Even before COVID-19, Mental Health America reports that the prevalence of mental illness among American adults was increasing. An estimated 19% of adults experienced mental health issues in 2017-2018, which was an increase of 1.5 million people since the previous year’s dataset. Suicidal ideation is increasing by approximately 460,000 people per year and youth mental health is also worsening. And then, in early 2020, we all became acquainted with the term “COVID-19.”
Demand for services skyrocketed. As mental health professionals, most of us have been run off our feet with full schedules and a mountain of calls and emails to return between sessions. At this stage, data is anecdotal and the numbers are not yet quantified, but one thing is abundantly clear: we need to take immediate action to promote access to mental health services across the United States.
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Mental Health Service Delivery Needs to Change
An article recently published in medical journal The Lancet in April 2021, entitled Reimagining Mental Health Systems Post COVID-19 stated: “Immediate and short-term attention has been directed to the negative mental health effects of COVID-19 in many countries. However, such attention needs to be put to more ambitious use. Now is the opportunity to make security the emotional and mental well-being of humanity a common expectation…”
We know that mental health is key to the well-being of our communities and that COVID-19 is taking a massive toll on mental health, with far-reaching and long-term consequences. A prolonged period of loss, trauma, and stress is already leaving a mark and there is not yet an end in sight. It’s not so much a discussion about whether our industry could change. My view is that it should, urgently.
I know I’m not alone in this. Another article in The Lancet, published in September 2020, suggested that economic issues arising from COVID-19 could not only increase the risk of mental health problems but also exacerbate health inequalities. The authors argued that: “Sustainable adaptions of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision.”
It’s logical that this question be asked: Is there a shortage of mental health professionals in America? The United States Department of Labor reports there are currently more than 550,000 mental health professionals practicing around the country. GoodTherapy published a well-researched article on this topic with some interesting graphics that I encourage you to read. It found that there are 30 psychologists and 15.6 psychiatrists for every 100,000 people, which should sound an alarm.
On top of that, there is a large disparity between metropolitan and rural counties, with an estimated 115 million people living in designated Health Professional Shortage Areas. To answer the original question, the Substance Abuse and Mental Health Service Administration estimates that America will have the following shortages by 2025:
- 10,470 marriage and family therapists
- 26,930 mental health counselors
- 48,540 social workers
- 15,400 psychiatrists
- 57,490 psychologists
As a result, an estimated 38% of Americans are not getting the mental health support they need. So yes, there is a shortage of mental health professionals in America – particularly in rural areas.
We need to start working smarter, not harder, to ensure we help as many people as possible without putting our own mental health at risk from stress, anxiety, and burnout. In order to achieve that, we need to take a closer look not at our services but at the delivery system.
Solution to America’s Professional Mental Health Shortage
The first step is to revolutionize online bookings. A lot of people are looking for mental health support right now, but if you think about it, the first barrier to access is scheduling. Prospective clients may have to call or email a number of offices before they can find someone suitable.
The checklist can be significant:
- Are there any mental health service providers in my area?
- Do they have the experience and expertise required to solve my problem?
- Will their office accept my insurance? If not, how do I find someone who does?
- Once I find someone who can help me, do they actually have space in their schedule?
Each of these questions is a potential roadblock to accessing mental health support – and that’s just for the preliminary consultation. If someone requires a course of treatment that requires follow-up appointments over a period of weeks or months, and their original provider has no capacity, they may have to follow these steps over, and over, and over again. It can be discouraging and even dangerous. Those seeking support may need help urgently to prevent a crisis situation.
That’s why I created Ravel Mental Health. This isn’t a sales pitch; rather, it’s food for thought about how we can collectively help more people. My hope is that it will become America’s new go-to mental health services platform. It’s an online booking system that doesn’t just tell people who you are: It allows them to check your availability and make an appointment on the spot.
Once you create a profile, you can select filters that match your geographical location, experience and expertise, insurances you accept, and availability. This means that all prospective clients need to do is log on, select the filters that best suit their needs, choose one of the providers that comes up, and schedule their first session on the spot. You can then respond to accept the appointment and get in touch with any registration paperwork that your office may require.
The other huge advantage to this system is that it allows people to prioritize telehealth, if they wish, which will make services much more widely available across America. Although COVID-19 brought incredible hardships to many people, one of the greatest things that came out of it – from a mental health services perspective – was that it made virtual mental health sessions commonplace.
Technology evolved quickly to ensure we could operate secure and HIPAA-compliant video consultations. There’s no reason why this should be restricted to larger cities. Promoting telehealth in non-metropolitan and rural areas will go a long way toward addressing the professional shortage, addressing inequalities, and ultimately ensuring better access to mental health care. This system means no more endless phone and email loops between providers and clients, no more administration-related stress, and no more turning away people who need help.
Revolutionizing Delivery of Mental Health Services
Mental health services should change after COVID-19. We owe it to our clients and ourselves. The effects of the pandemic are still very real and, although it’s a challenging and uncomfortable period in history, it is giving us a unique opportunity to keep asking important questions. Why do we do what we do? Who do we help? What do they need from us? How can we do better?
As professionals, we should all be continually assessing the services we provide, and the methods by which we provide them, to ensure we’re meeting the needs of our communities while utilizing good practices that promote sustainability, efficiency, and equitable delivery for all Americans. This is the perfect time to think critically so we can improve mental health care right across the board.
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