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Local therapists are in high demand. But how are they doing?

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Anskit, via Flickr
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As part of an occasional, ongoing series on mental health topics, WMRA's Randi B. Hagi asked clinicians how they're handling an increased demand for their services.

I think most of us are feeling like there's a lot to be stressed about right now. Dealing with the emotional aftermath of the pandemic, the lives it took, the state of the economy and politics, mass shootings – the list of adverse experiences shading these times goes on and on.

When we're in crisis or feeling stuck, we may be advised to seek out mental healthcare, or maybe you already see someone regularly. But how are those clinicians experiencing the current milieu?

AMY GHAEMMAGHAMI: Every clinician in our practice has a waitlist.

GEORGE NIPE: I've got therapists who've got 50 people on their caseload, and I've got others who are closer to the 80s.

I spoke with four mental healthcare providers in different settings about how their work has changed in recent years, and how that's affecting them. Ellen Dotas is the manager of the psychiatric emergency response services team at Sentara RMH.

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Randi B. Hagi
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Ellen Dotas oversees the Sentara RMH team that treats psychiatric emergency patients.

ELLEN DOTAS: We see people of all ages, from young children up through elderly people. They come in with a wide variety of problems … an anxiety attack or trouble handling a stressful situation or a breakup or something like that, to somebody who is actively suicidal … or is psychotic. Substance abuse issues, all different kinds of issues.

In addition to having someone onsite at the hospital 24/7, in the last few years RMH has also started providing telehealth consultations to five other Sentara emergency departments all over the state.

DOTAS: A lot of times we'll have people come in and say, "I can't see a counselor for a few months," or "I can't find anyone who's taking new clients right now." Or they'll call to try and find a psychiatrist in the area, and a lot of the psychiatrists are booked up too, months in advance.

NIPE: You'll notice a lot of people will have 'not accepting clients,' and I 100% respect that.

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Randi B. Hagi
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George Nipe sees clients himself and also supervises other therapists at the Harrisonburg Rockingham CSB.

George Nipe is the senior manager of adult outpatient services at the Harrisonburg Rockingham Community Services Board. CSB’s are operated through Virginia’s Department of Behavioral Health and Developmental Services. Nipe estimated that they have about 125 more clients now than they did pre-pandemic.

NIPE: And while I'll kind of mitigate my individual caseloads, like I might put a person off from not getting new clients for a week, our door never shuts. Which is good – you have to have a place like that.

Dr. Lewis Weber, a therapist who runs his own practice in Charlottesville, is keenly feeling the demand for his services.

LEWIS WEBER: It's challenging times. And it's also challenging times for the people that are doing the work, the mental health people on the front lines, because we are human beings, and we deal with similar kinds of stresses as well. And it's painful and sad to be in a position where I have to turn people away or say we can only do a limited amount.

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Lewis Weber
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Dr. Lewis Weber started his private practice over 40 years ago.

Besides just the number of people seeking their help, these therapists and counselors talked about the intensity of the symptoms folks are experiencing, and how so many people are really struggling to regulate their emotions and anxiety these days.

DOTAS: That might be just struggling with a lot of depression, or sometimes we see people that are very agitated, or their anger is just really something they're struggling to control … and I think it's in large part due to all of the stress that they've been under.

WEBER: And so simple tenderness towards others is going to be challenging, and particularly toward yourself. So you've got a lot of people being super critical of themselves.

GHAEMMAGHAMI: You have got to be kind and believe in the goodness of your fellow man.

Amy Ghaemmaghami is the director for outpatient behavioral health at Augusta Health.

HAGI: Do you think that's become harder for people in the last couple of years?
GHAEMMAGHAMI: … and to be more understanding, to show compassion on the daily.

GHAEMMAGHAMI: I think, as people have become isolated, they sort of forget how to act as a community. And so I think there are times where you really have to make that commitment to your neighborhood, to your community, to your church or your faith.

Another thing the therapists I talked to said was that they don't usually experience the exact same trauma – like a pandemic – at the exact same time as their clients.

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Augusta Health
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Amy Ghaemmaghami, director for outpatient behavioral health at Augusta Health in Fishersville.

GHAEMMAGHAMI: We all couldn't see our aged parents in the nursing home or the residential living facility. I mean, I didn't hug my mother for a year.

So, how are they coping? Basically, by practicing what they preach – meditating, prioritizing relationships, and making time for activities they love.

GHAEMMAGHAMI: We're just finding that it's really, really important to manage our social worlds and do the things we love to do and volunteering and just getting together, enjoying the arts and culture … I went to the Kennedy Center this weekend with some friends to see To Kill a Mockingbird.

Now, there were a few silver linings that came up in our conversations, too.

WEBER: The hopeful sign is that a lot of people really want to work on themselves, and I think that's positive … I love the work. I still love the work, you know. I'm obviously an older clinician and I just enjoy it so much that I don't see myself retiring. It's a real gift and honor to be able to be intimately involved with people who are willing to share themselves, and a chance to see people grow and change.

Randi B. Hagi first joined the WMRA team in 2019 as a freelance reporter. Her writing and photography have been featured in The Harrisonburg Citizen, where she previously served as the assistant editor; as well as The Mennonite; Mennonite World Review; and Eastern Mennonite University's Crossroads magazine.