More need for mental health services in troubled economy

    How are therapists, counselors and mental health agencies dealing with the increased demand for their services?

    Mental health providers across our region report an increased demand for their services due to economic hardships like job loss or home foreclosure. At the same time budgets for mental health services are being cut and people have less money for therapy. What are therapists and providers doing to bridge the gap – Maiken Scott reports from WHYY’s Behavioral Health desk.

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    No matter what the economy is like, money is an important subject in therapy sessions. It’s a common source of anxiety and strife in relationships. Right now, though, many therapists find themselves dealing with with their own stress. Their desire for financial stability can conflicts with their stated mission to help people:

    Feiler: This is what I do, this is what I’m trained for, it’s not to turn people away, and yet it’s to decide what my limits are.

    Therapist Paul Feiler has seen several clients cut down or stop sessions in recent months because of financial worries. He works both in New York and Philadelphia, and his clients include stock brokers and Wall Street executives. Feiler doesn’t take insurance payments; his patients pay out of pocket. He says that when therapy comes to a sudden halt, it’s difficult for both parties involved:

    Feiler: So much of the work isn’t just about being compensated, it’s about this unique relationship that develops over time, so I think when it ends somewhat abruptly when somebody realizes wow I have lost my job – that’s hard.

    Feiler says like many of his colleagues, he is trying to come up with ways to provide services and hang on to his client base. Sliding scales are one way. Another is to set a sort of Happy Hour discount for therapy:

    Feiler: The peak hours are in the evenings usually in the early morning before and after work. So if somebody is willing to come during the day that may be a way of lowering the fee – another one is to consider group because group is usually less expensive.

    Philadelphia therapist Deborah Whalen has only lost one client so far whose home was foreclosed, but she says financial worries are a big issue in sessions these days.

    Whalen: I think that across the board, people are just really concerned about how long is this going to go on, there are all these question marks which just increases anxiety.

    Whalen says this is her first experience at doing therapy during a recession. She’s been talking with colleagues about how best to adjust to new challenges.

    Nationally, counseling centers and community mental health facilities say many more people are seeking their help, even as strapped governments cut budgets. In Pennsylvania, Joan Earney, Deputy Secretary in the Office of Mental Health and Substance Abuse Services encouraged agencies try to reduce costs without cutting services:

    Earney: I think we’re in unique economic times and that we all have to contribute to assure that folks will be okay. And quite honestly, we really want and believe that there are still administrative efficiencies that can be accomplished at the agency level as well as the county level and that’s really what we’re going to seek to have them cut.

    Dr. Colleen Logan president of the American Counseling Association, says this is the kind of moment counselors are trained for:

    Logan: The research says and our experience tells us that we are the long pole in the tent in terms of being the ones who can help everyday people with everyday problems, in this case everyday people with extraordinary problems.

    At Friends Hospital in Philadelphia, chief medical officer Mark Rothman, worries that people with money woes might be reluctant to seek help.

    Rothman: For example if somebody doesn’t have insurance they might be afraid of incurring additional cost so they might stay away from the crisis center or making the call that they need.

    As his profession adjusts in a troubled economy, therapist Paul Feiler has shifted his focus a bit – he is providing coaching for people who lost their jobs and are trying to figure out what’s next:

    Feiler: Some of the work is to really support them in identifying their strengths and where at this point in their careers they would like to go.

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