Therapy Prescribed for Mental Health System

New programs aim to reverse worker shortage

Curious about people and desiring to help them eliminate barriers to living successfully, Susan Berck left a corporate career in 2001 and enrolled in a five-year program to become a psychologist.

Two decades later, she believes her profession is in need of therapy. Berck, who is based in Newburgh and has many patients from Beacon, is among the Highlands therapists who have waiting lists or are not accepting new clients.

“I get probably 10 calls a day from people who want to come in and work with me,” she said.

This year marks the third in a row that licensed therapists report heightened demand from people experiencing anxiety, depression, substance abuse and other behavioral health problems, according to the American Psychological Association.

Forty percent of psychologists responding to an annual APA survey said they were seeing more patients than before the pandemic and had a waitlist. Sixty percent said they had no openings for new patients. On average, they reported being contacted by nearly 16 people per month looking for treatment.

There was already a shortage of therapists before the pandemic but it became more pronounced because of a wave of people suffering from anxiety and/or depression triggered by COVID-19, isolation and layoffs. Some therapists have staff vacancy rates as high as 40 percent, according to the Mental Health Association in New York State.

What’s left is a mental health system that is “bursting at the seams,” said Jean-Marie Niebuhr, deputy commissioner for Dutchess County’s Department of Behavioral and Community Health. Clinics such as Family Services in Beacon are having to “almost triage” whom they accept, focusing on the highest-risk clients, she said.

Family Services, whose therapists and counselors provide individual and group counseling at clinics in Beacon and seven other municipalities in Dutchess and Ulster counties, has openings for 15 licensed therapists and medical personnel, said Leah Feldman, its CEO.

While the wait time between referral and an intake appointment is shrinking, people seeking treatment still have to wait an average of 13 days, said Feldman. The volume of services is less than in 2020, but Feldman partly attributes that to a need for more therapists. “Demand for services, coupled with staffing shortages, has been the greatest challenge,” she said.

In response to the shortage, New York State is allocating nearly $2 billion for bonuses and cost-of-living increases that are partly aimed at retaining mental health workers, whose salaries are depressed by low reimbursement rates from private insurers and Medicaid, the health program for low-income adults.

The state also established a $9 million loan repayment fund for psychiatrists and psychiatric nurses who commit to working at community clinics.

“You have to bring people into the field who are interested in becoming helpers, and you have to pay them enough to want to do that work and stay doing that work because it’s hard work,” said Niebuhr.

Family Services, whose staff also includes psychiatrists and nurses, is one of the community providers where employees have received bonuses of up to $3,000 though a state-funded initiative created to help retain health care and mental hygiene workers. New York State allocated $1.2 billion its 2023 budget for the bonuses, which are available to people earning less than $125,000 annually.

The budget also includes cost-of-living raises of 5.4 percent for human service workers and the loan repayment program for mental health professionals. Newly hired and existing psychiatrists can qualify for up to $120,000 in repayments and psychiatric nurse practitioners up to $30,000 if they remain employed at a community mental health program for three years.

“Giving some level of reimbursement makes a big difference,” said Berck. “It gives a leg up to people who need a leg up so they can do the kind of work that they want to do and make a difference in the communities in which they live.”

There are also new services in the works.

Dutchess is contributing $3 million to help create the Behavioral Health Center of Excellence in Poughkeepsie at MidHudson Regional Hospital. Part of the Westchester Medical Center Health Network, the hospital houses Dutchess’ only inpatient psychiatric program for adults. (Putnam Hospital has the only inpatient psychiatric beds in Putnam County.)

The project at MidHudson Regional will add 20 inpatient beds, for 60 total, and DBCH will hire someone who will be embedded at the center to improve services, said Niebuhr. “If an individual is an inpatient in the unit or is in the emergency room, when they come out our staff will be there to help facilitate a proper discharge and connection to community-based services,” she said.

Dutchess County continues to operate its Stabilization Center, a 24-hour facility in Poughkeepsie where people in crisis can get help, and Putnam County is spending $2.5 million to open a similar facility.

There are some other positives. Five people who were “imminently ready to kill themselves” in November relented after calling Dutchess County’s general help line and 988, which is specifically for people considering suicide, according to Niebuhr. One of the calls came from an emergency phone on one of the county’s bridges, she said.

In addition, 60 percent of psychologists told the APA that they were using therapy and support from peers to manage burnout and 63 percent said they were able to balance work and life.

Berck is nearing retirement age, but plans to keep working. “I love what I do,” she said. “It’s nice to see that the work that you do makes a difference in the world and in people’s lives.”

If you are suffering mental distress, the National Suicide Prevention Lifeline is available 24 hours a day by calling or texting 988.