When my usual Monday teletherapy session ended and I shut my laptop, I didn’t know that would be the last time we spoke.
In June, the receptionist at my New York–based mental health provider called me, informing me that my therapist was leaving the practice immediately and that I would need to find someone else. I never spoke with her again, and my upcoming sessions were erased from my online calendar after I hung up the phone. I couldn’t help but get emotional. It wasn’t solely about losing the consistency and comfort of online therapy or the rapport we established, but rather the piles of homework I now had on my plate to find yet another right fit.
Of course therapists have lives of their own, with unexpected changes that may alter their career trajectory. But I wasn’t prepared to let someone in only to have the relationship end before it really began. I felt like I was in the middle of a sentence that was cut off.
I’ve been going to therapy since high school. When I moved to New York last August, I needed a new provider who worked in the state. It took me three months of researching—on and off and on again because who can realistically dedicate all their nights to scrolling provider websites—to find someone that stuck. My research included cross referencing therapists with my insurance, reading their bios, and checking to see which ones were open to new clients—which were never very many. I also requested phone screeners with potential therapists to make sure I even wanted to move forward. I knew it was a financial investment, but also a critical investment in my overall mental health.
All that work paid off, and after three sessions, I was thrilled I had found someone I genuinely felt understood me and my anxiety, and had tangible tactics for me to support my overall well-being. Within six months, I felt like we had a bond that feels hard to put into words.
Now that she’s gone from the practice, I’m back to square one—after feeling like I was consistently growing and opening up more each subsequent session. It doesn’t mean it all went to waste or that I won’t lean on some of the tools I learned from her, but it will take a while to build that level of comfort with someone new—and to find someone. The process of finding a therapist is so long and complicated, it’s easy to see why people feel defeated, and delay or avoid going to therapy altogether.
Feeling comfortable with your provider matters
When coming to terms with accepting guidance from a mental health provider, you’ve already shown “tremendous vulnerability,” “conviction,” and “courage,” says Dr. Tom Zaubler, former chair of the department of psychiatry at Morristown Medical Center and chief medical officer of NeuroFlow, a telehealth company.
“It should be easy,” he says. “Someone has that activation energy to take the step to get the help they want, and then they can’t find anyone. No one has availability.”
Even the lists people can obtain denoting which providers match insurance options are “notoriously inaccurate,” Zaubler says. And still, over 5.5 million adults with a mental illness are uninsured.
Over half of adults with a mental illness—27 million people— don’t receive the help they need, and roughly 60% of youth with “major depression” don’t receive treatment, according to 2022 data from Mental Health America. As the number of those struggling with mental health continues to rise, people are met with more obstacles to finding providers, whether that is cost, having the time to find someone, or not even knowing where to start, according to the American Psychological Association.
For those looking for a mental health provider, it almost feels like a rite of passage to be met with disappointment.
“If you’re prepared to know that you may need to call five people before somebody returns your call or you connect with someone, that can kind of mitigate some of the disappointment,” says Lisa Hunter Romanelli, a licensed clinical psychologist and CEO of the Reach Institute, a nonprofit focused on children’s mental health.
Beyond wait lists and insurance deciphering, it’s incredibly difficult to find a mental health provider who syncs, another compounding factor making seeking help that much more challenging.
Romanelli reminds people that therapists play a different role for everybody. Some people may be drawn to one personality over another or feel more secure opening up if their provider shares an identity with them; gender, race, religion, and sexuality may all play a factor.
“You want somebody who’s qualified, but you also need someone who you’re comfortable speaking with and who you can relate to in some way,” Romanelli says. “If you don't feel comfortable with the therapist, that’s gonna limit the effectiveness of it.”
The credentials don’t carry any weight if you’re not doing the type of therapy that will work best for you, says Jenny Okolo, a psychiatric occupational therapist who emphasizes that many different kinds of therapy are effective for a variety of problems, from cognitive behavioral therapy (CBT) to diagnostic behavioral therapy (DBT), to name just two. For starters, it might help to see if the provider you’re looking at has experience tackling challenges you also face, which can affect your level of comfort with them.
My initial question is, then, how do you know when you feel comfortable?
It may just be about feeling “comfortable enough” to try them out, as Romanelli puts it. It’s important to not “spin your wheels,” she says, if someone does not seem to meet your goals after a couple of sessions, but to also be aware of the time it takes to build trust and to see if there’s potential.
“Expecting that the first time you meet with a potential therapist, you’re automatically going to click with them and feel completely at ease is probably an unrealistic expectation,” she says.
Trusting your instinct on that first session and being open to the process is key, especially when it’s so hard to nail down that first appointment in the first place, something Zaubler says is a result of a flawed system not a flawed person.
And if someone doesn’t work, that’s also part of the process.
When learning she may not be a client’s right fit, Romanelli says she isn’t offended—that it only makes her job more meaningful if people feel connected to her and empowered enough to say when it might not be working.
If mental health were more ingrained into the primary care system, searching for a provider and getting recommendations earlier rather than later would help relieve a lot of this unnecessary stress, Zaubler says. The rise of telehealth could also fill in some of the access gap, helping people who have had to travel far or have trouble getting off work, he says. For now, it’s imperative to validate the struggle for people dealing with their mental health or who want to preventively speak with someone about their well-being and are searching for a provider, because help can make all the difference.
Accepting that you’ll have to manage your mental health struggles alone is not the answer.
“It is not just something [where] you can pull yourself up by your bootstraps,” says Zaubler. “Because it does impact quality of life. It does impact how our bodies function.”
This month, I decided to give another therapist a go with the same office I had in New York because they had a last-minute opening. Frankly, I don’t have the energy to start from scratch and plunge into a deep dive of research, phone calls, and wait lists. I am fortunate to have an option that works with my insurance, and I know it might just take time to build that comfort. I do still have that fear that something is going to change again, and I’ll be back to the drawing board.
More important, though, I know it’s not worth giving in to the frustrations of a difficult process, because mental health matters: One of the reasons I’ve been drawn to report on mental health is that it’s something people don’t always feel as if they can prioritize. And maybe normalizing helping each other search for that right fit can alleviate some of the dread from searching on our own.
