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The Lack of Mental Health Care in America

Rubino Counseling Services
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The United States is facing a mental health crisis. We are facing a crisis in the number of people dealing with a mental health issues and who need psychotherapy.  We are noticing this crisis especially in children and teenagers.  Depression, Anxiety, PTSD, suicide and drug overdoses are at epidemic rates in teenagers (CDC).  Additionally, the CDC reported that the number of teenagers killed by guns increased by 30% between 2019 and 2020.  Additionally, the CDC reported that 45,000 people under the age of 19 years died as a result of a gun.  Imagine how many parents, other siblings, friends and first responders are dealing with PTSD, anxiety and depression due to these deaths.  Additionally, the CDC reported that between 2019 and 2021, the percentage of high school teens experiencing persistent feelings of hopelessness and sadness increased from 37% to 42%, continuing a decade-long trend of declining mental health among young people.  For LBGT+ teens and minority teens the rate is as high as 57%.  Currently for teenagers and children depression, anxiety, PTSD and drug overdoses are at epidemic rates and the number one cause of death for teenagers are guns and the second leading cause of death is suicide.  When we look at the nation as a whole 29% of people reported experiencing depression in 2020 which is a 10% increase since 2015 (CDC).

While we see there are many people who need psychotherapy, there are not enough therapists to meet the current need.  According to the APA, 56% of Americans or 6 out of 10 people are seeking psychotherapy.  Our country did not have enough psychotherapist prior to the pandemic, but the need has significantly increased since the pandemic.  In fact, since the pandemic started 80 percent psychotherapists reported seeing an increase of people seeking psychotherapy.  The largest increase of people seeking therapy was in children aged 13-17 years old.  There was a 46% increase in this age group (APA).  Additionally, many psychotherapist reported receiving calls from at least 15 new patients per day.  Most psychotherapist stated that they could not keep up with the demand for psychotherapy and were unable to treat many of the new patients calling their offices even using wait lists.  While the pandemic is declining, there still is a significant need for psychotherapy.  Many people are still struggling with anxiety and trauma conditions.  Additionally, now people are trying to resume their daily activities prior to the pandemic.  Many people are finding it difficult to resume their routines prior to the pandemic and many are having difficulties getting out of bed (APA).

People who live in major cities are having and had easier times finding psychotherapists because they are more available in large cities.  However, people living in rural areas were and still are having significant difficulties finding psychotherapists because of their location and the lack of psychotherapists in rural areas.  Many of these people are having to resort to telemedicine for psychotherapy.  However, the lack of the internet in rural areas is making even telemedicine difficult for some patients.

What happens to people who cannot get psychotherapy? For children and teenagers they may develop life long anxiety or depression disorders.  They may develop significant difficulties leaving their homes, they can become antisocial and they can become dependent on drugs or alcohol.  These are a few issues that may develop.  We do not know who will develop what symptoms or conditions for sure.  However, research strongly indicates that children and adolescents who do not receive psychotherapy when symptoms first occur are more likely to develop mental health disorders as adults (APA, CDC).  Adults who do not receive therapy are more likely to struggle with mental health disorders for the rest of their lives.  Also they are more likely to turn to drugs and alcohol as a way to cope and often live isolated lives (APA, CDC).

Why is this happening in the United States?  The primary reason is because we do not place a high priority on mental health.  Another reason is that we do not place a high priority on those studying to be mental health professionals.  For example, besides my Bachelor’s degree, I have a Masters degree in Clinical Psychology and my Doctorate degree in Clinical Psychology and I am certified to treat anger management, military and their families and first responders.  I also took the same neurology course as medical students and worked over 5,000 hours as an intern.  However, in order to hospitalize a patient I have to call the police and have them decide if someone is suicidal despite all of my training.  Mental health professionals are not allowed to treat patients as we feel is necessary.  Instead we need to follow a patient’s insurance guidelines.  Finally, we are not paid the same as other professionals with the amount of education and experience that we have acquired.  This is all due to a negative stereotype about mental health.  Many people feel it’s not real and people who are depressed are faking.  However, as we do more and more research we are finding a strong link between physical and mental health.  A fact we really need to pay attention to.

The statistics that I quoted above were all getting worse over time.  Also the mental health issues are increasing at a significantly fast rate.  Before we were referring to rates increasing over 10 years, now we are looking at two years.  Look at our environment in the United States.  Suicide is the second leading cause of death, we are handing out narcon because teenagers are over dosing at an alarming rate.  We have at least one mass shooting a day.  Ethnic minorities and LGBT+ adults and adolescents have to be careful where they go and what they are doing because violence against them is increasing significantly.  We are also seeing a significant increase in antisemitism.  The economy is uncertain and inflation is on the rise.  Many teenagers are afraid they won’t be able to afford a home. Many teenagers are afraid that they won’t live until 18 and they will be shot a school.

We are living in a very stressful world and it doesn’t not seem like we are going to change our society any time soon.  We still have people who believe Trump won the 2020 election and that the attack on the Capital Building was a peaceful protest.  These people choose to ignore how many police officers were killed that day and have committed suicide due to the trauma of that day.  Additionally, when they were trying to hang the Vice President, how can you call that a peaceful protest?  With all of this going on we are going to need more psychotherapists so children and teenagers do not have to wait months for the psychotherapy treatment they desperately need.  We also need to treat psychotherapists with the respect they deserve and make insurance companies pay psychotherapists a fair rate.  Otherwise, with the rate of psychotherapists retiring because they are at retirement age and placing the pressure on the remaining psychotherapists to treat everyone who needs therapy, you will have psychotherapists burning out at tremendous rates.  It seriously time for us to take a step back and re-evaluate our mental health system, our attitudes regarding mental health and how we are going to save our mental health system and the mental health of our Country.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children, teenagers, trauma victims including first responders.  For more information about his work visit his website www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3