March 22, 2022. That’s the earliest date Laura McKiver can get for a psychiatry appointment and be prescribed medication to combat her ADHD. She’s on four wait lists in total.
“It’s starting to get harder and harder to actually do my everyday life things,” the Cheltenham veterinary technician said.
As the coronavirus spread, more and more work-from-home people decided to adopt pandemic puppies and kittens. This tripled McKiver’s workload. With it came heightened levels of stress and a return of her ADHD, which, with the help of medication, she previously had under control.
“If my mental [health] is not good, I can’t do my job in the way I’m supposed to,” the 28-year-old said. “I can’t communicate with my family in the way I’m supposed to. I become a different person.”
Like so many people around Philadelphia, McKiver has struggled to find support. Although she’s been able to find a psychiatrist, she can’t get her medicine without an appointment.
Christina Crews, communications director for the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, says part of the problem is that providers have struggled to hang on to their staffs, which means they can’t take on as many new patients.
Shelley Z. Goodman, a clinical psychologist in Elkins Park, knows this struggle intimately.
“People have been traumatized,” she said. “From being stuck at home or being afraid to go out. And then in addition to that, the shootings in Philadelphia don’t help either.” There have been more than 2,100 people shot so far in 2021.
For more than a month Goodman has had to turn away two to six potential clients a day. Over her 25 years as a therapist she’s used to working about 38 hours in a week. Now she is seeing patients around 50 hours, from 8 a.m. to 6 p.m.
“It tugs at my heartstrings,” she said, “because I know how hard it is to find a therapist.”
Others in her field have been calling her to ask if she can take referrals, but she has to constantly tell them no.
“I just don’t have any more,” she said. “I’ll fall apart if I don’t have some time off.”
Adolescents suffering alongside adults
Silver linings in the middle of a pandemic don’t always seem possible. But for Roisin Hagerty there was at least one. Her daughter, often plagued with anxiety, had a bit of a reprieve from feeling overwhelmed when schools shut down and everything became remote.
That served as a welcome blessing for Hagerty, a registered nurse from Oreland who had to navigate a hospital environment ravaged by COVID-19.
But schools eventually welcomed students back into the classroom and her daughter had to return. With the addition of masks in classrooms and social distancing in the hallways came the return of the 16-year-old’s anxiety.
Before the pandemic, Hagerty would call her insurance company, set up three consultations, and let her daughter pick her therapist. That was not the case when Hagerty started looking for help for her daughter in October.
“Being in the pandemic, it was a real struggle,” the mom of two said. “Everybody kept saying, ‘We’re not accepting new clients.’”
Places like the Pediatric Anxiety Treatment Center at Hall-Mercer (PATCH) in Society Hill have seen a nearly 400% increase in referrals this year, said Emily Becker-Haimes, clinical director at the Penn-run specialty clinic that treats adolescents with a range of mental disorders.
Before the pandemic, the center would get maybe three to four referrals a month. Now it sees upward of six a week.
“I think remote schooling and obviously, all of the stressors of not being able to socialize and engage in the world, and just a lot of the messaging about the stress, has all culminated in a lot of kids needing more help than I think our entire mental health system is used to and is prepared to serve,” Becker-Haimes said.
From 8,000 to 9,000 psychologists treat children and adolescents in the United States, but the need is around 30,000, according to Jodi Brown, a child and adolescent psychiatrist in Bryn Mawr.
Why are there not enough clinicians?
In Elkins Park, Ava Adames tries to show people there are other forms of therapy they can tap into at her holistic healing store, Violets in Bloom.
“I work with people calibrating or recalibrating their frequencies so they can feel more energetically balanced,” she said. “In other words, help people to lessen anxiety, depression, bouts of anger and rage.”
She started the private practice as COVID-19 first appeared in the Northeast in March 2020. Like most businesses, hers was shut down for three months.
“When I reemerged and reopened it, I was hit with so many people that felt like they had nowhere to go because their traditional medical offices were still trying to catch up,” she said.
Many told her they were on wait lists and just wanted any kind of help to combat the stressors that came out of the pandemic.
There just aren’t enough therapists, counselors, and clinicians.
“We know from a lot of national work that demand just far exceeds supply,” said Briana Last, a doctoral candidate in clinical psychology at the University of Pennsylvania. “We simply don’t have the workforce that can meet the demands of growing treatment seeking and also growing rates of psychological disorders in general.”
Last and a group of clinicians partnered with the city to examine clinicians and the issues they are facing.
“We had a global mental health crisis preceding COVID-19,” said Rinad Beidas, associate professor of clinical psychology in psychiatry at the University of Pennsylvania who also worked on the study. “And the needs have only been exacerbated by COVID-19.”
A number of factors — including clinicians’ educational debt and their struggles with finding care to deal with their own mental health issues — have made it hard to get more professionals in the field and helping patients, the study found. Clinicians are experiencing burnout and may not be at their best when treating patients.
Even before the pandemic hit, about 30% of clinicians were unable to find mental health services themselves, the study found.
It took Becker-Haimes, clinical director of the Pediatric Anxiety Treatment Center at Hall-Mercer, eight months to find her own therapist.
“And I’m pretty savvy about the system,” she noted.
Last offered a prescription for improving the lives of clinicians, including subsidizing their training and making sure they have their own psychological support.
“I think we just really have to think innovatively,” said Beidas, who called for more funding for mental health issues. “How do we make this what is our equivalent of fluoride in the water and take a multipronged, multilevel approach?”
All the while, people are suffering without proper care.
Hagerty just wants someone to help her daughter deal with the stress of it all and has become frustrated. A few weeks back, she was finally able to find a therapist for her daughter.
But less than a week after speaking to a reporter, she emailed to say that the new therapist had quit and that her daughter was back to square one.