The lack of mental health care providers – a national problem that has been described locally in bleak and catastrophic terms – has worsened further.
Fredericksburg Counseling Services Inc., a free clinic that provided services to low-income and uninsured patients in the area, closes after 60 years because it cannot find people to run the program. The closure affects both those who received care as well as future practitioners who were working towards certification.
Over the years, FCSI has offered up to 17 internships per year to graduate students who completed their clinical training in Fredericksburg.
“Letting go has truly been a struggle and what breaks my heart the most is that it’s needed most right now,” said Catherine Jennings, chair of the FCSI board of directors. “But you can’t run something without staff.”
Fredericksburg Counseling began providing pastoral care at the church in 1962, then arranged for therapists to provide clinical care on a voluntary basis. In 1999, FCSI created what Jennings called a “shiny model”.
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Trainees who had to work with certified therapists to obtain the necessary training hours came to the free clinic and counseled low-income and uninsured residents. At its peak, the clinic served 210 patients a year, according to a press release.
At one time, the clinic had an executive director who applied for grants and a personnel director, a board-certified therapist who could oversee the training of interns. Eventually, these positions were merged for financial reasons.
But lately, the clinic has discovered that staff is an even bigger issue than money.
“Even with additional outreach to secure other eligible vendors, we were unable to secure the necessary personnel to continue operations,” said Anise Broadus, office manager.
Mental health care providers are “just not there,” Jennings said. “A lot of them are just gone, retired, just exhausted. They’re everywhere.”
Even before COVID-19 hit and created higher levels of anxiety and stress, there were not enough psychiatrists in the United States to treat the 1 in 5 Americans with mental health issues, according to a article on the Association of American Medical Colleges website.
He cites a analysis published by the National Library of Medicine this predicts a shortage of 14,280 to 31,109 psychiatrists by 2024. The study was conducted in 2018, when the biggest concern was how many providers would retire and not leave the workforce due burnout due to the pandemic.
At a local summit in August, representatives from Fredericksburg-area agencies met to discuss ways to get more mental health workers in the pipeline. A community health improvement plan, developed earlier this year by the Rappahannock Area Health District and Mary Washington Healthcare after months of work, noted that mental health was the region’s No. 1 priority.
Brandie Williams, deputy executive director of the Rappahannock Area Community Services Board, explained the severe staff shortage. She cited the Virginia Health Care Foundation’s annual assessment of behavioral health workers.
According to the report, nearly 800 behavioral health professionals — therapists, social workers, psychiatrists and psychologists — graduate from Virginia colleges and universities each year. Last November, there were 1,378 job postings for behavioral health specialists in the state on Indeed.com.
“I affectionately call it the catastrophic report,” Williams said at the time. “Not only do we not have enough behavioral health professionals now, but we are not producing them at the rate necessary for what we need now, let alone the needs five years from now, 10 years from now.”
His agency is a perfect example. The Community Services Commission has positions for 70 therapists who work in emergency departments, with drug offenders, veterans and inmates and on an outpatient basis with those who need mental health and addiction counselling.
Nearly half, or 30 of the 70 positions are open, said Amy Umble, communications coordinator. It’s not because of a lack of funds – there aren’t people to fill the positions, she says.
That’s another reason the shutdown of Fredericksburg counseling services is such a loss, said RACSB director Joseph Wickens.
“The shortage of therapists is having a dramatic impact on the local community, making it especially difficult to see the Fredericksburg area losing such a valuable resource,” he said.
Rufus Phillips, CEO of the Virginia Association of Free & Charitable Clinics, commended Fredericksburg Counseling Services for its “long history of community service and…commitment to serving some of its most vulnerable residents.”
He noted that the Moss Free Clinic provides mental health services to underinsured and uninsured people in the greater Fredericksburg community.
Additionally, the Virginia Telehealth Network is working with the state clinic association to create a new program called the Virginia Telemental Health Initiative. It will provide free mental health services to eligible individuals through Virginia’s Free and Charitable Clinics.
The program will begin seeing patients next month at six sites and will expand statewide in 2023, according to the association. An announcement will be released later this month.
Meanwhile, Fredericksburg Counseling Services is struggling to find new providers for its patients and redistribute assets to community organizations that serve the uninsured. The council plans to cease operations by the end of the year.
Cathy Dyson: 540.374-5425