The Mental Health Crisis in America

Before the Pandemic America was gripped with a mental health crisis. Addiction, suicide, violent crimes were on the rise. Mental health was hard to access and almost inexistent in some places. Depression and anxiety were the most reported issues, with poor resources and over burdened and poorly paid mental health workers expected to be magicians with no wand and no trust. 

The situation became alarming as the Pandemic wore on and we are now at a crossroads of addiction, severe mental health and isolation that is leading to urban decay, chaos and fear. There are no resources still, the moneys always promised fall in the pockets of ex-politicians, their buddies and relatives and by the time any resources trickle down to those in need, it is neither sufficient nor effective. Yet the facile ways in which leaders and those politicians (some dare call themselves “activists”) speak of the "need for more mental health" makes it seem as if they have the will and the way, but a shadowy figure is stopping them from showering communities with those much needed resources. It's a farce, a joke and it gives mental health workers a reputation of not working hard or well enough. We are in general, poorly paid, overworked and well-meaning professionals, being pushed around by corrupt institutions who pocket the grants and provide little above minimum wage for highly qualified and often dangerous work. The lack of oversight, the cronyism, the outright corruption seen in many community non profits needs to be addressed, before any change ever takes place. Of course corruption is an equal opportunity vice. The well connected and well spoken, the snake oil peddlers get wealthier and everyone else becomes more desperate. 

No, there will not be any change coming to this country in the mental health landscape. There will be a few more thousand people who will be wealthier, have better homes and bigger cars, who can eat in fine restaurants, and get well trained but unconnected chumps to write their proposals and account or not, for their expenses. 

After all, there are some philanthropists out there who are handing out the billions they got through divorces or deaths, and who think that just handing out money is sufficient. No accountability, just graft. And the poor and the addicted and the mentally ill never reap the benefit of their "generosity". 

the mistakes of a rookie

 I started my own practice as a psychotherapist after dreaming of it for years. COVID19 changed my plans and after saving enough to keep me through a dry spell, ensuring that  I would not have to stay in NYC and not renew my lease, and all matters of other small details, I handed in my resignation. Due to vaccines and the need for me to work another month, I stretched my work yet another month and then, my nice insurance, my colleagues, and superb ones they still are, the support team that ensured that all I had to do was show up, my great office, all of that, puff! gone!
I was/am on my own, now for more or less 9 months, the time it takes to gestate a baby. It was slow going, a few hits and misses, and slowly I started to accumulate clients. My agenda was filling up, sometimes more, sometimes less. 

I confess to having little business acumen, to being too insecure and too fearful. I realized soon, that every person I spoke to, I would have to be doing an interview AND presenting my resume. Supposedly under 15 minutes. Ahahah! Many people I am sure got what they needed from my 45 minute session and decided, hey, she provided me with the tools I need to get going. Those were the ones that maybe did not need therapy after all. Not everyone does! People can have a supportive family, circle of friends and community and feel open enough about their issues that the need for therapy is covered. 

So on to the other blunders...

Giving clients 70+ minutes when their insurance is practically threatening anyone who puts down the code for 53 minutes that we will get audited. Good enough. But time management is also good practice. 

These were the easy ones. The hard ones have been, being ok with last minute cancelling, like, sorry I know you sent me a Zoom link but I have a....and my reply always being, "ok life!"

I don't think I'll ever charge anyone for not cancelling within 24 hours but having regular notice is a must that I have to communicate initially. It was so bad that in the last 2 weeks of December, my first and last 2 weeks of working in the last 2 weeks of December, I scheduled and rescheduled and descheduled most of my clients. That's not acceptable, not when people know that they will be having vacations. This might have been partially my fault! I might have shown anxiety and reluctance. I'll never know. My agenda, I need to use a paper agenda, was so crisscrossed that as the new yaer started I totally forgot a fairly new, but really reliable client and that is, to me unacceptable. 

New rules:

Scheduling on Zoom at the beginning of the week. Be parcimonious with people who are always trying to change the agenda, be compassionate with the ones who are always there. 

The age gap is real. I got a slew of youngsters from fancy universities and proceeded to lose them because, I could not understand their issues, I don't think most of them needed therapy, more than a few times at least, and my training was different. This issue will be covered in a new blog issue that no one will read. 

Always be empathic and compassionate, but know that for lots of people it's a business transaction, and their attachment to you is fickle and it's a generational thing. Be ok with it.