Our mental healthcare system is at a breaking point…
Our mental healthcare system (and really all of healthcare) is at a breaking point. Demand is at an all-time high, with more and more providers on the brink of burnout. For providers still in the game, their caseloads and waitlists are overflowing, and the demand just keeps growing.
Therapy seekers are lucky to even get a call back, let alone find a provider that actually is a good fit. And if you’re a minority actually hoping to find a therapist with shared identities and values, you might FINALLY find someone, only to learn that: they have an extensively long waitlist, they’re not licensed in your state, they don’t accept your insurance, and/or you can’t afford their rate.
To no fault of the providers, many have either moved to private pay or coaching to: actually be able to pay the bills, mitigate burnout, avoid dealing with the hoops that insurance companies make us jump through, avoid pathologizing diagnostic frameworks, decrease caseloads so that they can actually be humans outside of work, and the list goes on and on.
While providers BEYOND DESERVE to get paid not only a living wage but to actually live comfortably, this mass exodus of providers to private pay, coaching, or leaving the field all together results in decreased access for those most in need. While some care providers might have sliding scale spots or reparations-based pricing models, this doesn’t fill the hole of extensive demand.
Hospitals, tech companies, and other healthcare systems are finding ways to monetize and profit from this extensive demand. While I do think some of them genuinely believe they are providing an innovative solution, they typically zero in on one component that they want to address, while failing to see things from a birdseye view, OR they fail to recognize how their solutions are perpetuating the exploitative systems that are already in place.
We are in this no-win situation because of colonial and capitalist systems that exploit providers and care-seekers alike. Profit takes precedence over humanity and wellness.
Every theory or approach to the work has started to feel hollow because what does it matter if the systems are never changing and keep inflicting harm? I think that many providers know the issues up close and intimately or are fluent in discussing the colonial and capitalist systems behind it all. I know many providers who think that they can create change by making their own little bubble in the world. While I truly believe that is important, meaningful, and a component of the change we need, we can’t either transform or create new systems in isolation. We need a collective movement.
And if we keep working in isolation, looking at things with a magnifying glass, or just continuing to name the problematic systems without actually doing something to enact change, the systems are still going to keep doing what they’re designed to do. They’re going to continue exploit providers and clients until there’s nothing left.
I’m tired. I’m tired of the constant moral injury of functioning within a futile, exploitative system just to be able to pay the bills and hope that I’m helping someone in some capacity. And I know I’m not alone.
I by no means am suggesting that I have all the answers—because I don’t. What I do know though is that we NEED to start cycle-breaking and get creative. Whether you’re of the opinion that we need to reform these systems from within or burn them all down, we need to do something differently.
Because the way I see it is that it’s all going to come crashing down either way.
We talk about being cycle-breakers in our relationships and lineages, but what about in the field? For any cycle-breaker, there is an infinite amount of unknowns, and I think that can often scare us away from enacting said change. But I hope that we can start to view those unknowns like a playground.
