We’ve long been advocates for therapists getting paid and at the forefront of pushing social advocacy for the therapist job. It doesn’t take a crystal ball right now to see that the COVID-19 coronavirus will have an economic impact on the near future of our profession. This may not be the news that we want to hear at the beginning of a shutdown, but the reality is that the adjustments to economic shut downs has ripple effects throughout all industries like we have never seen before, including post 9/11 and the Great Recession. While the first few days of panic switching our clients over to telehealth platforms is over, we are afforded an opportunity at an uncomfortable look into the future: many therapeutic business are not in a place to weather the storm that is coming.


At an agency and director’s meeting last week in the Los Angeles area, some agencies lamented that a prolonged disruption to services and medical needs would quickly cut into the less than 12 months of reserves that many agencies hold for financial crises. The focus in the news so far has looked at two areas of need during this shut down crisis: saving lives and keeping businesses open. The second point is the focus of this article, as it has been an arguing point for many agencies during times of economic surplus and will surely be a continued argument as grant requirements are not met (and need to be repaid) and clients are slow to return. Some of our followers on social media have pointed out that they are required to continue to see people in face-to-face sessions during the shutdown or will lose their jobs. There will be a reliance on economic relief through government forgiveness and a hope for benevolent grant foundations, but at this point it is all just hope.


Further compounding this are mixed messages from licensing boards, government agencies, and professional organizations. In legislation that expanded the use of telehealth across state lines for Medicare participants, the Center for Medicare and Medicaid Services has not clarified how they will interpret the legislation whether it will be only for COVID-19 cases, while the American Psychological Association interpreted the law liberally. Despite local calls for limiting groups of people for meetings, the California BBS reaffirmed that associates in private practice and corporations need to be met for face to face supervision to remain in compliance with the law. The lack of coordination between governmental departments leaves clinicians with the tough choice to determine the best course of action. While some point to the guidance of the ethical codes call for a “higher standard than the law,” others deride ethics policing during this time.


All of this brings us to the sobering reality that individual clinicians will likely be left to fend for themselves and will be the ones held accountable. Clinicians will be shamed into seeing clients in agencies that are not financially protecting themselves, left to interpret conflicting information, and will see a shrinking landscape of job opportunities in the future. Much like Elizabeth Warren’s plan for the companies taking a government bailout during the COVID-19 scare, the mental health field should adopt some of the same as a general practice:


  • At least minimum wage for workers
  • A minimum of one year’s financial reserves
  • At least one seat on a board of directors reserved for worker representation


It is with these kind of changes that we can assure that the mental health workforce are able to remain viable. While this may not seem the best opportunity to bring these changes, it is highlighting our need to continue to change and advocate for our profession to remain viable in an ever-so-fragile world. If we are to remain there to serve society’s most vulnerable, we cannot afford for our workforce to be among them.

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