Anxious. Overwhelmed. Stressed out.
These words have framed the experiences of many Americans over the last two years as pandemic living grinds into the third year. Across the country, a new type of healthcare crisis is unfolding: a mental health and wellness firestorm, and the nation’s therapist providers are finding themselves on the front lines of a different kind of epidemic.
Social workers, counselors, and psychologists find themselves overwhelmed with requests for services, and an onslaught of new patients, including children, who desperately need their support. Results of a recent New York Times poll, where 1,320 mental health professionals were surveyed about how their patients are managing the ongoing pandemic living environment, show that general anxiety and depression are the most common reasons patients seek support, but family and relationship issues also dominate therapy conversations. Most alarmingly, the survey reported that one in four patients report severe stress and suicidal thoughts as the motivating factor to seeking therapy.
Stress is generally categorized in one of three categories:
Positive stress—normal and helpful in daily interactions;
Tolerable stress—more intense events, such as natural disasters or the death of a loved one; or
Toxic stress—occurs with frequent and prolonged adversity.
The real issue occurs when stress is not mitigated, and continues for an extended time, or is triggered by multiple sources. Toxic stress can be linked to many chronic diseases, including heart disease, diabetes, and cancer, leading to decreased quality of life and shorter life spans. Supportive relationships and clinical therapy are both shown to prevent or reverse the impact of toxic stress.
Mental health providers report that they have experienced a surge in new patient requests, and are struggling to keep up with the demand, creating an increased stressor for those providers as well. The results show the demand is from both returning patients and those new to mental health services. Many cases also include front-line and healthcare workers, who have experienced trauma in daily work. The report also shows equal demand in all 50 states, with more requests for medications, and a marked increase in children’s mental health issues.
“The pandemic has functioned like a magnifying glass for vulnerabilities,” said Gabriela Sehinkman, a licensed clinical social worker in Shaker Heights, Ohio, specializing in serving the Latino community.
Survey data reflected that six in 10 therapists believe the increased demand will last for at least the next year. As they wrestle with the guilt of not being able to meet the increased patient requests, along with burnout from the intensity and long hours, four of 10 respondents worry about the mental health system breaking and report needing to protect their own mental health.
How can we address this growing crisis? Policy change at both the state and federal levels will be required to address the primary access barriers of cost and insurance coverage. Better access to insurance-covered telehealth services would be a good start, as well as licensing updates from state boards to allow these sessions for clients across state borders. Increased federal and state funding for public clinics is also needed, as well as increased pediatric care. More educational support and training programs, including loans and scholarships, are needed to increase the number of trained counselors, particularly for people of color.
In 2020, in conjunction with WAGES, a community action agency, NCCAA launched a pilot Social Determinants of Health/toxic stress program. The program leverages the evidence-based ‘Resources for Resilience’ curriculum and the ‘Positive Parenting Program’ for training on helping to mitigate the effects of stress. The successful pilot initiative has shown positive outcomes which will be shared with other local CAAs. For more details, contact Elle Evans Peterson, NCCAA, director of Health Policy and Equity.
SAMHSA’s National Helpline 1-800-662-HELP (4357), available 24/7 in English and Spanish
NAMI Mental Health Helpline 1-800-950-NAMI (6264), available Monday through Friday, 10 a.m. – 10 p.m., ET.
National Suicide Prevention Lifeline 800-273-8255, available 24/7 in English and Spanish