Demand for therapy increased during the pandemic
And we already had a mental health problem before
On February 1, 2022, the U.S. Senate held a hearing to address the nation's "growing crisis" of mental health and substance use disorders.
Mitch Prinstein, Chief Science Officer of the American Psychological Association, testified:
"The COVID-19 pandemic has placed an enormous strain on individuals, families, and communities. Beyond the very real physical ramifications of the virus, the effects of social isolation, disrupted routines, loss of jobs and income, and grief associated with the death of a loved one have caused significant distress and trauma, which typically have downstream effects on mental health."
Calls to the National Helpline for mental and/or substance use disorders increased by 55% from 2019 to 2021
The Substance Abuse and Mental Health Services Administration (SAMHSA) supports a National Helpline "for individuals and families facing mental and/or substance use disorders."
In 2019, before the pandemic, the Helpline received 656,953 calls. In 2021, the Helpline received 1.02 million calls, a 55% increase in two years.
The percentage of adults reporting symptoms of anxiety disorder and/or depressive disorder increased almost 4x from 2019 to 2021
The National Center for Health Statistics (NCHS), in partnership with the Census Bureau, began collecting data for the Household Pulse Survey on April 23, 2020. The survey includes "questions to obtain information on the frequency of anxiety and depression symptoms."
In 2019 from January to June, 11% of adults reported symptoms of anxiety disorder and/or depressive disorder. In January 2021, over 40% of adults reported the same symptoms.
Psychologists reported increased demand for treating anxiety disorder and depressive disorder from 2020 to 2021
The American Psychological Association (APA) conducted the COVID-19 Practitioner Survey from August 28 to October 5, 2020. 1,787 doctoral-level active licensed psychologists in the U.S. responded to the survey.
In 2021, the APA conducted a follow-up survey from August 30 to September 17. 1,141 psychologists responded to the follow-up survey.
From 2020 to 2021, psychologists reported increased demand for treating anxiety disorders (up from 74% to 84%), depressive disorders (up from 60% to 72%), and trauma- and stress-related disorders (up from 50% to 62%).
62% of psychologists reported an increase in patient referrals in 2021
In 2021, 43% of psychologists reported an increase in overall number of patients (up from 29% in 2020) and 62% reported an increase in patient referrals (up from 37% in 2020).
68% reported a longer waitlist since the pandemic started and 65% reported they had no capacity for new patients.
There was already a mental health problem before the pandemic
During his testimony before the Senate in February 2022, Mitch Prinstein said:
"To be clear, the need for greater investment in behavioral health care predated COVID-19. According to results from SAMHSA’s 2019 National Survey on Drug Use and Health, 26% of U.S. adults with any mental illness had unmet mental health needs during the previous year, and over 47% of those with serious mental illness report having unmet needs."
In December 2021, María Luisa Paúl wrote for The Washington Post:
"Combined with an uptick in gun violence, a reckoning on racial justice, a climate emergency and a divisive political landscape, the coronavirus-related hardships have taken a toll on young Americans’ mental health at a time when it was already in decline."
Jean Twenge, a professor of Psychology at San Diego State University, offers a historical perspective in an article published by Psychology Today:
"The increase in mental health issues is most consistent between the 1930s and the early 1990s. There is little doubt that anxiety and depression increased between these decades. After that, trend shows an inconsistent pattern, with some measures leveling off at historically high levels, some continuing to increase, and others declining ... the youth suicide rate declined after the early 1990s. However, most other measures of mental health have not improved in the last 20 years."
For more historical mental health data, here are two resources:
Are there possible solutions other than therapy?
Prinstein advocates for the passage of the Mental Health Professionals Workforce Shortage Loan Repayment Act on the basis that "a strong mental health workforce is critical to combating the long-term impact of the pandemic and remedying longstanding access gaps."
"Nationwide, even before COVID-19, the U.S. was facing a serious shortage of mental and behavioral health providers, including psychologists, with every state having documented mental health professionals shortage areas. By 2030, these shortages are projected to worsen significantly, with rural communities facing major challenges in recruiting licensed mental and behavioral health care professionals."
Therapy (often paired with medication) has become the default solution for mental health disorders. As mental health disorders increase, the obvious response is to increase the number of therapists in the workforce.
However, is it possible that we're not looking at this the right way?
Increasing the number of therapists is a reactive response. Therapy can help once a patient is already suffering from a mental health disorder, but what about before that?
What can be done to catch the early signs of a mental health disorder and offer preventative care to the patient?
Further, this preventative care might not need to be the burden of the healthcare industry.
What can we do as communities to support each other?
Lori Gottlieb, a psychotherapist and author of Maybe You Should Talk to Someone, was interviewed for a Berkeley magazine article.
The interviewer asked, "If you could wave a magic wand and change our society so people are less likely to need therapy, what would you change?"
And this was Gottlieb's answer:
"Lack of connection. No matter what people come in with, there’s an underlying sense of loneliness, disconnection—even if they have friends and family or are surrounded by people. I think people are feeling a lot of depression and anxiety because they aren’t being nurtured by connection. We’ve lost that sense of community that used to be so inherent—at least in my parents’ generation—where you had neighborhoods, and you’d go outside and kids would play. I’m not idealizing the past, but I think the one thing the past did have was a greater sense of organic community.
Nowadays, because we move around so much, we don’t necessarily put down roots in the same way. And each family becomes its own little silo. We aren’t just in each other’s lives organically. Then add technology to that, and people are not having many “I/thou” interactions, where you make eye contact and you’re not distracted by your phone on the table pinging or dinging or vibrating or by the screen on the wall in the restaurant. We lose that unstructured downtime, where we might run into people and get in a conversation or go take a walk. I’m not anti-technology, but I think that people feeling disconnected contributes to a lot of the low-lying depression and anxiety I see."
What happens when you go to therapy? You talk and the therapist listens. Of course, there's more to it than that. And not all therapy is the same. But a big part of at least some types of therapy is this talking-listening interaction.
What if we're each other's therapists? What if all we really need is to feel heard? And what if all we have to do to support each other is just listen?
What can we do as individuals to help ourselves?
Humans are social creatures; we can't do everything on our own. We need each other.
But perhaps there are some self-guided practices that can help to alleviate some of the symptoms of mental health disorders.
Meditation, mindfulness, and journaling are a few options.
There are even apps for self-guided therapy.
If you need help or want to talk to someone ...
1-800-662-4357 (TTY: 1-800-487-4889) is the number for The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline. It's free, confidential, and available 24/7/365. They can refer you to local treatment facilities, support groups, and community-based organizations.
988 is the number for the National Suicide Prevention Lifeline. "The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States."
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