The U.S. is reportedly experiencing a significant shortage of mental health professionals, affecting over 150 million people in shortage areas, and projected to worsen. The shortage severely limits access to care, particularly in rural and low-income communities, where Medicaid recipients face challenges finding providers that accept their insurance. They are also likely dealing with unrecognized trauma, which the industry’s standard treatments fail to address.
Additionally, mental health workers are adversely affected, with a CDC report indicating that those in settings with staffing shortages are more likely to experience anxiety and burnout. The COVID-19 pandemic has further exacerbated this crisis by increasing both the number and severity of mental health cases, straining the already overwhelmed mental health care system.
There is a widespread consensus among stakeholders that increasing the number of mental health workers is essential for improving access to care and addressing the rising prevalence of mental health issues. Stakeholders, the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA), professional associations such as the American Psychiatric Association (APA) and the American Psychological Association (APA), and researchers and academics in public health call for more mental health workers. This includes government officials and agencies, who advocate for policies and funding to train and recruit more mental health professionals.
These calls for increasing the number of mental health professionals to focus on the quantity of workers needed to meet “demand” without addressing the underlying systemic issues within the mental health care system. This approach tends to emphasize hiring more therapists and practitioners while continuing existing practices and treatment models, such as symptom management and reliance on medication.
Simply adding more workers will not resolve the deeper problems, such as inadequate training, a lack of focus on relational and environmental factors affecting mental health, and the ongoing industry-generated stigma surrounding what it calls mental illness.
A more effective alternative to simply increasing the number of therapists is transforming the entire mental illness industry through an Interpersonal Neurobiology (IPNB) lens. This would involve shifting the focus from mere symptom management and standardized treatments to a more nuanced, person-centered approach that takes into account the neurobiological, relational, and environmental factors shaping an individual’s well-being.
The current model largely isolates mental health from the body, the environment, and the social context in which people live. It also tends to over-rely on diagnostic categories, medications, and talk therapy, assuming that more treatment automatically equals better care. However, mental health cannot be reduced to diagnoses and standardized protocols. Instead, it must be understood as an intricate interplay between the nervous system, social relationships, and broader systemic forces.
In an IPNB-informed approach, the focus shifts to restoring regulation within the nervous system by fostering safety and connection, which are key components of health and healing. Rather than simply assigning more therapists, the system would first recognize that distress often arises from disrupted nervous system functioning due to chronic stress, trauma, and lack of relational safety. Care would begin by creating environments that promote co-regulation and social support, recognizing that the nervous system thrives in conditions of safety, both internally and externally.
This model also rejects the idea that individual suffering is simply a result of “bad thinking” or “chemical imbalances.” Instead, it views the body as a dynamic, adaptive system that responds to its environment. Trauma, chronic stress, and adverse social conditions can all contribute to the body’s inability to regulate itself, leading to emotional, cognitive, and physical dysregulation. The goal of care, then, would be to restore the nervous system’s capacity for self-regulation through interventions that address both the physiological and relational aspects of distress.
For example, rather than offering endless Cognitive-Behavioral Therapy (CBT) or psychotropic medications as a first line of treatment, care would be personalized to meet the neurobiological needs of the patient. This could involve modalities such as somatic therapies, neurofeedback, relational and community-based support, and other interventions that directly engage the nervous system’s capacity for healing. The emphasis would be on helping individuals feel safe in their bodies and environments rather than simply treating symptoms in isolation.
Additionally, the healthcare system needs to create community-based care networks that provide ongoing relational support. Mental health professionals would be trained in trauma-informed practices and equipped to understand the nervous system’s response to adversity. Rather than rushing patients through 50-minute sessions, care providers would work collaboratively with individuals to understand their unique needs and histories, offering long-term support for nervous system recovery.
In this model, the social and environmental context would also be acknowledged as central to mental health. Factors such as poverty, discrimination, lack of access to basic resources, and toxic stress would be seen as critical contributors to mental health challenges. Solutions would not rely solely on individual therapy but would also focus on addressing these broader systemic issues through advocacy and community-building efforts.
The key to a transformed mental health system lies in moving away from reactive, short-term interventions and toward a comprehensive, proactive approach that fosters resilience and regulation across both individual and community levels. Healing would no longer be about simply “fixing” the person but about co-creating environments that support the body’s natural capacity for self-regulation, connection, and recovery from trauma.
This post includes content generated by ChatGPT, a language model developed by OpenAI. The AI-generated content has been reviewed and edited for accuracy and relevance.
