As the shortages of mental health services and professionals continue to be addressed, if you or a loved one is struggling with a concerning mental health need, the first course of action is to seek help.
According to Kylie McColligan Oleski, licensed clinical psychologist at Geisinger, because of the increased stress on mental health caused by COVID-19, “it is especially prudent for individuals to proactively seek out behavioral health supports. Although a psychiatry shortage exists in this area, there are several other avenues outside of psychiatry that individuals can pursue to address their mental health concerns.”
When Adriana Richard’s father passed away a little over a year ago, she sought therapy to help her through the grief. The 18-year-old Milton resident said she couldn’t secure an appointment until more than two months later. A few months after that, after being admitted to the emergency room, her medical team at Geisinger decided to schedule her for weekly therapy sessions.
“Geisinger normally doesn’t do this because of how full they are,” Richard explained. But she was grateful for the help she received and continues to receive. Even though the pandemic has made it that much more difficult to get an appointment.
“There are some times when I am without therapy for a week or two,” she said. “I have major depressive disorder and PTSD, so this is a big deal for me, as it is some of the only time I can talk to people who help.”
Also because of the pandemic, she has to “visit” with her doctor, when she is available, via telehealth appointments. At times she must be placed on the cancellation list, even though her doctor works to schedule her appointments a month in advance.
“This is definitely a struggle considering the current state of the world, as well as grief, depression, anxiety and PTSD,” Richard said. “It is incredibly hard to go weeks without an appointment because I look forward to those times to get the help I need.”
Elisabeth Kunkel, chief medical officer at the Pennsylvania Psychiatric Institute and a professor in the Penn State College of Medicine’s Department of Psychiatry and Behavioral Health, says that if there is a wait list when you call for a psychiatry appointment, get your name on it. While some people have reported longer waits, she said the typical wait is usually one to two months, depending on the location. She encourages individuals to be proactive and make multiple calls to various mental health facilities. By calling, you may also receive help via a referral to a non-medical provider to address if you are dealing with mild anxiety or depression. If you are dealing with more serious and urgent issues, such as hearing voices or manic symptoms, you will likely be referred to the emergency room.
Kunkel said one of the problems that has occurred during the COVID crisis is that many people are delaying care and showing up in the emergency room with acute problems. From there, they are typically referred to a psychiatric hospital, “and there’s a limited number of psychiatric inpatient beds,” she said.
Michaels said a good first step is to reach out to a counselor, or therapist. Even though they can’t prescribe medication, they have the ability to refer someone to a doctor. Besides that, she said, “A lot of people don’t need medication. A lot of people, all they need is therapy, all they need is counseling.”
Don’t confine yourself to a psychiatrist if you can find the help you need elsewhere — even simply by speaking to your minister, she said, adding also that, "a lot of time psychologists do better therapy than a psychiatrist.”
Michaels said other alternatives might also include entering a study, which might get you an appointment much quicker.
Oleski said ongoing, consistent self-care is certainly helpful to one’s mental health, but when that doesn’t seem sufficient, “it is helpful to explore more targeted coping mechanisms, many of which can be taught via self-help resources and with the support of a professional…”
But even as they try those things, she said it’s also a good idea to be proactive by researching behavioral health providers in the area “should they decide to obtain professional support.” Websites like psychologytoday.com offer search engines for providers by geographic region and specialty. Individuals can also contact their insurance company to obtain a list of providers who accept their insurance.
“Ultimately, either a psychologist, counselor or social worker are all very well equipped to provide therapy services,” Oleski said. “It’s all a matter of personal preference and finding the best fit for you. However, if medication management services are a main goal of treatment, an individual would be best served by a psychiatrist, or a psychiatric nurse practitioner, or a physician’s assistant who specializes in mental health.”
Considering the psychiatry services shortage, however, Oleski said individuals can also talk with their primary care provider or family doctor who can provide a referral or even discuss “psychotropic medication management options”.
Though scheduled meetings with her therapist have often been interrupted, Richard has found some other methods for getting help.
“I currently have an emotional support animal that helps with a lot of this, and has been a great source during the pandemic,” she said, adding that she will be bringing the animal with her to college. Though she has not been able to get an appointment with the psychiatry department at Geisinger, she is currently seeing a psychiatrist at her university, and has been able to work with her primary doctor for adjustments to her medication when needed.