Can we learn something from Catholics and Latter-day Saints when it comes to America’s therapist shortage?
Of all the shortages caused by the pandemic, the therapist shortage is among the most troubling
Of all the shortages caused by the pandemic, the therapist shortage is among the most troubling. The number of people seeking mental health services so exceeds available appointments that people across America are being placed on waitlists that are 10 deep.
It’s one thing to not be able to find toilet paper or hand sanitizer; it’s quite another to not be able to get help if you’re having suicidal thoughts.
As such, there’s been a lot of talk lately about how to get more people into therapy. The barriers to care include not only the effort it takes to get an appointment — some people are calling 30 to 40 offices before finding someone who can take them, The Seattle Times reported — but also cumbersome insurance requirements that have resulted in an increasing number of therapists who will only take cash for a visit that can cost $100 or more.
The problem is usually couched as a problem of too few providers. And no doubt there are sound proposals to expand services in order to reach those in acute need. But other experts have suggested that it’s equally important to have resilient people and caring communities that help reduce the need for therapy in the first place.
In their 2005 book “One Nation Under Therapy,” Christina Hoff Sommers and Dr. Sally Satel decried a fragile “helping culture,” one that is less and less about building a self-reliant society and more about relying on credentialed strangers to lead us through our personal adversities. While acknowledging that people in crisis absolutely need professional help, Sommers and Satel argued that too often therapists are treating occasional anxiety and sadness, which they say are simply part of the human condition. They warned that excessive introspection in some of these cases could actually make people feel worse.
It’s a tricky balance, of course. On the one hand, it’s vital to reduce the stigma that often exists around seeking help when it’s needed the most. Yet sometimes vital mental health services are difficult to come by when therapists are occupied treating low-risk individuals, some of whom stay in therapy for decades.
The growing demand for therapy may also be influenced by the widely reported fact that Americans have fewer friends and support systems than they did three decades ago. According to a June report by Daniel A. Cox and the Survey Center on American Life, “Signs suggest that the role of friends in American social life is experiencing a pronounced decline. The May 2021 American Perspectives Survey finds that Americans report having fewer close friendships than they once did, talking to their friends less often, and relying less on their friends for personal support.”
The pandemic has a role in this, but Cox noted that other, more lasting factors are at play, including people spending more time at work, and spending twice as much time with their children than adults of generations past, “crowding out other relationships, including friendships.”
One of the most startling numbers in this survey was the growth in the number of people who say they have no close friends. In 1990, just 3% of Americans said they had no close friends outside of their family; in 2021, more than 1 in 10 Americans — 12% — said that. Additionally, in 1990, 75% of respondents said they had a “best” friend compared to just 59% of people today. And, of course, Americans are marrying later, if at all. As Lois Collins wrote for the Deseret News, “When young adults delay marriage and starting a family, they become less likely to do either.”
Finally, the mental health crisis (as described by The New York Times) cannot be divorced from the decline in participation in organized religion. Churches and other places of worship have historically been places where people made friends and found emotional and even logistical support. In my grandmother’s last few years, she found herself increasingly alone other than family, as her husband and close friends died. But she still had a robust social life, almost all of it through the Catholic church she had attended for 50 years. It is also true that parishioners often look to clergy to help them navigate challenging issues that may not rise to the level of professional mental health counseling.
It is no surprise, then, that people who belong to a religious group have weathered the pandemic better than those who have not. Members of The Church of Jesus Christ of Latter-day Saints, for example, report strong social ties which often correlate with better mental health outcomes. Cox told Tad Walch of the Deseret News that Latter-day Saints have experienced less of a “friendship recession” than other Americans.
“In terms of their social connectedness, they’re doing way better than than your average American. This has a whole host of benefits. We know that loneliness is incredibly damaging to your emotional health, to physical health, so being rooted in these communities, having people they can rely on to weather something like a pandemic, which for many folks was socially isolating, is just an incredibly good position to be in,” Cox said.
Americans are often advised not to talk about religion or politics because the subjects are too emotional and divisive. But when we talk about mental health, or the need for more therapists, we do troubled Americans a disservice by not talking about one simple thing that could improve their mental health: joining a church. There’s no waitlist.