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DISTRESS AMONG PSYCHOLOGISTS: PREVALENCE, BARRIERS, and REMEDIES for ACCESSING MENTAL HEALTH CARE a Dissertation Presented to T DISTRESS AMONG PSYCHOLOGISTS: PREVALENCE, BARRIERS, AND REMEDIES FOR ACCESSING MENTAL HEALTH CARE A Dissertation Presented to the Faculty of Antioch University Seattle Seattle, WA In partial fulfillment of the Requirements of the Degree Doctor of Psychology By Kimberly G. Patterson-Hyatt August 2016 DISTRESS AMONG PSYCHOLOGISTS: PREVALENCE, BARRIERS, AND REMEDIES FOR ACCESSING MENTAL HEALTH CARE This dissertation, by Kimberly G. Patterson-Hyatt, has been approved by the committee members signed below who recommend that it be accepted by the faculty of the Antioch University Seattle at Seattle, WA in partial fulfillment of requirements for the degree of DOCTOR OF PSYCHOLOGY Dissertation Committee: ______________________________ Mark Russell, Ph.D., ABPP Chairperson ______________________________ Bill Heusler, Psy.D. ______________________________ Colin Ward, Ph.D. ______________________________ Date ii © Copyright by Kimberly Patterson-Hyatt, 2016 All Rights Reserved iii 1 ABSTRACT DISTRESS AMONG PSYCHOLOGISTS: PREVALENCE, BARRIERS, AND REMEDIES FOR ACCESSING MENTAL HEALTH CARE Kimberly G. Patterson-Hyatt Antioch University Seattle Seattle, WA This study completed a critical review of psychologists’ mental health by developing a conceptual analysis based on the current empirical literature of the mental health needs of clinical psychologists. Distress among psychologists was explored by examining the following domains: (a) examining the prevalence of mental illness and psychological distress that exist among them, (b) examining the barriers they encounter to seeking treatment when experiencing this distress, and (c) reviewing current interventions and integrating remedies for access to mental health care that best meets psychologists’ needs. Results included several themes within each domain shaping a contextual picture of some of the challenges faced by psychologists and gaps that need to still be further addressed. The following five themes were found within the domain of lifetime prevalence of mental illness and psychological distress among psychologists: psychiatric disorders reported reaching at approximately 81%, substance use (primarily ethanol) vacillating from 1% to 70%, psychological distress ranging from 10% to 74%, impairment varying from 4.6% to 63%, as well as burnout and compassion fatigue found stretching to 80%. There dominant barriers in place that created obstacles for psychologists to access appropriate and effective mental health services, which included: limited insight, education and prevention strategies lacking, keeping distress secretive, institutions of psychology being unsupportive to the distressed psychologists, utilizing reactive interventions versus preventative ones, lacking 2 evidence-based research on psychologists’ distress along with interventions that remediate stress, an unsupportive and avoidant culture when dealing with psychological distress, and limited psychotherapy resources. There are at least six suggestions identified for intervening with psychologists facing barriers to accessing care, which included: educating and increasing awareness, improving systemic influences, utilizing self-care, developing a culture of support, increasing empirical research, and utilizing personal therapy and treatment programs. Inconsistencies were found in the literature, which harness poor integration between prevalence, barriers, and interventions. Particular areas discussed included: empirical research, personal therapy, ranges in prevalence, shame, and self-care. Limitations of the study and areas for further research were discussed. The electronic version of this dissertation is at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu. Keywords: mental illness, psychological distress, psychologists, treatment, barriers, remedies, interventions, psychiatric disorders, substance use, burnout, compassion fatigue, systems, education, self-care, personal therapy, denial. Dedication “Healers are spiritual warriors who have found the courage to defeat the darkness of their souls. Awakening and rising from the depths of their deepest fears, like a Phoenix rising from the ashes. Reborn with wisdom and strength that creates a light that shines bright enough to help, encourage, and inspire others out of their own darkness.” (Melanie Koulouris) For the psychologists who have discovered their strength on their own path of healing and share their light with others. iv Acknowledgments To start, I would like to give special thanks to those keeping the faith in others that struggle to do so for themselves; for those that believed in me, when I did not believe in myself. I am who I am today because of you. My mentors, my teachers, my supervisors, my friends, my family, and my partner have carried me through the many peaks and valleys that have eventually led me to this point and keep my fuel running high. Special thanks, Dr. Tien and Dr. Russell, for your guidance, patience, and commitment. You have played a substantial part to my personal development and professional achievements, as well as reminding me and showing me how to stand strong in the face of difficulty. A special thanks to my teachers and committee members who remained patient and committed to my academic growth, while encouraging me to be inquisitive and critical. Thank you to my supervisors that remained dedicated, sacrificed their time, and shared their wisdom with me. My friends, family, and partner who have forced me to personally grow, reminded me of my resilience, and helped me stay grounded both outside and within my professional goals. I am grateful for you all. For better or for worse, I would have been someone doing something completely different without you, for I am merely a reflection of what you see. v Table of Contents Page Dedication .......................................................................................................................... iv Acknowledgments ................................................................................................................v List of Tables ..................................................................................................................... ix Chapter I: Introduction .........................................................................................................1 Statement of the Problem .........................................................................................1 Importance of the Study ...........................................................................................4 Method Review With Guided Theoretical Framework ...........................................6 Theoretical Framework ............................................................................................8 Purpose of the Study ................................................................................................8 Research Questions ..................................................................................................9 Chapter II: Review of the Literature ..................................................................................10 Mental Illness and Psychological Distress .............................................................10 Defining Mental Illness and Psychological Distress .................................10 Prevalence of Mental Illness and Psychological Distress ..........................16 Existing Literature on Barriers to Treatment .........................................................31 Defining Barriers to Mental Health Treatment ..........................................31 Barriers .......................................................................................................32 Preliminary Themes of the Various Forms of Barriers to Treatment for Psychologists ......................................................................................................36 Preliminary Understanding of Effective Treatment Interventions for Mental Illness and Psychological Distress: Designing the Framework ..............38 Chapter III: Methodology ..................................................................................................43 Overview of Purpose and Research Questions ......................................................43 vi Plan of Action ........................................................................................................43 Description of Materials Used ...................................................................43 Description of Methodology ......................................................................44 Limitations of Study ..................................................................................46 Ethical Considerations ...............................................................................48 Chapter IV: Results ............................................................................................................49 Combined Research on Prevalence of Mental Illness and Psychological Distress Among Clinical Psychologists ............................................................49 Theme 1: Psychiatric Disorders .................................................................49 Theme 2: Substance Use ............................................................................54 Theme 3: Psychological Distress ...............................................................58 Theme 4: Burnout and Compassion Fatigue ..............................................62
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