By Moryt Milo
When an individual is in the midst of a mental health crisis, time is precious and treatment is critical—finding a hospital bed, doctor, or psychologist oftentimes comes down to luck and luck doesn’t equate to care.
Former Palo Alto University (PAU) president Maureen O’Connor, Ph.D., JD, says the problem is because demand far outweighs availability, and the data is telling.
According to the American Psychology Association, almost 60% of psychologists say they have no openings for new patients, and almost 70% maintain a waitlist with an average time of three months for a first appointment. The other troublesome fact is that within the next five to ten years nearly 40% of all psychologists will retire, stretching demand even farther.
“You all are well aware of the provider shortages facing our families and communities,” O’Connor, who served as PAU president for nine years, told the audience at a NAMI-Santa Clara County general meeting.
Behavioral health provider shortages are at the top of the need list in the Bay Area, California, and the country. PAU is one of those rare institutions that specializes only in graduating students with various degrees in the field of behavioral health.
“Our alums have no difficulty finding a position, there is such a need,” O’Connor says.
Still, it’s important to understand the core disciplines in the field whether it’s a person seeking help for a loved one, friend, or themselves, O’Connor says. Being familiar with the distinct roles of the five major licensed providers in California can help lead to better decision making. These disciplines include psychiatrists, psychologists, marriage and family therapists (MFTs), licensed professional clinical counselors (LPCCs), and licensed clinical social workers (LCSWs).
Five Distinct Disciplines
Psychiatrists are medical doctors who diagnose mental health disorders. They can prescribe medication and treatment and can also provide psychotherapy, even though this aspect is less common today. They will often help coordinate treatment with therapists.
Clinical psychologists are individuals with a Ph.D., a rigorous five-to-seven-year process. These individuals can provide psychotherapy, are trained to do psychological assessments, work in clinical schools, hospitals, or have a private practice. They are less likely to be in the public sector. Those with Ph.D.s often go into research. Those with PsyD degrees use their doctorate for assessments and testing not research. Their work is evidence-based using practices such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT) when working with patients.
The licensed professional clinical counselors (LPCCs) degree was added to California’s behavioral health lineup in 2009. California was one of the last states to add the master’s degree. These counselors focus on wellness, personal growth development, life transitions, mental health, relationship issues, and coping skills. The work of the LPCC evolved over time to cover grief and career counseling. They don’t specialize in assessments or family systems. They typically work in out-patient community settings, schools, and with school counselors.
Marriage and family therapists (MFTs) are licensed professionals who address mental health issues within the context of relationships and family health matters. They key into family dynamics. They can work in behavioral health settings such as residential treatment facilities or schools. To earn a license, they are required to have 3,000 hours of supervised experience. Once licensed they can establish a private practice.
The fifth group is licensed clinical social workers (LCSWs). These professionals have a master’s degree in social work and provide evidence-based services, interventions, and diagnoses. The client empowerment and advocacy approach is how they are trained in the field. They have access to an array of services in the community to help support individuals and families. Their professional choice is to work in the public behavioral health care system. For them equity is a significant factor.
There is one last group, Peer Support Specialist, that has been slowly growing in California. This is a statewide program. The individual needs to complete 80 hours of curriculum and training requirements that include 17 core competencies and pass a statewide exam to be certified. Through their own lived experience, they can speak the language others can’t and offer support to someone who is struggling with mental illness.
“They are not a licensed professional but bring very important support to the rest of the system. Maybe the most important connector to the people in the recovery journey,” O’Connor says.
The common bond with all of these professionals is a desire to work with people who have mental health needs.
Each professional brings a fairly distinct perspective, with particular curriculum and particular training experiences, O’Connor says. If it was all working together in a synchronized manner, it would provide comprehensive multi-disciplinary mental health care.
O’Connor is forever looking at the future with a wide lens for the good of those in need and the professionals who have dedicated their lives to the challenging field of mental health.
“By working together these professionals can ensure holistic care, with biological, psychological, social, and relational aspects of mental health,” she says. “In my pie-in-the-sky dream world that’s what I would like to see.”
To watch Dr. Maureen O’Connor’s entire presentation, click here.
