Why Many Therapists Have Waitlists Right Now

As we round out the second year of the pandemic, many people are frustrated at the unavailability of local mental health services. Many therapists are booked for weeks; for anyone looking urgently for therapy, this can be a daunting predicament.

How did this labor shortage come to be? Here are a few observations as a psychiatrist and therapist with five decades of experience.

1. Insurance companies have not made things easy.

They have been cutting rates for years, auditing providers, clawing back fees, and generally making mental health coverage challenging, if not impossible, to find and navigate. Most insurance companies have inadequate panels.

A recent article in the Washington Post documents the way insurance companies often claim to have providers that they either do not have or who are unavailable. One patient was quoted as having called 73 doctors on the insurance company’s panel, none of whom was available for at least two months.

When it is nearly impossible to find in-network providers—even though the companies are required to have adequate panels in order to remain legally operational—we should smell a rat. If they aren’t helping you find an in-network provider qualified to treat your (or your children’s) condition, start shopping for another insurance company and report them to DFR.

2. Consider what things feel like from the therapist’s chair.

Many therapists, regardless of age, experience, or specialty, are reporting record levels of burnout. If your therapist has opted to take a rest, cut back hours or retire early, it’s important to mourn the loss of access to them. On the other hand, they have been holding everyone’s stress for the last two years, so many are at a breaking point. If your therapist has restricted hours or has been hard to book, don't take it personally.

3. Big tech has changed the mental health landscape—and taken a bite of mental health as we knew it.

In the wake of COVID, programs that purport to offer “therapy on demand” and that make exorbitant claims at availability and effectiveness have tainted the intimate nature of the therapist/client relationship, anchoring the dynamic to something akin to a life coach or personal service. I wrote a previous blog on the corporatization of therapy that I regard as, by definition, inadequate and even dangerous. Big tech has created another force that drives down the fair market value of mental health services, edging out legitimate practitioners whose experience gets undersold by promises of convenience (and expedience).

If it seems too good to be true, it probably is.

It is wise to be skeptical of any company that makes a pitch for stewarding your mental health, sight-unseen, and without proffering validating research, references, or credentials. This is doubly true for services offering impersonal, online substitutes. Always beware of services that undercut costs by undermining legitimate therapists and therapies.

How to Get Help Anyway

If your preferred therapist has a waitlist, what can you do in the meantime to get the help you need? The following suggestions may help:

1. Consider broadening your search.

While you wait for a therapist to become available, consider working with other disciplines or going out-of-network. There are many competent professionals in several disciplines: counselors, social workers, or psychologists (with either Ph.D.s or Psy.D.s). These people are also highly trained, and all have finished graduate school. Some are operating in a supervised practice.

Your FSA/HSA may cover their fee when you demonstrate that there is no one in-network, which means less haggling with your insurance company. While years of experience matter, recency of education also accounts for something. Many new therapists are looking to get practices started—and you could help them while getting the help you need.

2. Look into group therapy.

Group programs and specialty classes are great options for learning to cope with mental health issues, especially if those issues are worsened through loneliness. Group therapy, done competently, is good therapy for many things. Many group programs are now available online during the pandemic and in its aftermath. This is not always a substitute for the benefits of individual therapy, but group support can be a bridge in the meantime and may even be the best therapy for you.

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3. Lobby for systemic change.

It is no secret that, relative to other medical services, mental health is woefully underfunded; care workers are deeply undervalued and underpaid. Licensed mental health practitioners must have a minimum of a Master's degree, plus hundreds of hours in practicum or additional education every year. However, this industry is not paid like other clinical fields with similar educations and backgrounds.

You can help by lobbying your local and state governments to prioritize mental health programs in your communities. Mental health should be better funded on community, state, and federal levels, and better reimbursed by insurance companies. As elsewhere in our changing economy, many therapists are retiring because of inadequate compensation.