Mental Health Professionals Are Adjusting to Pandemic Demand

During the pandemic, many have been encouraged to manage mental health through therapy, leading to an uptick in demand for providers.

In November 2020, the American Psychological Association found that mental health professionals reported an almost 30% increase in the number of patients since the beginning of the pandemic. At the same time, those professionals reported seeing 74% more patients for anxiety disorders and 60% more for depressive disorders.

While more people are getting the help they need, the influx has overbooked many mental health professionals—forcing them to refer clients to long wait lines or refrain from accepting new clients altogether.

“The year 2020 saw a 30% increase in hours worked,” Geoff Michaelson, PhD, a Virginia-based psychologist specializing in sex therapy, tells Verywell. The increase, while considerable, has been manageable for him. But for some of his colleagues, that hasn’t been the case. “I do refer out, but clearly see more and more colleagues who are not accepting new patients,” he says. “My expectation is that the surge will continue and increase.”

If Michaelson is correct, the profession may take a while to adjust, making it harder to find a provider when you’re struggling. “We need more, well-trained mental health professionals,” Monica Carsky, PhD, a clinical psychologist and professor based in New Jersey, tells Verywell. “But the training is expensive due to the amount of faculty time needed to train psychotherapists.”

Uptick in Demand

Just one month into the pandemic, texts to federal government mental health hotlines increased by about 1,000%. Although time has passed and people have settled into the reality of a pandemic, that surge is still reflected in psychologists’ offices—or Zoom calls.

In addition to the influx, many public industries employing mental health professionals have faced losses and cutbacks in the past year. This means psychologists in schools, healthcare firms, and hospitals have found themselves out of jobs, unintentionally contributing to the shortage.

“There’s a difference between private practice and those who are in that public setting,” Karissa King, LMFT, a therapist based in California, tells Verywell. “An advantage in private practice is that we get to call our own shots, which is a benefit to us as clinicians because we can put our own boundaries in place.” Still, she’s been dealing with an influx since the beginning of the pandemic. “We’ve been able to manage, but of course that creates for a long waitlist,” she adds.

Specialization and Insurance Further Limit Access

Even if those who once found help in schools and hospitals switch to a professional in private practice, that doesn’t mean they won’t experience difficulty finding someone who treats their disorder. The reported upticks in anxiety and depression disorders, trauma and stress-related disorders, and substance-related and addictive disorders, could hold the tension between supply and demand even more taut for certain therapists.

“Lots of people are grieving and traumatized after losing loved ones, friends, and dear colleagues,” Michaelson says. “Addiction has increased. Add that to a divided society and what used to be everyday concerns—health, money, food, housing, the weather, old age, accidents, and death from all causes. Resilience on both sides of the couch is highly strained. Yes, we need more clinicians.”

Tightening access to clinicians, especially to those with certain specializations, may be further exacerbated by insurance policies, Carsky adds, making therapy inaccessible for some. “This may not be true for all, but the insurance companies often reimburse so poorly for psychotherapy that therapists are not motivated to be on insurance panels, or leave them as soon as they can,” she says. “This means that patients who do not have out-of-network coverage are not able to have therapy until a network therapist has time.”

How Are Mental Health Professionals Coping?

Amidst technological changes and increased demand for their services, therapists are finding ways to cope with these new challenges.

Technological Changes

“Going back to non-distanced work will be scary for people, even after vaccination,” Michaelson says. The field might adjust long-term to the introduction of telehealth.

That’s the case for King. She works with her husband to form a therapist-life coach team. About half of their clients were already online before the pandemic. So when the pandemic occurred, that half turned to 100%. “We paid rent for a few months even though we didn’t use the office at all,” King says. “And we said, you know what? This online thing is working really well. Our clients prefer this, and not just because of the pandemic. They’re working people who are getting counseling on their lunch break, so it’s working out.”

With all the changes, only one out of 100 clients that the Kings have seen in the last year said they didn’t like online sessions. “We are permanently, for the foreseeable future, shifting to this model,” King says. “It’s working for just about everyone.”

Similarly, Carla Marie Manly, PhD, a clinical psychologist based in California, had been offering telehealth sessions before the pandemic, especially for clients who travel. When March came around, many of her colleagues “were very upset and feeling out-of-sync with clients.” Manly felt that way, too, until she realized that there was something to gain from virtual sessions.

What she missed from in-person sessions—body language, serving her clients tea—she was able to gain in virtual sessions. Namely, she was able to see the client’s full, unmasked face, as well as their home life. “Are there kids screaming in the background? What is their home life like? Is there a cat jumping on their head? How do they handle the stress in their life?” Manly says. “You never see that in an office setting.” During the pandemic, she’s talked to clients from their cars, closets, and bathrooms.

The burst of telehealth during the pandemic seems likely to continue, with mixed results so far. Still Manly adds, many will adjust. “In the long haul, we will see more of a shift in comfort with technology-based therapy,” she says. “Many psychotherapists have given up their offices and said, ‘This works quite well.’”

“I must be in the minority, but I’ve seen the pandemic as a huge opportunity to learn to be more flexible, more giving, more supportive, and more grounded,” Manly adds. “So for me, it’s been a great test.”

Juggling Their Own Mental Health

While adjusting to the technology, Manly herself was feeling “a bit flummoxed.” In her personal life, she makes sure she does her daily walks and breathing exercises. She also enjoys her dog’s company. But outside of this more individual self-care, being able to provide therapy and mental health resources on a wider scale has helped with feelings of helplessness.

“We felt like our hands were tied. I want to go to my office. I want to see my people. I want to do what I normally do, but I couldn’t,” she says. And then one day early on, she “had this epiphany: Go do Facebook Lives.”

Every Wednesday through the end of December, she would live-stream on Facebook. People could count on her to speak through multiple issues as a therapist, free of charge. She does speaking engagements via Zoom, teamwork exercises for local business employees, and runs a women’s support group in addition to Facebook Lives. “I try to help in ways that make me feel not so responsible for not taking on every person who tries to get in my queue,” she says.

Michaelson’s self-care techniques also reflect this need to help others. He has the support of his family, he says, and makes sure to rest, eat a balanced diet, exercise, and uses calming techniques like meditation, mindfulness, and self-hypnosis. But he also tries to manage his thoughts. “How should we think? Ask ourselves what is the most effective thing to do in the situation,” he says. “Accept what we can’t change. Do everything one can to change the rest. Be the hope people need and join with others.”

How to Find a Therapist

If you’re having trouble finding a therapist right now, experts say asking for referrals can be helpful. Call your top choice, and if they’re not available, ask if they can refer you to an intern or a colleague with a similar skillset.

As part of their practice, the Kings oversee a team of interns and have been increasingly referring clients to them. “We’re not just saying, ‘Sorry, we’re full! Go back to your insurance list,’” King says. “Instead, we’re saying, ‘We’re booked out this far, do you want to wait that long?’” If not, at least one intern tends to have openings in the same week. “So, we’re giving hope to people that way,” King adds.

And interns aren’t lesser than the therapist you’re hoping for; they’re at a master’s level in school, and are closely supervised and constantly receiving feedback, King says.

“My team of interns and I meet for supervision every week,” King says. “We do case presentations, so I’m really familiar with their caseload. I’m giving them recommendations and working through treatment plans with them.”

Still, if the therapist you hope for can’t take more clients and doesn’t have interns, the onus doesn’t have to just be on you to look for another one, Manly adds. When she’s overbooked and a client asks to see her, she knows that it’s much harder to find a therapist when you’re dealing with mental health issues. So, she makes referrals. “I do my very best to be clear: I can’t help you personally, but if you give me your insurance, name, and zip code, I can confidentially help you find a therapist in your area,” she says.

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