The pandemic has stretched a stressed industry even thinner

By Brad Spiegel

Granite State News Collaborative

Jamie Wood did what numerous people have done in the past two-plus years since coronavirus became a daily discussion. The Francestown business owner, wife and mother tried to seek help to deal with everything coming at her at what felt like supersonic speed.

Wood had obvious anxiety about how she could keep her two sons and husband — who was susceptible to catching COVID due to a previous condition — safe when she had to work. Wood is the co-owner of nh images photography + video in Nashua, 

Eventually, that challenge got a little easier when another issue surfaced, presenting new problems. Droves of clients canceled or postponed events for fear of gathering in large groups early on in the pandemic.

“You can imagine during the pandemic how all events shut down,” Wood explained. “All of our couples were rescheduling. We were losing all that income for that year. It became very stressful. A lot of people could work from home, but we couldn't do that. We were also dealing with difficult clients. At one point, I broke down.”

As she sought counseling, Wood discovered what many already knew or would soon find out — it was not easy to find therapists in New Hampshire. Many aren’t taking on new clients or have a waiting list of more than six months. 

In need of professionals

Like Wood, many people needed help navigating the new normal of the pandemic. There were many issues — adults now teaching their children at home; kids dealing with not seeing their friends; loss of work or a place to live; or relatives and friends contracting the disease. And that’s just scratching the surface. 

In a September 2020 poll of 1,800 psychologists by the American Psychological Association, three out of every four said they had more patients with anxiety disorders than they had prior to the pandemic. Sixty percent had more depressive disorders patients and 30% had more patients than before. More than a third of the 1,800 polled were receiving more referrals.

Susan Stearns, the executive director of the National Alliance on Mental Illness in New Hampshire, or NAMI-NH, said all health care professions are experiencing shortages. However, the lack of mental health professionals — in New Hampshire and around the country — not only predates the pandemic but has been exacerbated by it. 

She attributes the shortages to several factors. In general, there aren’t enough people entering the profession. She also cited issues with reimbursement from insurance providers and the stress from COVID.

“The stressors that have caused people to seek care are the same ones causing people to leave the field,” she said. 

Seeking alternatives for help

Knowing about the shortage in and around Francestown, which is about 20 miles west of Manchester, Wood opted for Talk Space, an online portal where you can pick your therapist and a plan that works best.

While this worked to a point, the plan that fit Wood allowed her only 10 minutes of video time (in addition to unlimited support via text) per month. When she decided she wanted more time to talk and see her therapist in person — she had picked one nearby — she wasn’t accepting new patients.

“It’s extremely difficult (having to wait to meet with a therapist),” Wood added. “I feel my circumstance is on the lower end of the scale than what other people are dealing with, but I still needed help and support. It is frustrating and sad for everybody. The lack of staff everywhere is so discouraging.”

Stearns said, for some people, telehealth options can be lifesaving — even if they are just a bridge while waiting for a local opening. 

“Pre-COVID, I was more hesitant,” about telehealth, she said, adding that the shift to remote offerings during the pandemic showed that it can work. “Telehealth is an important tool.” 

Wendy Marie Prescott, who has had her practice in Keene for seven years, has seen an uptick in clients. She said she used to get about two to four referrals per week. Now she sees that same number every day.

“COVID certainly has exacerbated everything (in our profession),” Prescott said. “I think the spike in anxiety and depression and other mental health conditions that were dormant before were sent over the edge and put into crisis mode when COVID hit.”

Lynne Walker, a relatively new therapist who just finished her school work in December 2021, works for Bodhi Counseling Services in Lebanon. She admitted she has nothing to compare to the number of calls she is getting but knows it is a lot.

“At least three to five people are contacting me every day,” said Walker, who previously was a neuro-muscular therapist for 20 years. “It’s been that way going forward from the day I started. I heard someone say at my internship that some places were taking 100 calls a day. 

“I am on a listserv for area clinicians, and we are all asking if anyone has openings. We are all trying to find help for people.”

Walker shared that she had difficulty finding someone to help her with pandemic-related issues. After a recommendation from a co-worker, she secured one after more than a year of looking.

While the wait can be long, Stearns stressed that those who need appointments should still be able to get one, eventually. She also pointed to support groups — there’s a list available on naminh.org — which can also be helpful while waiting for an appointment.

She referred people in crisis to the New Hampshire Rapid Response Access Point website nh988.com and 833-710-6477 — a number people can call or text to get help. 

Problem extends to schools

While private practice therapists report feeling overwhelmed, so are New Hampshire school counselors.

Felicia Sperry, president of the New Hampshire Association of School Psychologists, said that the system was already stressed with a shortage of counselors. With new factors like learning how to be back in school after one to two years away, not being able to hang out with friends, first graders not knowing how the school day works because they didn’t have kindergarten, or even the stress of their parents losing jobs, to name a few, thrust into their lives, children need help even more than ever.

“Prior to the pandemic, we were already in a state of significant shortage for support in New Hampshire,” said Sperry. “Prior to the pandemic, we were experiencing a long waitlist for kids who needed outside services. The pandemic stressed out an already stressed system.”

Sperry said the most common system in the state is multi-tiered system support (MTSS), where they collect academic, social, emotional, and behavioral data to identify kids who might be at risk. After a meeting with parents, kids could be referred to a therapist.

“There definitely has been an increase of kids at risk,” added Sperry, the MTSS coordinator for the Oyster River School District. 

“I would say all of this year a student isn’t getting to see an outside therapist without encountering a waiting list. Some (parents) will give up if they can’t get in at first. I gave a family six different referrals, and all of them said they are not accepting new clients at this time.”

The Centers for Disease Control conducted a study in November 2020 for the six months after the pandemic hit. Visits to emergency rooms for mental health-related issues for kids ages 5-11 rose by 24% and ages 12-17 by 31% from the previous year.

Stearns says the local professionals and the state recognize the problem. Health and Human Services Commissioner Lori Shibinette has convened a group to look into the issue and explore solutions, which is in its early stages. 

–Rosemary Ford contributed to this report

In crisis? For help visit the New Hampshire Rapid Response Access Point website nh988.com, or call or text 833-710-6477.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.