Waitlisted: Growing shortage of therapists intensifies mental health crisis

Mary Mour helps people deal with anxiety, grief and depression, a heavy and stressful job that takes a toll. She needs a therapist too, but the ones suited to help her have long waitlists — and she's been waiting for a year and a half.

"Unfortunately, there are not enough of us," she said. " There are just not enough options."

As therapy becomes more mainstream and people face long-held anxieties, depressions and other mental health problems, many have flooded to a limited pool of counselors and doctors for help.

The trend has been exacerbated by the mental strain of the deadly pandemic and an era in which technology brings news of wars, climate disasters and mass shootings to our phones on a daily basis. As a result, local providers said waitlists that can vary from weeks to six months have become common, leaving many patients to struggle with no relief.

The spike in demand during the 2020 lockdowns has remained elevated, contributing to widespread reports of provider burnout from heavy workloads.

In 2020, some 30% of psychologists reported that they could not meet patient demand. That percentage increased to 41% in 2021 and 46% in 2022, according to data from the American Psychological Association.

A recent national study by the National Alliance on Mental Illness laid out some grim statistics: the percentage of people who couldn't schedule mental health care was almost double that of those who couldn't schedule physical health appointments.

The situation is especially troubling for the many children and teens who have to wait weeks to months for an appointment or drive long hours for an available provider, said administrators at Riley Children's Health.

So Indiana University Health is ringing the alarm. Hospital officials last month released a 45-minute-long documentary film to raise awareness of the severity of the mental health crisis among children and teens.

"In the state of Indiana," the trailer for the film starts, "one in seven children has contemplated suicide in the last six months."

Therapist shortage hurts some more than others

The shortage of mental health providers affects people differently.

People who can afford self pay, have flexibility in their schedules and who have commonly treated disorders like anxiety and depression may have an easier time finding and scheduling with their therapists of choice.

That's especially true if they're willing to work with recently graduated therapists, who tend to have lighter patient loads because people often prefer therapists with experience, providers said.

Most people need insurance to afford therapy.

"We're seeing a divide take place," said Mary Margaret Sweeney, an Indianapolis-based therapist. "Those that take insurance always have waitlists. Therapists who are self pay have room in their schedule."

People who rely on private or government insurance plans and need appointments outside of standard business hours will have an even harder time finding therapy. The same goes for those who need a provider who specializes in more severe or specific disorders, such as bipolar disorder or Obsessive-Compulsive Disorder, or those looking for a provider who specializes in or shares their background, such as therapists of color or queer therapists.

Sweeney, who specializes in treating sexual dysfunction, said queer and trans people often seek her out as she may have a deeper understanding of their condition.

"They're looking for people who won't pathologize their queer identity and say 'You're depressed because you're trans,'" she said.

Provider shortage hurts children

The shortage of mental health providers is particularly dangerous for children, who are especially vulnerable to self harm. The rate of youth suicides in Indiana is increasing due to poor access to care and other issues, according to IU Health officials.

In fact, the rate of youth suicides in Indiana has been higher than the national average since 2000, according to state officials.

Treating problems like anxiety, attention-deficit hyperactivity disorder and depression when they emerge in children can prevent more serious problems and emergencies later in life, said Dr. Zachary Adams, a clinical psychologist at IU Health who specializes in child and adolescent psychiatry.

The provider shortage crisis has been an issue for Riley doctors and administrators for many years, Adams said. The problem is statewide and nationwide.

And, treating children can prove more difficult than treating adults, said Rachael Fisher, administrative director for behavioral health for Riley Children's Health. Fisher started as a therapist and moved into management of mental health providers.

"With kids, you have to work differently," she said. "You're treating the child but also the family. When you have the adult, you just have the adult."

That means therapists must work with the family to identify problems and fix relationships.

What can be done about the shortage?

For adults and children alike, the solution is straightforward: more providers in different fields from all backgrounds.

But accomplishing this will not be simple.

Education to become a therapist, psychologist or psychiatrist can be expensive and the cost can discourage some interested students, Mour said. More programs that forgive loans and provide subsidies will encourage more people to take on the job, she said.

Some therapists stop accepting insurances because of low reimbursement rates, said Sweeney. Improving those rates to make the profession a more financially enticing career will attract more people as well.

Riley Hospital for Children experts say fixing the problem may include training more providers, raising awareness and forming more partnerships, supporting primary care doctors who see children and youth with mental health conditions and helping connect families with available counselors.

For people like Mour, the problems are compounded.

She knows what it's like to be a frustrated patient and an overwhelmed provider — which worsens the shortage problem. Therapists often need mental health counseling themselves because the job can take a toll, she said.

"You're not going to be rich being a therapist," she said. "When it comes to the amount of work: you put in more than you get out. Burnout is high."

Binghui Huang can be reached at 317-385-1595 and Bhuang@gannett.com.

This article originally appeared on Indianapolis Star: Indiana patients face increasing waitlists for therapy