As the impact of the pandemic on mental health continues, psychologists are reporting a large increase in demand for treatment of anxiety and depression compared with last year, according to a new survey by the American Psychological Association. 

Many psychologists also said they had increased workloads and longer waitlists than before the pandemic.

“As more people seek treatment for mental health conditions, the demands on psychological practitioners have increased,” said Arthur C. Evans Jr., PhD, APA’s CEO. “Like many other health care providers, psychologists are feeling the pressure.”

More than 8 in 10 (84%) psychologists who treat anxiety disorders said they have seen an increase in demand for anxiety treatment since the start of the pandemic, compared with 74% a year ago. Demand for treatment of depression is also up, with 72% of psychologists who treat depressive disorders saying they have seen an increase, compared with 60% in 2020. Other treatment areas with greater demand included sleep-wake disorders, obsessive-compulsive and related disorders, and substance-related and addictive disorders, the survey found.

The number of psychologists who reported receiving more referrals this year almost doubled from last year (from 37% in 2020 to 62% this year). Almost 7 in 10 psychologists (68%) with a waitlist reported that it had grown longer since the start of the pandemic. 

With these indicators suggesting many psychologists are working at or beyond capacity, more than 4 in 10 (41%) reported being unable to meet the demand for treatment (up from 30% last year), and 46% said they felt burned out (up from 41% last year). 

“These numbers highlight what we have been saying since the early days of the pandemic—we are facing a mental health tsunami,” Evans said. “We need to continue to support treatment via telehealth, and we must invest in screening, prevention, and innovative interventions to expand access to various levels of care.”

The pandemic led to a switch to telehealth for many psychologists, and virtually all clinical psychologists continue to provide at least some services remotely (96%), according to the survey. While few have returned to seeing patients entirely in person since a year ago (about 4% vs. 3% in 2020), a greater number of psychologists have adopted a hybrid approach of seeing some patients in person and some remotely (50% vs. 33% in 2020), revealing a slow progression back to the office.

APA continues to advocate for continued flexibility in insurance coverage of telehealth services, including audio-only telehealth, as well as equal coverage and reimbursement for telehealth services in comparison with in-person treatment. Telehealth services enable patients from underserved communities—such as rural areas and communities of color—to access these services, often for the first time.

Demonstrating that telehealth is here to stay, 96% of psychologists said that the use of telehealth during the pandemic has proven its effectiveness as a therapeutic tool, and 93% said that they intend to continue providing telehealth as an option in their practice after the pandemic.

In coping with the additional demand for treatment, more than three-quarters of psychologists said that they were able to maintain a positive work-life balance (77%, up from 66%) and nearly two thirds said that they practiced self-care (64%, up from 55%).

Methodology

The 2021 American Psychological Association’s COVID-19 Practitioner Survey was distributed to approximately 26,400 doctoral-level active licensed psychologists (both APA members and non-members) in the U.S. between August 30 and September 17, 2021. A total of 1,141 psychologists responded. This was a non-probability sample, and thus it is not possible to calculate confidence intervals or margins of error.

The 2020 COVID-19 Telehealth Practitioner Survey was fielded from August 28 to October 5, 2020. A total of 1,787 psychologists responded to that survey.