You Can Ask for Mental-Health Help, but Can You Find Any? – The Chronicle of Higher Education

In a recent town hall, President Biden talked about the mental-health crisis we are experiencing in the wake of the pandemic: If you have a broken spirit, its no different than a broken arm. You shouldnt be ashamed of it. You should seek the help. Theres a lot of people who can help.

But are there?

At this point, I feel pretty confident in saying that everyone in higher education is aware of the mental-health toll the pandemic has taken. Ive written about it (The Staff Are Not OK), others have written about it, studied it, and covered it we are all aware. And while awareness and destigmatization are important when it comes to dealing with mental-issue concerns, weve reached a pivot point where we need to ask, Whats next?

Self-care means seeking help. Just reach out, we are told. But what if so many people are seeking help for mental-health problems that there is no one or nothing available to reach out to?

I have been pretty open about my past mental-health struggles. And I was doing fine during our extended Covid crisis until I wasnt. Last summer, what was supposed to be a week of vacation turned into five days of uncontrollable crying. I wasnt in crisis, but I knew I wasnt doing so well. I messaged my doctor (out of town on what I am sure was a much-needed vacation) and tried to get in to see my therapist (no immediate appointments were available unless it was a crisis).

When it comes to physical health, we often talk about preventative medicine to catch a condition before it becomes a crisis that leads to serious illness and hospitalization. Our insurance (if we are fortunate to have it) usually covers annual check-ups and routine tests. There are tiers of care: When I break my arm, I go to urgent care, but if I am having a heart attack, I go to the emergency room.

While its important to have a system in place for emergencies, its problematic when thats the only form of care readily available. Too often now, the only way to get mental-health treatment is to be in crisis. Everyone else gets put on a waiting list that may take a month, four months, or more. And even for those in crisis, the road to getting the help you need is anything but simple.

More than a decade ago, I did have a mental-health crisis. When things got really bad, I called the number for mental-health services, listed on the back of my insurance card. A recording answered and immediately informed me that if I was having a psychiatric emergency, I should hang up immediately and call 911.

I wasnt thinking about hurting myself or anyone else, so calling 911 didnt seem like the solution. But I also wondered: What would happen if I did? Would I be involuntarily committed? Restrained? Would they send the police and not an ambulance? At the time I had a 1-year-old daughter. What would happen to her if I called 911? What would happen with my job?

I stayed on the phone listening to the voice describing other options, and selected the one I thought might fit my situation. Waiting on hold, I began to practice my story. How do I sound bad enough that they understand I need help but not so bad that they send the cops? I must have told and retold the narrative three or four times to various people on the phone while they tried to get me appointments with doctors and therapists, all while making sure that I was OK and my daughter was OK and that we would continue to be OK until these appointments happened.

I had to bring my 1-year-old to the appointments because I was an adjunct and my husband was a graduate student. We couldnt afford child care, so wed arranged our schedules so that, when one of us was working, the other was off. I was repeatedly asked if I could find anyone to look after my daughter during the counseling sessions (she wouldnt have been there if I could), which only made me feel worse as a parent and a person. Once the medication started working, I stopped going to therapy. (I repeated the same pattern a few years later restarting therapy and then dropping it once I got the medication right.)

Im talking about all of this here because its important to understand what reaching out actually feels like and means in practice to someone in crisis. You are navigating systems and bureaucracies when you are the least capable of doing so, weighing the cost and benefits, deciding just how much to disclose. That is what all of us academics, staff members, students face in making the decision to seek help. Keep in mind that my crisis happened in the best of circumstances: I was fully insured and had relatively secure employment, and we werent in the middle of a pandemic.

Today, the fallout from Covid has placed our mental-health system (such as it is) under even more strain than before. People are reaching out in record numbers, and there simply arent enough trained professionals available to meet the need. We always knew that higher educations mental-health and counseling services were insufficient, but now they have reached a systemic breaking point.

In short, unless you are in crisis, there isnt much hope of seeing a therapist when you need to, let alone trying to find an expert who is attuned to your particular needs. Where you live heavily dictates the services and therapists you have access to, especially for people of color, for those who are LGBTQ, for those whose second language is English, and for people who arent religious. Telemedicine is helping, but the onus is on the person who may or may not be in some sort of crisis to start cold-calling therapists who may or may not take their insurance and may or may not even be taking new patients.

This past summer, when I felt myself struggling, I went looking for a therapist. I called office after office to inquire if they were taking new patients, but all of my messages went unreturned. At some point, I remembered that my employer provided a health-care advocacy service for all employees. I reached out to that service, outlining my issues and what I was looking for in a therapist. I was told that they would start looking immediately, but I should expect to wait at least 10 days to get a response not an appointment, mind you, just a call back with the name of a possible therapist.

Ten days. If it takes professionals who know the terrain and are doing this as their job 10 days to find a therapist for me, think of how much more difficult it is for people searching for help on their own.

The acute shortage of mental-health professionals is not the fault of our colleges and universities, but their reliance on a broken system to cope with the mental-health needs of their employees and students is. We help people in crisis but do little to prevent it from reaching that point. We have flooded the mental-health emergency rooms and urgent-care services, and there is little left for those of us who are teetering on the edge, trying to prevent a fall.

Administrators: Before you tell people on your campus that all they need to do is reach out, be cognizant of what help is actually available when they do. Unless leaders start talking about routine mental-health care, we will never get past the crisis phase.

I am not a mental-health expert, but here is the advice I would offer in this period of heavy demand for services and low supply:

President Biden was right when he said, if you have a broken spirit, its no different than a broken arm. We need to make sure that getting aid for our broken spirits is as straightforward a process as getting an X-ray and a cast for a broken arm.

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You Can Ask for Mental-Health Help, but Can You Find Any? - The Chronicle of Higher Education