Breaking Through

INSIGHT AND INSPIRATION FOR NAVIGATING MODERN MENTAL HEALTH CARE

BY ANNA RUSSELL

If you’ve flown enough times, you know to “secure your own mask before helping others.” If you spend regular time in health and wellness circles, you probably also know this phrase is used as a metaphor for prioritizing self-care. But what happens when you wait for a proverbial drop in cabin pressure to make sure there are enough masks to go around?

At the height of the COVID-19 pandemic, Americans found themselves cut off from both supplies and services—and caught off guard by their lack of preparedness to deal with that.

“The pandemic forced people to sit with their thoughts—literally quarantine with them—some for the first time, and some right alongside their families,” explained Dr. Tiffaney Parkman, director of The University of Baltimore’s B.A. in Human Services program. “Maybe before, their normal way of coping was to ignore their issues or problems, but now, they couldn’t access their usual distractions. People began to realize they didn’t have an actual plan for their mental health care.”

“The hardships that came with the pandemic were awful to experience … if you didn’t do something to address them, then being swallowed up by this miserable situation was inevitable,” said Dr. Courtney Gasser, director of the M.S. in Counseling Psychology program at UBalt.

As it turns out, therapy was ripe for virtual practice. A study published by the JAMA Network Journals of the American Medical Association comparing telehealth and in-person visits between 2019 and 2022 noted that “by August 2022 … overall mental health service utilization was 38.8 percent higher than before the pandemic.”

That being said, according to their COVID-19 Practitioner Impact Study, members of the American Psychological Association reported seeing increases in the number of patients seeking treatment for anxiety (+79 percent), depression (+66 percent), substance abuse (+47 percent), and trauma (+64 percent) since the beginning of the pandemic. That same study also reported that 60 percent of practitioners acknowledged that by 2022, they had no availability to accept new patients and 72 percent have longer waitlists than they did pre-pandemic.

“You’re worth the time and effort it takes to find a professional that works for you.”
LINDSAY JIMMINK

“[The pandemic] helped some people to connect with mental health resources in an unprecedented way,” says Gasser. “However, it’s also shown us that not everyone has equal access to health care or wellness resources, including counseling.”

Both faculty and alumni practitioners from the University of Baltimore agree there’s no time like the present to give your mental health the attention and care it deserves, but when access is restricted by time, cost, supply or even doubts, where do you begin? And should you even bother?

WE ALL NEED PROFESSIONAL CARE

Giovani Aguiar: At some point in our lives, we all need professional care. We go to the gym, we take vitamins, we eat well, all for the sake of our physical health. We need to do the same for our mental health. We should not wait until we get overwhelmed with emotions and feelings. We should be working on how to deal with emotions and feelings on a regular basis.

Bonnie Zucker: Usually, if you are thinking about therapy, it’s a good sign you would benefit from it. The main indicator is when you have symptoms that are interfering with your life in any way. While no one feels happy all the time, if you find yourself feeling down or sad more often than not, it means you should seek treatment. Also, if you have habits that you’d like to change, going to therapy is often a great way to do that.

Crystal Baldwin: Therapy is not just for times of crisis but also for times when things are manageable but difficult, a life transition is occurring, or even when things are going well!

GETTING STARTED

Zucker: Your primary doctor is always a good starting point; if they don’t have any recommendations, you can get a list from your insurance company. Many providers are also out-of-network, but you can pay upfront and then hopefully receive partial reimbursement from your insurance company if they offer out-of-network benefits.

Joanne Frederick: If you’re searching online, start with on Psychology Today. You can drill down by location or put in the preferred gender or race of mental health professional you’re looking for. You can even search by specialty or modality, if you know what you’re looking for. You can get into as much detail as you need to find someone. But I definitely suggest taking an all-of-the-above approach—don’t limit your search to one place; explore all the options open to you.

Lindsay Jimmink: Reviews and feedback are an important part of the search process. Online reviews (e.g. Google) are great, but also a doctor referral can be really helpful. For instance, if your primary care physician can professionally vouch for a therapist and is willing to refer you, that’s usually a good sign. And I’m always a fan of word of mouth—there’s a reason why people spread names. I’ve gotten patients because others have said, “I love Lindsay!” I’m very grateful for that.

DECISIONS, DECISIONS

Jimmink: Good mental health care comes down to figuring out what kind of professional you need to see. There can be a lot of trial and error involved. It’s like when you go to your doctor for physical symptoms—you may not know what specific type of treatment you need going in, so you see different specialists until you figure out you need to see a cardiologist.

Angela Frazee: There are a lot of different therapy modalities out there; clinicians should be able to share theirs and explain it to you in layman’s terms so you can see if it resonates. Therapists talk to you, help you process things and learn skills, whereas psychiatrists can assess symptoms and prescribe medication, but tend not to dig deep. If you’re concerned about something like a learning disability or ADHD, you can look into neuropsychological assessments and testing.

Tiffaney Parkman: Depending on where you are, securing an appointment with a mental health care professional can take months. If you’re unsure about what you need, start by talking with your primary care physician. They can run tests, do lab work, and potentially even start you on medication to steer you in the right direction to buy some time before you can talk to someone. Don’t forget—if you have access to them, employee and student assistance programs are great resources to help you get started.

A MATCH MADE IN THERAPY

Baldwin: I encourage everyone to interview potential therapists. This helps feel out personality compatibility and allows for you to learn more about the therapist’s specialties, background, and modalities. If you are of a marginalized identity, it is perfectly acceptable to ask a therapist additional questions about their competency in working with clients of that particular group. Your safety and comfort are the priority in this process.

Zucker: After three sessions, you should be clear about your connection with the therapist and if they are a good fit for you. First, ask yourself if you feel they understand your presenting concerns, have a clear sense of treatment goals and if they have a plan for reaching those goals. Second, do you feel like you can share anything without being judged? Finally, ask yourself if you feel that the therapist appreciates your strengths and has a positive mindset about you and the therapy process.

Frazee: A good fit is going to be different for each person and unique to what they’re looking for and what feels good to them. Some people want a more directive therapist, some more of a listening therapist. Understanding what kind of person you’d like to talk to will be helpful.

“We all go through hard times in life and there is no shame in ever asking for help to get additional support.”
ANGELA FRAZEE

Courtney Gasser: Your therapist should be someone who can help you fulfill your goals for counseling, offers you a safe space for being emotionally vulnerable and whose focus is on you. Counseling can feel uncomfortable at times because it is a place where we process our pain, yet the therapist is there to form a positive professional relationship with you and offer a supportive space to do this hard work. If after a few sessions, you don’t think this is a person who can offer you such space, then looking for a different therapist is usually a good idea.

THE STRUGGLE IS REAL

Baldwin: Since 2020, there haven’t been enough therapists to meet demand and, unfortunately, waitlists are now commonplace. I recommend placing yourself on multiple waitlists and checking back every few weeks to increase your chances of getting seen earlier. While mental health apps are not a substitute for therapy, they’re helpful in the interim, so I do recommend people utilize apps, books and the social media content of licensed therapists.

Zucker: Be patient. Don’t just schedule with someone who has availability—it’s worth waiting for someone who’s the right match for you and your presenting concerns.

Frederick: Remember, it’s always better to start identifying an individual who will fit your needs and life be-fore there’s a crisis. But if that happens, this is the time to start engaging in self-help. I have a number of books and articles I recommend people can read, or that they start journaling. These are things that can help get you through while you’re waiting for more help.

PUTTING YOUR MASK ON FIRST

Aguiar: You need to reserve time for yourself, no matter how busy your day/week is. A few minutes in the morning, midday or at the end of the day, just to do something that brings you peace and re-energizes your soul. Spending time with people you love, or doing something enjoyable can be very rewarding.

Frazee: There are some great social media accounts online right now that talk about mental health and are a great place to start listening to concepts. I also love books and workbooks on mental health. I have a few that I highly recommend, but if that is not your thing, journaling can be really helpful to just process what’s going on for you. Also, make sure to fully nurture yourself. Focusing on what I believe are the three cornerstones of wellness—sleep, nutrition and exercise—is always a great place to start.

Frederick: Look into support groups. There are groups for everything you can think of and many of them offer online support. There are groups for substance addiction, like drugs and alcohol; process addiction issues, like gambling, technology, food, etc. They can help keep us afloat. And you can create your own support group, too. Start with your own network and just put your story out there. You’ll be surprised at how many people you know or how many people they know have experienced similar trauma. We just need to tell our story, because when we do, other people will realize they don’t have to be alone in this either.

Parkman: Everyone should be unapologetic about taking their own mental health days and doing whatever they think is right for them during that time. I started incorporating mental health days into the semester calendar during the pandemic, because it just got to be too much for students sometimes. Now, it’s a staple of all my courses.

Gasser: Self-care should be tailored to the individual and their circumstances. For example, if someone is always on the go, then spending quiet time meditating or even not doing anything at all may be particularly revitalizing. If it is a problem to find time for self-care activities, then scheduling in your self-care time might be helpful.

SOME FREE ADVICE

Aguiar: Mental health is as important as physical health, if not more important. We all need to be advocates and stop the stigma surrounding mental health issues. It is OK to ask for help. You are not alone.

Baldwin: Be aware that most large tech corporations offering mental health services online are not a great option for quality care. Unfortunately, these companies share and sell your protected health information for marketing purposes and have high turnover rates, which means most customers will not have the same therapist for long. These unethical practices place their clients at risk.

Frederick: Remember, if you have to take medications, that is perfectly normal. Many people are on mental health medication, whether it’s for anxiety, depression, bipolar, schizophrenia, anything at all. And medication does work. When you see someone functioning well, remember, they might be medicated. So, normalize it. Because that’s one of the things that keeps some people from requiring crisis services. A lot of times, we need that extra help. And that’s OK.

Jimmink: Cost isn’t always preventative. Some people can’t afford to pay out-of-pocket or the co-pays, even if they are insured. In those instances, it’s very important to talk to providers and see if they offer a sliding scale. Many do. Some places offer discounted rates for seeing interns or those still under supervision. And in the state of Maryland, there’s also the Pro Bono Project, and they do take on clients for free. I think it’s really important for people to know that help is out there, even if you don’t have the money for it.

Parkman: Everyone should devise a mental health care plan to prepare them for the next pandemic or the next disaster, whatever it is. The more resources you have—friends, community, family, doctors, access to services, designated funds—the better off you’re going to be. Ask yourself: ‘Where do I stand? What if something happens tomorrow? What’s my capacity to bounce back? To face that issue head on and come out as minimally scathed as possible?’ And if you cannot answer those questions, then get to work formulating a plan to answer them.

Anna Russell is advancement communications coordinator at The University of Baltimore and serves as managing editor of the magazine.