‘We’re exhausted’: Bay Area’s mental health shortage worsens as need explodes

For Nataly Velasquez, a counselor at a teen crisis center in Concord, just getting through the day can seem like a small miracle.

Velásquez is tasked with leading therapy groups and individual patient sessions, but too often also struggles to respond to emergencies on the inpatient mental health hospital floor. One patient may be trying to harm themselves, while another may need help calming down a manic episode.

“We witness things that you might see in a movie, things that someone might say are extreme or just unbearable to witness,” Velasquez, 34, said.

In the Bay Area, overwhelmed mental health workers are reaching breaking point. In addition to serving on the front lines of a national crisis, many are also struggling to manage the costs of living in one of the nation’s most unforgiving housing markets. After supporting an already strained care system during the pandemic, some are leaving the field altogether.

“Counselors definitely feel a lot of burnout,” Velasquez said. “We’re exhausted.”

Mental health care providers say the exodus is deepening a long-standing shortage of psychiatrists, social workers, drug counselors and other mental health and addiction professionals as the need has exploded in the wake of the pandemic COVID-19.

“This is already a pretty fragile and fragile existing workforce,” said David Mineta, executive director of Momentum for Health, a Silicon Valley nonprofit. “And when you have vacancies and you don’t have enough co-workers, that makes it very, very difficult.”

David Mineta, CEO of Momentum for Mental Health, poses for a photo at its offices in San Jose, Calif., Tuesday, April 7, 2020. (Nhat V. Meyer/Bay Area News Group)

How the region responds to the shortage could be crucial to addressing many of its most serious challenges post-pandemic, as many residents continue to struggle with the lasting effects of social isolation, financial insecurity and grief.

Studies show that children and young adults have experienced high rates of anxiety and depression. Overdose deaths have increased. And thousands of people with serious psychiatric disorders continue to languish on the streets of California.

“With the pandemic, it followed a tsunami or a behavioral health crisis, where there was just so much more need,” said Elisa Koff-Ginsborg, executive director of the Santa County Association of Mental Health Contract Agencies Clear.

Even so, the Bay Area still has more mental health workers per capita for most places than the state as a whole. And some state officials and local health worker unions question whether there really is a major shortage, although experts note that available data is incomplete and does not reflect the full impact of post-pandemic needs.

There is broad agreement, however, that county health agencies and community nonprofits like Momentum, the groups that most often treat the region’s most vulnerable patients, face the greatest struggle to recruit and retain workers.

“I hear a lot of anecdotes about people burning out, especially in what we might call safety net behavioral health,” said Janet Coffman, a health policy researcher at UC San Francisco.

A Coffman UCSF survey last year found that more than 70 percent of California county behavioral health agencies had difficulty hiring psychiatrists, clinical social workers, registered nurses and many other types of mental health workers ..

Darren Tan, deputy director of the Santa Clara County Department of Behavioral Health Services, said in an email that “his agency’s market assessment shows a small pool of potential workers and high attrition among current ones.” .

A separate 2018 Coffman report before the pandemic sent the need to grow predicted that if all types of providers can’t hire more workers in the coming years, demand for psychiatrists could be 50% higher than supply, while the deficit of psychologists. and other therapists could reach 28%.

For the nonprofit Abode, which provides housing, mental health and addiction services to the homeless in the Bay Area, the region’s staggering cost of living makes maintaining its workforce a constant challenge.

“Housing affordability, food affordability, livability affordability and the nation’s standard of pay for this work,” said Brittney Kirkland, Abode’s senior director of health and wellness, ” with high attrition rates, people are leaving the field faster than ever.”

In the Bay Area, the highest paying mental health positions, typically psychiatrists, can earn salaries above $300,000. But community health workers, who work directly with low-income families in treatment plans and make up a significant portion of the mental health workforce, can make only $55,000 to $65,000 a year, according to a new report by the ‘Silicon Valley Regional Institute. Studies, a non-profit research group.

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