to have a steady flow of new patient referrals,” she explains. “At the same time, many children who had previously improved and left our care experienced a resurgence of their symptoms and needed to return to treatment. Others who were making progress in therapy experienced a worsening of their distress and needed to increase session frequency and or stay in treatment longer than anticipated.”
Challenges of Virtual Therapy
Like school, work, and socializing, therapy moved online for many people during the pandemic. This has helped therapists remain connected to their current patients while adhering to social-distancing precautions, as well as reach new patients who may not otherwise have easy access to mental health services. “We are a very busy practice, and telemedicine has increased our ability to provide services to a wider variety of people that were previously unable to take advantage of therapy due to transportation or other barriers,” says Janet Kahn-Scolaro, LCSWR, PhD, administrative director of behavioral health at Mount Sinai South Nassau. Switching to video therapy wasn’t without challenges for mental healthcare professionals, though. They had to quickly learn how to use specialty video chat platforms with security features to protect patients’ private health information. They also needed to coach patients on how to use those platforms and navigate technical difficulties and delays. “There are many people who lack access to appropriate devices or Wi-Fi or may not be technologically savvy enough to figure out a video visit,” says Dr. Parmar. “I have to rely on email communication with patients to send out important forms, handouts, or scales and expect that it will be completed in a reasonable and timely manner, which often does not happen. Patients may not have access to a printer at home or an appropriate device like a laptop to be able to fill out forms.” In addition to logistical issues, therapists have also had to figure out new ways to develop deep connections with clients from behind a screen. “I find myself constantly in the process of fine tuning my ability to have a meaningful connection with patients with the physical limitations imposed by video visits,” says Dr. Parmar. “It is challenging to pick on subtle nonverbal cues or changes in the patient’s demeanor while having a virtual visit. It is easy for patients to get distracted during appointments attended from home or other places.” And while the ability to connect with patients virtually at home has “helped save lives,” it has made it hard for mental health professionals to disconnect at times, says Leela R. Magavi, MD, psychiatrist and regional medical director at Community Psychiatry. “I find it difficult to disconnect and separate home and work life. I know that any extra time I spend working only benefits my patients, so it is especially difficult to unplug,” she explains. Laura Rhodes-Levin, LMFT, founder of The Missing Peace Center for Anxiety, agrees that the drive to care for patients can eat up much-needed downtime. “It is very hard to limit the amount of appointments you’re willing to do when so many people are suffering and you feel it is your purpose to help,” she says.
Coping With Burnout and Stress
Heavier caseloads, growing concerns about patients’ well-being, and a lack of work-life balance, combined with their own personal emotional stress from the pandemic, is leading to a risk of burnout among mental healthcare professionals. “Like everyone else, mental health clinicians have had their ups and downs and have been feeling stressed and worried. As the pandemic persists, the risk of burnout is an increasing concern,” says Aude Henin, PhD, founding co-director of the child cognitive-behavioral therapy program at the Massachusetts General Hospital. Burnout can impede a therapist’s ability to provide quality care to patients. It can also lead to other health problems, like insomnia, heart disease, excessive stress, and increased risk of other illnesses. “In some ways, it is just part of the human condition, and we use our experiences to try to help understand others. However, it is not helpful to patients if we do not take care of ourselves properly,” says Dr. Kahn-Scolaro. “As the pandemic has persisted, some professionals have decided to leave the field and go into areas that involve less patient contact.” The U.S. Department of Health and Human Services has already predicted that we’ll have a shortage of many types of mental healthcare professionals by 2025. If burnout leads to an exodus of therapists from the profession, that could leave many people without the support they need to recover from the emotional blow of the pandemic.
Finding a Therapist During the Pandemic
With mental health professionals across the country struggling to meet demand, it can be difficult to get an appointment with a therapist during the pandemic. But don’t give up hope, says Rhodes-Levin. “This may sound corny, but I really believe that we get the help that we are meant to get. If 10 places are saying no, for example, it just means you haven’t found the right place or the right person,” she says. Here are tips on finding a therapist and getting mental health support during the pandemic:
Add your name to therapists’ waitlist—a spot may open up sooner than expected. Consider joining virtual group therapy. “Our patients actually rate their group therapy experience higher than any other type of treatment provided,” says Dr. Kahn-Scolaro. Discuss your concerns with your primary care doctor. “Some do evaluate and treat psychiatric conditions and can refer out to psychiatrists who have openings when warranted,” says Dr. Magavi. If your child needs mental health care, consider connecting with their school’s guidance counselor for additional support. You may also be able to get emotional support from a pastor or counselor at a faith-based organization, adds Dr. Parmar. Ask for referrals from therapists who say they don’t have availability, as well as from friends, relatives, and other folks in your community.
“Don’t give up until you find support,” says Rhodes-Levin. “You are worth the effort, and happiness takes work.” The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. If you’re looking for a therapist right now, you may find yourself at the bottom of a months-long waitlist. But there are other ways to get support in the meantime. Consider joining virtual group therapy, talking about your mental health concerns with your doctor, and asking for referrals to other mental health professionals.
