10 ways to get mental health help during a therapist shortage

Long waiting lists can make it hard to find a therapist. So we asked 300 mental health providers what patients should do.

(Illustrations by Chelsea Conrad/The Washington Post)

Anxiety and depression have been on the rise in the United States since the start of the pandemic. This has led to a crisis in mental health that has been worsened by the shortage of mental health counselors.

A significant number of mental health professionals are not accepting new clients. Others have long waiting lists.

The Washington Post asked mental health professionals what advice they would give people who are struggling to find a therapist. About 300 experts from across the country responded with advice on getting an appointment — and tips on what people can do in the meantime to try to help themselves. Here are their recommendations.

Be persistent, and cast a wide net

Websites such as Psychology Today, Therapy Den and ZocDoc have directories that allow you to search for mental health professionals who specialize in particular issues such as anxiety and depression. They also show you which therapists take insurance and, most important, which ones are accepting new clients.

Once you have your list, prepare for that initial phone call or email — many therapists’ preferred method of contact — by providing detailed information about your needs and what you hope to get out of therapy. This helps them know whether they can help or whether they should refer you to someone else.

“Doing a little bit of that prep work to figure out what it is that you’d like to work on can go a long way in getting matched up with a therapist who may be a better fit than just cold-calling and saying, ‘Hey, I need a therapist,’ ” said Esther Benoit, a licensed professional counselor in Newport News, Va.

If you find a therapist who seems like a good fit but can’t see you for a while, ask to be put on a wait list and then request recommendations for other therapists who specialize in the same mental health issues. Also, keep in mind that group practices may be able to fit you in sooner than solo practitioners.

When all else fails, you may be able to ask your health insurance provider for appointment assistance. “Tell them you’re not able to find providers and have them do the work for you,” said Jenna Wolfson, a licensed clinical social worker in Santa Cruz County, Calif.

Be flexible with scheduling

Many people want appointments during lunch hours or after work or school, but if you are able to see a therapist during the workday — particularly via telehealth — you may have better luck finding a therapist sooner.

Michelle Slater, a licensed mental health counselor with a private practice in Jacksonville, Fla., said it is easier to squeeze in telehealth appointments partly because she can meet with clients from any private location. “I have been in a parked car to do sort of crisis support in the moment,” she said.

Wolfson said, however, not everyone has that flexibility during work hours. If you are experiencing a mental health crisis and cannot leave work, she suggested speaking to your human resources department about using the Family Medical Leave Act, which allows up to 12 weeks of unpaid leave for eligible employees, so you can properly address your mental health needs.

Consider an out-of-network provider

Many providers do not accept insurance but will give a superbill that clients can submit to health insurance companies for reimbursement.

If you cannot pay standard rates out of pocket, ask therapists about a sliding scale. Some therapists may reduce their rates to accommodate clients on a case-by-case basis. But Slater said it helps to have an established relationship with a therapist before asking them to do it. “The better I know my clients, the more willing I am to work with them,” she said.

See a therapist in training

Jonathan Schettino, a licensed psychologist with a private practice in Baltimore, said people often balk at seeing a trainee, but there are a number of advantages — the main one being that you will have two sets of eyes on your case rather than one.

Trainees may be students who have not yet completed their degrees, but more often they are pre-licensed graduates who are earning their hours under the supervision of a licensed mental health professional. “If the training program is high quality, the person that you’re working with may be supervised by someone who is a nationally recognized expert in the field,” Schettino said.

Where do you find one? Colleges and universities with counseling programs will sometimes have training clinics where trainees can work at lower rates to gain experience. Others work in community health-care centers that serve lower-income clients. And some can be found in private practices and are often listed as interns or residents, Schettino said.

Coaches — such as a health and wellness coach — may be another option when you cannot find a therapist.

“Coaches can be a nice way to move forward with an issue while waiting to take the time to explore the underlying issues that are contributing and/or causing problems,” said Lakeasha Sullivan, a clinical psychologist with a private practice in Atlanta who has written a wellness article for The Washington Post. But, she said, make sure that the coach is recommended by a nationally recognized organization.

Join a support group or therapy group

Support groups and therapy groups facilitated by mental health professionals are a great resource.

Support groups aim to help people feel normalized as they cope with similar issues such as anxiety and depression, substance abuse or grief. Therapy groups try to help people with similar diagnoses such as obsessive-compulsive disorder feel supported by one another as they work on their issues.

“I love groups,” said Slater, who leads a mindfulness group on SESH, a membership-based platform for therapist-led online support groups. “We’re all walking around feeling alone, and really we’re not. There’s something very validating about being with people who are struggling in similar ways.”

To find a reputable group, contact nationally recognized associations such as the National Alliance on Mental Illness, mental health clinics in your area, your health insurance company or your primary-care doctor for recommendations.

Support, however, does not always have to come from a structured mental health group. Religious, cultural and other social support networks can be invaluable.

“There’s a difference between getting support in the moment and then getting therapy that’s actually going to produce change,” Slater said. “What is it that you need? Are you looking for change? Are you in crisis? Are you looking for new coping skills? Do you just want to vent and be heard? Because that puts it in different categories of what your friends, family, bartender or hairdresser can do versus what you might need therapy for.”

For college students, check out university health centers

Many health centers or counseling centers at colleges and universities offer a set number of therapy sessions for students. Once that number has been met, they may refer students to outside therapists.

Take advantage of your employee assistance program

Some employers offer an employee assistance program as part of the benefits package for their workers and immediate family members. It includes a set number of free therapy sessions with a mental health professional.

Call hotlines

Perhaps the most popular hotline — 988 Suicide & Crisis Lifeline — is touted by many therapists as a free but valuable resource for people in crisis, and it is not only for those struggling with suicidal thoughts. Slater said she has encouraged her own family members to call it during difficult times and uses it as a backup for her clients when in crisis.

You can reach it by dialing 988.

The American Psychological Association also has a list of other hotlines that provide support and resources for specific issues, such as the Substance Abuse and Mental Health Services Administration.

In a life-threatening mental health crisis, however, call 911.

Try apps

Try using apps such as BetterHelp and Talkspace to engage with a licensed therapist while you wait to see one in person.

Or, if you prefer the self-help route, apps such as Insight Timer, Calm and Headspace offer things such as guided meditations aimed at reducing stress and anxiety, which some experts say can be beneficial regardless of where you are on your therapeutic journey.

Look into self-help options

Be open to some DIY mental health work, including books, apps, TED Talks and stress-reducing activities such as meditation and exercise — regardless of whether you have found a therapist.

Carmen Grant, a licensed clinical social worker in Ramona, Calif., said she recommends self-help books or workbooks, which work well for motivated people, written by mental health professionals.

“I would stay away from self-help books that aren’t written by therapists only because that’s just the person coming from their own experience, and people aren’t all the same,” she said.

The same goes for other self-help tools.

Schettino said you have to be “a little bit savvy” to make sure those books, apps and chats are based in science.

This is a challenging time for many people who are searching for therapists. But one expert urged people to try to reframe their frustrations.

“The act of going to therapy is not therapy. Therapy is applying the skills — thinking through different ways of understanding oneself between the sessions,” Sullivan said. “The real work happens between sessions, and people can engage in that real work before they consult with a professional.”

correction

An earlier version of this article incorrectly stated the name of the National Alliance on Mental Illness as the National Alliance on Mental Health. This version has been corrected.

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