“When I started looking for, on my own, a psychiatrist, I had very little luck,” said Syracuse, who lives in Whitefish, Montana. Although her therapist, a non-prescription provider, gave her a referral, there were no appointments available for six to eight weeks.
For a person with mental health issues in the midst of a pandemic, it seemed a long way off. “If I’m being honest, it wouldn’t go very well,” he said. “It seemed to me that no matter what I was doing, I couldn’t get the help I was looking for or that was out of reach.”
At a time when the ongoing pandemic is straining mental health, many people are going without care. Experts say the pandemic is exacerbating the shortage of mental health service providers that predates the current crisis.
If you find help, it may depend on where you live, who you are, and how much you have to spend.
As it is for suppliers
“At first, I increased the hours significantly,” said Akua K. Boateng, a psychotherapist from Philadelphia. “I still have a one- to two-month waiting list. This has never happened to me before.”
Finally, Boateng realized that he could not keep up with the increase in hours indefinitely, which he heard from other professional colleagues.
“I started having a little burnout,” he said. “I was doing all this while I was in a pandemic and experiencing all the things that everyone else was going through.”
Everyone works as hard as they can
“Everyone has been working as hard as they can,” agreed Todd Essig, a clinical psychologist and psychoanalyst who is part of the American Psychoanalytic Association’s Covid-19 advisory team. When Essig distances a potential patient, he offers suggestions from other professionals. Nowadays, they often return empty-handed.
“They come back several weeks later and check to see if I have any openings, because they haven’t had more luck anywhere else,” he said. “This never happened (to me) before the pandemic.”
Like Boateng, Essig emphasized that problems in mental health care predate Covid-19. He noted the decline in reimbursements by insurance companies to network providers that have led some professionals to decline the state of the network, making their prices beyond the reach of many seeking attention. .
“The pandemic exposes fault lines that should have been corrected years and years ago,” Essig said.
Inequalities in care
While people in any community may face obstacles when seeking mental health care, scarcity is not evenly distributed.
“In more than half of the counties (and most of them were rural), there were no mental health providers,” said Paul Gionfriddo, president of Mental Health America, a nonprofit organization with the mission of address the needs of people with mental illness. Even in urban areas where there is theoretically attention, finding a provider can be difficult.
“We’ve seen consistent patterns in which, even if people show up available and take on new patients, they’re often not available or take on new patients either,” Gionfriddo said.
Rural people are not the only ones who don’t.
“There are a lot of differences based on race, gender and age,” Gionfriddo said. Young people are the group most likely to miss out on mental health treatment. “We often overlook children’s problems,” he said. “Historically they have been the most needy populations and historically they have been less cared for.”
Men are also less likely to receive the care they need, Gionfriddo said, in part because they wait longer to find help. And despite a greater willingness to seek care, Gionfriddo said blacks in the United States have less access to mental health services than their white counterparts.
The LGBTQ population is also at particularly high risk, Gionfriddo explained. “People who identify in this population are significantly more affected by mental health issues,” he said. “They have some of the biggest needs, but the least understood, recognized and addressed.”
Is technology the solution to the crisis?
Mental health care was scarce before the pandemic. Now, rising demand has made scarcity worse. But in the struggle to tailor the provision of mental health care to Covid-19, telehealth can be a problem.
“It’s helping, as it provides greater access to areas that normally didn’t have access to it, or limited access,” Gionfriddo said. “We’ve advanced about ten years in telehealth in one year.”
The pandemic has also forced some changes to insurance. “Until the pandemic, the Medicare program did not cover a telephone conversation,” he explained. “Phone calls are refundable now.”
New technologies, such as text or chat therapy, are also promising, Gionfriddo said. Different groups need different types of care and new technologies facilitate the diffusion of services among a relatively diffuse population.
“This gives us the ability to microorient information and resources and, in fact, generate sufficient demand within smaller communities,” he said. “It should not be done only locally”.
Telehealth will not solve all the problems
But while telehealth may provide care in areas with few providers, it will not address the lack of mental health care in the United States.
“It doesn’t expand the number of suppliers,” Gionfriddo said. “It just distributes them a little differently.” Stressing the importance of long-term sustainable solutions, he noted that pandemic-related emotional distress could last far beyond a vaccine.
“The impacts of this on mental health that are being felt today will occur for many years to come,” Gionfriddo said. And, he explained, some of the more serious consequences of untreated suffering (including suicide) can take a long time to appear.
“No one will know if the suicide rate rose as a result of the pandemic for at least a couple of years,” he said. But focusing on 2020 suicide rates would be completely the wrong question, he added, because suicide is often a final-stage event that can occur after years of suffering.
“In fact, you have to look at suicide rates over the next 15 years to get an idea of how far the pandemic has affected the nation’s mental health,” Gionfriddo said.
Find and ask for the help you need
If you are looking for mental health care, experts say it is important to start right away. Despite the shortage, there is help. If you have health insurance, a good place to start is to call the insurer’s information line to request contact information from network providers.
After weeks of calls and delays, Syracuse found a psychiatrist who could write a new prescription for antidepressants. It made a difference. “Since I changed medication, I’ve felt 100 times better,” he said. “Everything is not as fought as it was, which outweighs the relief.”
One problem, Syracuse said, is that symptoms of depression and other mental illnesses can make it difficult to motivate while seeking attention. It’s easy to give up when things feel so hard.
If this is what you are struggling with, Syracuse recommended asking a loved one to offer some logistical support. When he communicated to his wife the lack of attention, he volunteered to call on her behalf.
“It was really helpful,” he said. “He took the load off me.”