Psychologists say they can't meet the growing demand for mental health care
npr.org
npr.org
Lack psychologists is not the cause of an increase in mental health problems any more than lack of doctors are the cause for an increase in broken bones.
Focusing on training more of them is to focus on the easy to medicate symptoms rather than the complex and varied root causes.
And given how many older adults have untreated mental health issues and just lived with them the work won't be wasted on a fly-by-night increase.
My point was that the discussion is often framed such that lack of psychologists is causing a mental health crisis. Their shortage may be making it worse since people cannot be treater after they have issues, but it isn't causing the issue in the first place.
I tend to think you would - though it'd probably come in the form of a definition change of just what a broken bone is.
Another problem is the insistence from insurers on only the most “evidence-based” treatment modalities. Everyone taking insurance has to play a dance with them to somehow shoehorn in the use of these or else get denied payment for months. As a result diagnoses and treatment methods that get put into the system are only those approved by the insurer - resulting in a dance that leaves a ton of actually useful individual treatments from being recognized. If it doesn’t bill, it can’t be mentioned, even if it’s working. This can also lead to pretty bad outcomes for clients.
The medical model of treatment is preferred by insurance because it’s the cheapest and quickest to tamp down symptoms but rarely gets to the root cause, especially in the most traumatized populations. Take a homeless person and put them in treatment - they’re probably neurodivergent, traumatized, high ACE score. Making surface symptoms like substance use go into remission doesn’t treat the underlying cause of the substance use.
Lastly, psychologists and therapists can’t make up for the lack of integrated community, sense of belonging and social purpose, and relational support networks that are failing all across society. We are an individualistic society that downplays the value of relational ties, which is part of the reason there is such a need for individual therapy in the first place. Relational trauma, lack of community resources, lack of time to spend with others, lack of social cohesion overall all contribute to a mental health crisis that is intricately tied with the excesses and stunted values of our socioeconomic system. It is an intentional feature, not a bug that people are suffering with little to no recourse.
More money will help, more education and spreading of concepts and ideas will help, but as a society there is a massive amount of work to undertake to slow the engine that produces the social pollution that ends with mass depression, anxiety and worse. It is long overdue.
As much as she cared about the kids she worked with, private practice has been much better for her own mental health and allowed her to have a decent income. And even then, it seems extremely emotionally taxing to provide 4-6 hours of effective therapy per day.
And it seems like this would be exacerbated by there being fewer doctors to pick up the slack.
Along the same lines, I wonder if the reliance on psychologists is a symptom or our increasing isolation. Whereas in the past, people would have gone to a priest, rabbi, older relative, family friend, they now go to a psychologist.
It's meant to help with processing and coming to peace with past events.
https://chat.openai.com/g/g-i283Q1fZr-bringing-peace-to-trou...
I wonder if AI will eventually fill this gap?
If you go to a counsellor and say "I'm feeling upset because my wife is yelling at me for cheating on her but I really want to keep cheating on her", an average counsellor can't say "well stop cheating on her, you numbskull" even if they know that's the best answer. Professional ethics dictates that they be neutral. So all they can really do is sit there and ask you questions about your feelings.
The things that increase people's mental well-being are well researched and often obvious: lose weight, find a church, get a girlfriend, make more money, call your mom, join the Army. Things that a professional counsellor could never tell you to do!
Not to say therapy is not a good idea for lots of people! But the modern need for therapy is not coming from some place of deep and widespread trauma. If anything, the opposite - we all live very comfortable lives full of emotional bed rest and mental junk food.
If I am going to a third party to adjust my behavior, I don’t want someone who is just going to validate my feelings. I want actionable advice.
> If I am going to a third party to adjust my behavior, I don’t want someone who is just going to validate my feelings. I want actionable advice.
I'm with you, but if you polled the average person looking for a therapist we are almost certainly in the minority.
It's definitely potentially problematic. So psychologists have in some way developed an idea that their role is to facillitate people's mental well-being within whichever lifestyle they lead.
This can be very effective for some things. For instance CBT can help you rewire your brain to work more the way you want. If you come to a counselor and say "I have anxiety with public speaking and want to get rid of it" then they have some tools that can help.
But on more fundamental issues like "I live in a sick society", these tools can help you get through your day, maybe, but the actual remedy is more fundamental.
This is why people need serious Liberal Arts and Humanities, but we as a society scoff at that more and more. Wonder if that has anything to do with our abject misery, hmmm.
I imagine that's not what they would say unless the patient were already of a religious bent. The mental health benefits of going to church are unrelated to the religion itself, but are related to having a supportive community and regular socialization. There are many other ways of getting those benefits.
A good therapist would recommend whatever method the patient would be most likely to adhere to.
If the simple answer worked, if it wasn’t more complex than you make it, then there would be no field of psychology in the first place. Lack of solution oriented advice is not a problem that anyone has.
The rehab is actually a good example. If someone has an alcohol problem there are a hundred different really intrusive interventions you are going to have to do completely outside of what a therapist alone is going to be able to accomplish.
Hilarious to imagine a ton of highly-trained psychologists complaining together about how the data shows that all they really need to do is tell people to go to church and join the Army, but they can't because of the rules of their professional associations.
https://academic.oup.com/ije/article/49/6/2030/5892419 https://news.gallup.com/opinion/polling-matters/389510/relig...
On both the basis of mental and physical health, the correlation with church attendance is one of the most robust and well studied. To my knowledge, none of the studied gauged the amount attendees believed or had meaning, but I'm sure it didn't hurt.
If I told you that Mormons or Scientologists were the happiest people on average, would you consider joining them?
I certainly question their sources of information since they did write "church" instead.
Perhaps it varies by culture/country? Because it's really way off experiences I know about (personal, friends, etc.).
When my wife was assigned a therapist after having a miscarriage, she got a young person who never had any kids. She almost got nothing out of the experience and it's hard to imagine what she could have.
The councillor can't just point out to the client to recognise how low they have fallen in their life because a percentage of them might find this realisation overwhelming and just decide to end it.
So, instead they tell the client that they are a victim of circumstance thereby resolving the client of their part in their own suffering.
The predicament is that by doing this a certain amount will die from overdose or other factors related to their addiction anyway.
While I am sure this is partially true I understand why this approach is taken. People have a tendency to push against criticism even if it is correct. Also there seems to be a bias whereby someone is more likely to go along with their own ideas than the suggestions of others. I guess this is due to the deep desire for agency that we all have as individuals.
There is a difference between telling someone something directly versus pointing them in a direction to make their own conclusion.
https://www.psychiatry.org/psychiatrists/advocacy/federal-af...
1 - I am passionate about philosophy and human psychology. I have yet found a psychologist with whom I can talk to about the various topics I am interested in. The younger ones are just shells of knowledge in the fields to the point where I am shocked they got degrees. I had a great relationship with an older therapist but unfortunately she retired.
2 - A relative is a certified psychotherapist. The amount of misinformation she subscribes to only reinforces my views that most are not to be trusted. Zero interest in debunking failed classical 'experiments'. Judgemental character, prescription instead of understanding etc.
3 - I've seen psychologists ruin a close to me person's life by validating all their strange fantasies.
With these data points, I no longer trust this profession and would rather appeal to a priest if I ever feel the need to feel myself heard.
This is everything that is wrong with this institution in a nutshell.
If one is--literally--mentally unwell (ill), their perspective is flawed by definition.
The industry has found that humoring flawed perspectives drives repeat business, like me selling a drowning man a glass of water. You can't say I'm not helping him, but I am deliberately not giving him the help he needs.
Consider further a world in which there are many minds for whom sensitivity to being wrong is such a high priority, as you seem to want it to be, that they may try and avoid formulating stances or taking positions at all. Lest they be wrong.
Sometimes it can be helpful to have someone explain to you how you have to have some confidence in your own capacity for intuition, your own ability make decisions, in order to make anything happen.
I certainly won't argue that there are probably a lot of ineffective practitioners out there, but to me that speaks to the difficulty of the task, of tuning between insecurity and confidence and arrogance. It doesn't suggest to me the task, or the institution that is still in its earliest years of trying to formally study it, is fundamentally flawed.
We all live in that world. These hypothetical individuals sound like people in desperate need of direction, not self-reflection. People don't go to therapists because everything's great and they're thinking clearly; therapists have a naturally-exploitable customer base.
Left to their own devices, these wayward souls tend to end up radicalized in some way. Your suggested approach sounds an awful lot like the outcome of grooming-- "I didn't tell you to do that. You wanted to do it." Make anyone spend enough time miring in their own confused thoughts and they'll start to normalize and rationalize whatever it is. No wonder we have so many gender-confused kids running around; they're exposed to the topic constantly. If that's what therapy amounts to, we can call off the labor shortage, because any accomplished child molester has the qualifications to do this job...I'm sure they need the work.
For some reason, doctors have little problem proscribing direct advice to ailing patients-- "you're dying because you won't stop eating cheesecake and smoking meth." Why are therapists so resistant to telling clients they're unlikable assholes and they need to fix their shit? Why the "need" for florid introspection that distracts from obvious problems, unless it's an intelligence-gathering exercise, looking for something else to blame or ideate? No other professional service works like this except fortune-tellers and the church (through confessionals) and their track record is about as effective. My mechanic doesn't wax poetic about thermodynamics, ask about the journeys I've been on with the vehicle and blame the engineers when my car doesn't start.
> It doesn't suggest to me the task, or the institution that is still in its earliest years of trying to formally study it, is fundamentally flawed.
My point remains: perceptions are subjective, are easily manipulated, and are frequently wrong. Eyewitness testimony is incorrect 50-fucking-percent of the time. This institution has already had scandals involving "discovery" of false memories and other manipulations of both its own personnel and the public. I've even had one insist I was molested despite no such attestations on my part (and it not being true). Psychiatrists have vouched for the perceived rehabilitation of rapists and murderers up for parole, who then immediately proceeded to rape and kill again within hours of release.
There are other peculiarities too, like insistence that hypersexuality is exclusively an artifact of abuse (and not at all precocious/excessive access to pornography), while sex addiction is not recognized at all in the DSM-V-- yet they'll offer to treat you for something they say doesn't exist. They like to tout the idea of all this domestic and sexual abuse going on based on what patients report, but it's not like they conduct any actual investigation-- they'll believe anything you tell them at face value (it's how Sybil got away with it for so long).
On that note, they've managed to legitimize what we used to call demonic possession as multiple/disassociative personality disorder. Here's an open challenge: prove it. So far, the highest-profile cases they've put forth have all been frauds, and it's so easy to act out the symptoms of that there are entire subreddits and hashtags dedicated to overprivileged children LARPing it. Why it's even still in the book, I cannot fathom.
It is junk science. They have some neat ideas about behavioral classification and CBT is as useful for humans as it is for dogs, but that's about it.
The one couple I know that talked to several priests in the end, is happier than ever.
Small sample size but it makes sense to me. Priests study people and have experience bonding people. Therapists seem to have experience separating people.
For example, while I might enjoy casual sex, I get that if I followed what's best for me, I really would abstain from having sex outside of marriage. And even in marriage, sex would hold more meaning and be even more bonding if there was a chance of a child being born. If that means I'd have a lot less sex, so be it, I still think that would be best.
I could explain lgbt issues also from their angle, but that would just upset HN. What you call questionable, is just as questionable from their side towards your views.
What do you think is more questionable.. waiting til you find someone very important to you, who promises to join you for life, before you have sex... Or a sorority girl having sex with two dudes at the same time at 19 yrs old because one made her laugh a lot and his roommate is really good looking. (I was the funny one in this story 20 years ago)
I disagree. The only difference between a priest and a therapist is that one blames God and the other blames everybody except You. Both are salesmen who externalize your problems on your behalf.
The church has a unique triangulation tactic in that they can bond a couple against supernatural forces. Therapy doesn't have that. The closest they come is blaming someone's parents.
I haven't spoken to a priest in 20 years, and that's mostly because I'm afraid of just how keen they are on "this is your fault/responsibility". They wouldn't blame anything on God IMO, but if they did, they would be very clear that the reaction to the problems is 100% on you.
I'm drawing from a Catholic/Lutheran upbringing from decades ago, but the verbiage is never "this is God's fault," it is kinder euphemisms like "this is God's plan" or "God is testing us."
You're expected to endure whatever it is, not react to it. Whatever it is that you're going through was always supposed to happen, so keep marching onward, Christian soldier, out of faith that God will guide you out of this and that there will be cake at the end of the trial.
> They wouldn't blame anything on God IMO, but if they did, they would be very clear that the reaction to the problems is 100% on you.
Well, Catholics lean this way I guess, but what I remember was more shaming people for being bad adherents to the faith, not so much grandma died because you touch yourself. She was always going to die when she did because God willed it.
If you are willing to suck it up and ask a pastor/priest for help, you probably already believe that a marriage is an important/sacred thing worth preserving and are willing to accept some authority and make sacrifices.
If you click through the article to the actual study[0] the article actually references, the data is broken down into the changes in each population.
The lowest growth population is Religious communities but it also has one of the higher decreases in population, which means it was one of the ones that changed the least over the past 12 months.
However, Religious communities is closest to Rural communities and Veterans.
[0]https://www.apa.org/pubs/reports/practitioner/2023-psycholog...
From my experience a priest would go into that discussion with the goal of keeping the couple together, while the therapist would want ( a good one ) the best for them, whatever that may be. If your goal is to stay together with someone don't go to a therapist.