Patients' mental health symptoms are worsening

APA first launched the Practitioner Pulse Survey in 2020 to assess the impact of the COVID-19 pandemic on practicing psychologists. This year, the organization distributed the survey to a random sample of 16,557 licensed U.S. psychologists between Aug. 30 and Sept. 29, 2023, and received a total of 561 responses.

In the survey, over half of respondents reported seeing an increase in symptom severity among their patients over the last 12 months, and 42% said they saw an increase in their patients' length of treatment. 

Although the number of psychologists reporting increased symptom severity has largely stabilized compared to previous years, the fact that symptoms have worsened for patients year after year suggests "a continuing crisis," APA writes.

The respondents also reported an increase in certain mental health disorders, including anxiety disorders, trauma- and stressor-related disorders, and sleep-wake disorders. Although there were small improvements in 2023 compared to 2022, the overall rate of patients with these disorders is still increasing annually.

According to Vaile Wright, senior director of healthcare innovation at APA, these increases in severity, treatment length, and more are all lingering mental health impacts from the pandemic.

"I think there are a variety of ways that individuals experienced trauma during the pandemic," Wright says. "It could be the loss of a loved one and the grief that comes along with that. It could be one's own sickness and the impact of hospitalizations."

When it comes to the types of patients that psychologists are seeing, respondents said they saw more patients from all racial and ethnic categories except for American Indian, Alaska Native and/or Indigenous people and Native Hawaiian and other Pacific Islanders over the last 12 months.

Almost a third of respondents said they had increases in patients from working poor populations. In addition, 26% of respondents said they had an increase in gay, lesbian, and bisexual patients while 41% said they had an increase in transgender and gender non-conforming patients. 

More psychologists are struggle with burnout

As lengths of treatment increased, 26% of respondents also reported an increase in their workloads compared to the 12 months before. More than half of respondents (56%) also reported having no openings for new patients.

Among psychologists who had a waitlist, 38% said their waitlist had grown over the last 12 months. Over two-thirds (69%) of these respondents said the average wait time for patients was up to three months. The remaining respondents said their average wait times were longer than three months. 

"We continue to see incredibly high demand for mental health services and an incredibly limited supply," Wright said. "This is not a sustainable solution to addressing the mental health crisis in this country." According to the survey, 42% of respondents said that they haven't been able to meet the demand for treatment from their patients.

In addition, 36% of respondents said they were burned out. Although this is a decrease from the over 40% who said the same in previous years, "it still indicates a significant proportion of psychologists are experiencing unhealthy amounts of stress," APA writes.

However, many respondents also said they have been able to practice self-care (73%) and maintain a positive work-life balance (63%) even with their increased workloads. A little less than half of respondents (49%) also said they use peer consultation or support to manage their burnout.

"We have peer consult groups throughout the week, and this is where we really support one another," said Mary Alvord, a psychologist and founder of Alvord, Baker & Associates, a private practice, who did not participate in the survey. "And then personally, I walk 3 to 5 miles a day ... as a way that I relieve my stress." (Chatterjee, "Shots," NPR, 12/6; APA 2023 Practitioner Pulse Survey, accessed 12/7)

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