For Natalie Velasquez, a counselor at a teen crisis center in Concord, Calif., just getting through the day can feel like a small miracle.
Velasquez leads therapy groups and does one-on-one sessions with patients, but is often busy responding to emergencies on the inpatient floor of a mental health hospital. One patient may be attempting self-harm, while another may need help calming down from a manic episode.
“We witness things that you see in movies, things that someone might call extreme or even unbearable to witness,” said Velasquez, 34.
Across the Bay Area, mental health workers are exhausted and reaching breaking point. In addition to working on the front lines of a national crisis, many are also struggling to make ends meet in one of the country's toughest housing markets. Some are leaving the field altogether, after supporting a care system already strained during the pandemic.
“Counselors are definitely feeling extremely burnt out,” Velazquez said. “We are exhausted.”
Mental health providers say long-standing shortages of psychiatrists, social workers, drug counselors and other mental health and addictions professionals, who have seen a surge in demand in the wake of the COVID-19 pandemic, have led to an increase in this population. He said the situation has become even more serious due to the leak.
“The existing workforce is already pretty fragile and vulnerable,” said David Mineta, CEO of Momentum for Health, a Silicon Valley mental health nonprofit. “When you have a vacancy and you don't have enough colleagues, it becomes really, really difficult.”
As many residents continue to grapple with the lasting effects of social isolation, economic insecurity, and grief, the region will need to address many of its most dire challenges post-pandemic. How we respond can be extremely important.
Research shows that children and young people have higher rates of anxiety and depression. Overdose deaths are on the rise. And thousands of people with severe mental illnesses continue to suffer on the streets across California.
“The pandemic was followed by a behavioral health tsunami, a crisis, where there was even more need,” said Elisa Koff Ginsborg, executive director of the Santa Clara County Behavioral Health Contractors Association.
Still, the Bay Area still has more mental health workers per capita in most occupations than the state as a whole. And while some state officials and local health worker unions have questioned whether there really is a significant shortage, experts say the available data is incomplete and that there will likely be more to come after the pandemic. They point out that it does not fully reflect the impact of needs.
But county health agencies and local nonprofits like Momentum, which most frequently treat the region's most vulnerable patients, face the greatest struggles in recruiting and retaining workers. Most people agree with what they are doing.
“We often hear anecdotes about people becoming burnt out, especially in what's called safety net behavioral health,” said Janet Coffman, a health policy researcher at the University of California, San Francisco.
A UCSF study by Coffman last year found that more than 70% of county behavioral health agencies in California were struggling to hire psychiatrists, clinical social workers, registered nurses and many other types of mental health workers. It turned out that
Darren Tan, deputy director of the Santa Clara County Department of Behavioral Health Services, said in an email that the agency's market assessment “indicates a small pool of potential workers and high burnout among current workers.” said.
Another 2018 report by Coffman found that if health care providers of all types are unable to hire more workers in the coming years, demand for psychiatrists will outpace supply before the pandemic causes demand to surge. The number could rise by 50%, while psychiatrists predicted there could be a shortage. The percentage of psychologists and other therapists he can reach 28%.
For Abode, a nonprofit that provides housing, mental health and addiction services to homeless people across the Bay Area, retaining a workforce is a constant challenge due to the region's staggering cost of living.
“Housing affordability, food affordability, livability, and the country's wage levels for this job all contribute to high rates of burnout,” said Brittney Kirkland, Abode's senior director of health and wellness. It demoralizes people.” From the field faster than ever before. ”
In the Bay Area, the highest-paying mental health jobs, typically psychiatrists, can earn salaries in excess of $300,000. But a new report from Silicon magazine finds that community health workers and health education professionals who work directly with low-income families and make up the majority of the mental health workforce earn annual salaries of just $55,000 to 6. It is said to cost about $5,000. Valley Regional Research Institute, Nonprofit Research Group.
The report includes a survey of students who earned a degree in mental health and addiction care in Santa Clara County and found that students who plan to remain in the Bay Area after completing their program, primarily due to cost of living concerns. It turned out that only 50%.
To keep more mental health workers in the community, health care providers want to continue expanding state and local workforce development programs, particularly student scholarships and loan repayment plans.
Proposition 1, a $6.4 billion mental health bond narrowly passed by Gov. Gavin Newsom, includes funding to increase the mental health workforce. That's on top of the $1.5 billion the state approved last year for various health workforce programs.
Rachel Massaro, director of research at the Silicon Valley Regional Institute, said there needs to be more emphasis on recruiting and training workers from diverse backgrounds that reflect the communities they serve. It could not only encourage more people to enter the field, but also help remove language and cultural barriers that make it difficult to reach many people in need of care. , Massaro said.
“There are huge benefits to building a sense of belonging,” she says.
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