Covid and the lockdowns increased self-reported cases of anxiety and depression. People were sequestered in apartments, homes away from work and many of the services they’d come to enjoy. Many were having to work (or unable to work) while their kids were studying over Zoom. With increased demand for therapists, not all therapists are equal in skill. Rachel Hall from The Guardian reports on when therapy goes wrong, when you are cared for by an unqualified mental health practitioner.
“The public needs more understanding that psychotherapy can do good but it also can do harm, and anything that’s powerful enough to change your life for the better is powerful enough to do some damage if it’s in the wrong hands and done wrongly, or recklessly,” said Glenys Parry, an emeritus professor at the University of Sheffield and an accredited psychotherapist.
Covid jump started online and telephone-based mental health counseling, as patients were unable to meet therapists face-to-face. Therapists and patients began connecting through apps, which is a great idea considering you do not necessarily have be in the same room with a counselor. It’s understandable that many people prefer to talk to a therapist over Zoom if they are far from their therapist’s office. However, telemedicine may exacerbate the problem of bad therapists, since younger, less experienced therapists have a way to meet with patients without the overhead of an office. One man complained his therapist seemed unprofessional. In one therapy session he could clearly see someone in the background making dinner. In another therapy session the therapist was a passenger in a car that stopped for gas. A reporter tracked down the young therapist who explained that during Covid she was forced to move in with her mother and there was no dedicated space for her to conduct her sessions.
It should come as little surprises then that social media is also driving quackery in the mental health field. According to The Guardian:
>From influencer therapists on social media to psychotherapy platforms advertising on TV and radio, going to see a therapist is increasingly mainstream – yet many people know little about who they are seeing and what they are getting.
It should also come as no surprise that some of these charlatans negatively affect their patients’ mental health. There is little research into the harm done by bad therapy, but experts suggest 5% to 8% of people actually feel worse after therapy. Finding a good match in a therapist can be compared to finding a good match in a romantic partner. Both can be very personal.
“One of the reasons therapy goes wrong is transgressive therapists who are literally abusive or exploitative, and they are in the minority, but they do exist,”’ said Parry. “But much more common are people getting in out of their depth, they don’t understand the limits of their competence – they’re trying their best to be helpful but they’re not able to see they’re making things worse.”Parry added that there were so many different models of psychotherapy, from cognitive behavioral therapy (CBT) to psychodynamic therapy or counselling, there was now “quite a lot of evidence people don’t really understand what it is they’re getting”.
I recently wrote about The High Cost of Poor Mental Health. Numerous studies have found people who are unhealthy mentally have higher costs for medical care that is seemingly unrelated to mental health.
Mentally unhealthy workers take more sick days and use more health benefits, costing $48 billion annually. A study in JAMA found that people with depression have a much higher risk for numerous chronic diseases:
People with depression have a 1.5 times greater risk of developing 29 health conditions, like poisoning and falls but also diabetes, back pain, and bronchitis, according to the findings.
Mental health disorders have exploded since Covid, but exactly what is mental illness and when does unhappiness turn into depression? Are negative people just annoying or are they clinically depressed and in need of pharmaceutical intervention? These are not just glib ideas. The New York Times talks about the role of misery in the mental health crisis.