There was sort of a guilt. I thought, ‘Wow, I got sick and now I’m not able to provide therapy or services like I otherwise would,’ which made it challenging to rest and take it easy and take care of myself.
“There was guilt,” he said. “I thought, ‘Wow, I got sick and now I’m not able to provide therapy or services like I otherwise would,’ which made it challenging to … take care of myself.”
Guilt was a common theme this past year, especially among therapists who turned prospective clients away. Cubbage said as a therapist of color, she recognizes her services are in high demand.
According to the United States Census Bureau, only 4% of psychologists in the U.S. workforce are Black.
Experts say burnout occurs when stress is prolonged, and there is no time to recover. Mental health professionals are especially susceptible, and the pandemic has made them more vulnerable.
That feeling you can’t name?: It’s called emotional exhaustion
Tia Dole, a clinical psychologist in private practice and chief clinical operations officer at the Trevor Project, which works to prevent suicide in the LGBTQ community, said while mental health providers are used to working in an emergency state, the duration and scale of the COVID emergency has been extraordinary.
“Before, when you’d have a patient in crisis, it’s over in a couple of hours, you have a debrief, you huddle up, you go, ‘Whew,’ you go home. In this case, it is going on and on,” she said. “I became numb, and then I became overwhelmed, and then I kind of went back to numb.”
Dole, who in her private practice focuses on treating Black, Brown and queer people, said not only were many of her patients struggling with a virus that disproportionally affects people of color, but they were also traumatized by the death of George Floyd this summer and the ensuing racial unrest.
Patients are also coming to therapists with more acute symptoms. Kimberly Griffin, a substance use disorder counselor at Lionrock Recovery, an online drug and alcohol addiction rehab program, who also has a private practice, said she’s seen an increase in substance use disorders as well as domestic violence.
“For the first time I believe in my life, I’ve experienced … symptoms of burnout,” she said. “The stress comes from trying to figure out how to help people who are experiencing something new at the same time that I’m experiencing something new.”
The pandemic has been a traumatic experience for many people, she said. Before the coronavirus she had a couple of clients coping with trauma, now she says she’s seeing trauma on “a mass scale.”
“I think this past year was the most challenging in my career because it magnified how many people were really suffering mentally and emotionally,” she said. “As a therapist, I wish I could help everyone, but that thought becomes overwhelming and, of course, it’s not realistic.”
Not all mental health professionals are providing care exclusively through telehealth. Some are working in hospital settings and continue to face health risks.
Dole, who works in New York City – once the epicenter of the COVID crisis – said when a patient having a psychotic episode comes into an emergency room, they are not likely to follow COVID precautions.
“You have someone who’s in a psychiatric crisis who is not thinking, who is not in their right self, who is not going to wear a mask, who is going to get too close,” she said. “I know personally so many people who ended up getting sick because of that.”
These professionals go to work each day not knowing whether they will be exposed to the virus, or whether they’ll expose a loved one. Those who work in hospital settings also end up providing support to their medical colleagues who lose patients to COVID.
“Not only are you treating patients, you’re also helping out your coworkers,” Dole said. “They’re trying to be strong, be present for their peers in the workplace environment. … Everyone is just really broken down. You’re watching people die who are 30 years old and it just doesn’t make any sense.”
The pandemic has been raging for nearly a year and has not abated. Experts say the negative mental health impacts will outlast the current crises. Research suggests the extreme and prolonged stress of the pandemic may lead to longer-term psychiatric disorders.
Many therapists said they are learning – or re-learning – the importance of self-care during a crisis they know will not end for their profession with widespread vaccinations.
“Even though we are therapists and mental health professionals and we have training and understanding of things above what the average person does, it doesn’t mean that we aren’t susceptible to dealing with our own mental health challenges,” Cubbage said. “As much as we show other people grace, we ask that people please extend that grace to us.”
Mental health professionals say they need organizational support to help ward off burnout. That could look like granting a clinician their day-off request, or respecting when they say they can’t take on another case. They also need better pay, Dole said, so more people can enter the field, stay in the field, and serve a greater share of the population.
In the immediate future, therapists also need to be able to continue to see patients remotely, Dole said, and they need insurance to continue to pay for it. Some insurance companies have already made moves to scale back coverage of telehealth services.
Despite the myriad challenges, mental health professionals say people who are suffering should always seek help.
“We’re challenged, we’re stretched thin, we’re finding higher acuity in stress levels in our patients but it’s what we’re here for,” Benko said. “People should still reach out.”
If you don’t have access to the care you want right now, there is still help available:
You can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night, or chat online.
The Crisis Text Line provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.
The National Alliance on Mental Illness has support groups for people living with mental illness.
12:02 pm UTC Feb. 11, 2021
2:13 pm UTC Feb. 11, 2021