It is well known that the mental health system is broken for clients — long wait times, endless phone calls, and poor relationships with therapists have left people feeling defeated. But as much as it isn’t working for clients, the mental health system in the U.S. is also not working for providers.
The COVID-19 pandemic has exacerbated underlying problems that existed before, and clinicians are now facing burnout rates at unprecedented levels. Pre-COVID, the average burnout rate of mental health practitioners was never higher than 61%. In a 2020 study of college counseling center practitioners, 90% self-reported burnout.
Mental health providers are a crucial piece of improving the mental health system in America as a whole, and we have a responsibility to provide better care for our caregivers. We take that responsibility seriously at Two Chairs, and it’s a priority for us to take care of clinicians through personalized caseloads, professional growth opportunities, wellness stipends, and choice around when and how they work.
To celebrate the launch of our new clinic in Seattle, we held a panel event about “Caring for the Caregivers,” featuring local clinical leaders Diane Mayes, Clinical Director at Crisis Connections, Jorge Tovar, Clinical Manager at Two Chairs in Seattle, Maria Coghill, Director, Mental Health at Kaiser Permanente Washington, and Dr. Shivani Kwatra, Internal Medicine at Kinwell.
We discussed the impact that COVID has had on clinicians and how the system can better support them. Here are some of our reflections.
The Impact of COVID-19 on Mental Health Clinicians
In March 2020, just like everyone else, clinicians had to adjust to a new way of living and working overnight.
The swift transition to teletherapy left them scrambling to adjust to a different way of relating to clients, in some ways putting in more effort to connect than they did before. As Two Chairs Clinical Manager Jorge Tovar said, “COVID in and of itself has been very uncontained, and this lack of containment has translated into the therapeutic space. Therapy used to be contained in a room, and now clinicians have had to adjust to the therapeutic relationship extending across a Zoom screen to wherever our clients are — and we are feeling that stretch.”
“COVID in and of itself has been very uncontained, and this lack of containment has translated into the therapeutic space. Therapy used to be contained in a room, and now clinicians have had to adjust to the therapeutic relationship extending across a Zoom screen to wherever our clients are — and we are feeling that stretch.”
While demand initially remained low and stable as people everywhere adjusted to staying inside and protecting their health, it very quickly surged to overwhelming levels. Screenings for anxiety and depression rose by 634% and 873%, respectively between January and September 2020, and demand for teletherapy grew 302% compared to pre-pandemic.
Over the course of the past few years, clinicians have struggled to keep up with providing quality care to a higher volume of clients, especially while trying to process their own emotions and protect their and their families’ health at the same time.
How the Mental Health System Can Do Better
High quality mental health care starts with taking care of clinicians. Here are several ways we can improve their experience.
Make Self-Care a Priority
First and foremost, we need to reduce the stigma around clinicians taking care of themselves, taking a step back, and being able to lean on others for support when they need it. Regardless of the environment, we should make self-care for mental health providers a priority.
Center Workplace Culture on Clinicians
Beyond prioritizing self-care, it’s important that we also provide care to clinicians and create a workplace culture of appreciation and recognition of the value they provide. This can be done by thanking them for their work often, building breaks into schedules, establishing clear workflows and communicating best practices, monitoring clinician well-being through one-on-one meetings, and creating a space of psychological safety.
Pay Attention to Workforce Development
It’s very difficult to work in a system where there’s a shortage of mental health providers — clinicians end up carrying the burden of all client needs in an entire population. As a system, we can change the course by recruiting and developing the next generation of mental health providers through creating a solid pipeline, establishing more post-graduate training programs, providing mentorship opportunities, and improving support and community for clinicians everywhere.
Utilize Measurement-Based Care
Numerous clinical trials have demonstrated that when routine client data is used to inform care, it results in better outcomes, achieved faster than usual care alone. When clinicians know from data — not just their intuition — that their clients are improving, they’re able to feel more accomplished and fulfilled at work. Through Measurement-Based Care, clinicians can have more meaningful conversations in therapy sessions, and they can make sure their clients are getting better.
Invest in Matching
Research shows that the relationship between the client and the therapist is one of the strongest predictors of whether or not therapy is effective. While the therapeutic match is critical to outcomes for the client, it also has a significant impact on clinician experience. When a clinician is well matched with a client, they are operating out of their strengths and are far more likely to be doing work they enjoy.
There is a lot of work to be done to improve care for mental health providers. And it’s important to remember that support can come in different shapes and sizes, whether it’s prioritizing self-care in workplace culture, reducing admin burden, or developing the next generation of clinicians.
It’s our responsibility to take better care of mental health providers, and when we do so, we’re contributing to a better mental health system for all.
We’re always interested in meeting talented, mission-driven clinicians. Take a look at our open positions, or get to know us and see what's happening at Two Chairs here.