Why Are So Many Therapists Quitting? Inside the Crisis of Burnout, Compassion Fatigue, and the Mental Health Workforce Exodus
The mental health field is facing a quiet crisis: therapists are burning out and leaving in record numbers. This article explores why-and what's at stake if they don't stay.
In the quiet corners of telehealth booths, suburban offices, and repurposed Zoom calls from spare bedrooms, something is breaking-but it isn't always obvious. Therapists, once seen as the emotional first responders of our society, are slipping away from the very frontlines they helped build.
They're not staging dramatic walkouts (though some are). Many are doing something subtler: turning down new clients. Reducing hours. Logging off for good.
In the past two years alone, the mental health field has watched a troubling pattern emerge: a mass exodus of licensed professionals who, after weathering a pandemic-induced tidal wave of need, are burning out at alarming rates. And unlike past waves of attrition, this one isn't just about overwork or underpay-it's about a deep, existential fatigue.
A recent survey by the American Psychological Association found that 46% of therapists say they can no longer keep up with patient demand. Meanwhile, therapist waitlists stretch into the hundreds in some regions. The shortage is so severe that clients in crisis are being turned away-not because help isn't needed, but because there's simply no one left to provide it.
This isn't just a problem of individual burnout. It's a signal that the scaffolding of our mental health system is straining under pressure it was never designed to carry. As we ask therapists to help us make sense of a world in chaos, fewer and fewer of them are able-or willing-to stay.
Matt Hussey
So, what's driving this wave of exits? Why are the very people trained to manage emotional overload walking away from the work? And what happens to a society when its therapists are the ones in need of healing?
That’s what this week’s Brink is going to try and find out.
A Mental Health System Under Siege
If the pandemic was an earthquake, the aftershocks are still rippling through the mental health landscape. What began as a public health emergency quickly mutated into a mental health reckoning. Isolation, grief, job insecurity, political unrest-it all collided in a perfect storm. And the result? A generation cracked open, seeking help all at once.
According to the National Center for Health Statistics, the percentage of adults reporting symptoms of anxiety or depression has remained significantly elevated since 2020, with some months seeing more than 40% of adults affected. Emergency room visits for mental health crises among adolescents surged during the same period, especially among girls, according to a report from the CDC.
The demand for therapy hasn't just increased, it's exploded. SimplePractice, a company that builds business software for therapists, found that nearly half (46%) of therapists say they're unable to keep up with the flood of new clients. Meanwhile, Psychology Today reports that many therapists are booking out weeks or even months in advance, forcing potential clients to wait or seek care elsewhere, if at all.
Matt Hussey
Ironically, the very progress we've made in destigmatizing mental health has contributed to this bottleneck. As more people feel empowered to ask for help, the system's underlying fragilities are being exposed. It's a cruel paradox: we've normalized the need for therapy just in time to realize there aren't enough therapists to go around.
And it's not just about volume, it's about complexity. Therapists today aren't simply helping clients navigate typical life stressors. They're holding space for climate anxiety, racial trauma, political division, mass shootings, and a collective sense of precarity that's difficult to even name. This isn't a wave, it's a tsunami. And the mental health workforce is drowning.
Burnout by the Numbers
In clinical terms, burnout is more than just "being tired." It's a triad of symptoms: emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. And among mental health professionals, it's becoming a defining feature of the job.
A 2023 survey found that 52% of therapists reported experiencing burnout within the past year. Among social workers, that number jumps even higher: 63% report symptoms of burnout, according to the National Association of Social Workers.
Burnout isn't just about fatigue, it's about disconnection. Therapists describe feeling numb during sessions, struggling to maintain empathy, and losing the emotional resonance that once grounded their work. Nightmares, irritability, and intrusive thoughts are common, especially for those working with trauma.
Matt Hussey
This emotional dislocation is compounded by professional instability. Turnover among mental health clinicians hovers around 33% annually, according to the National Council for Mental Wellbeing. That figure is staggering when compared to other healthcare fields. For instance, primary care physicians have an average annual turnover rate of just 7.1%, per data published in JAMA Health Forum.
When burnout becomes chronic, it stops being a workplace issue and starts becoming a safety concern: both for clinicians and for the clients they serve. As therapists disengage, the quality of care declines. And in a field where trust is the treatment, that erosion can be devastating.
The Emotional Labor Nobody Sees
There's a silent weight therapists carry that doesn't show up in job descriptions or productivity metrics. It's the emotional labour of being a professional container for other people's pain.
Therapists spend hours each day absorbing stories of grief, violence, addiction, abuse, and trauma-without flinching, without judging, and without breaking. This isn't just about listening; it's about holding. Holding the space, the emotion, the aftermath. Over time, that labor accumulates. It's called compassion fatigue, and it's the occupational hazard nobody talks about until it's too late.
Defined by the American Institute of Stress, compassion fatigue is a form of secondary traumatic stress that can mimic symptoms of PTSD. It's what happens when caring becomes corrosive-when repeated exposure to others' suffering begins to erode a person's own sense of safety and wellbeing.
Matt Hussey
"Bad sleep, nightmares about violent clients, fatigue, poor appetite and concentration... I have felt like a bunch of overcooked spaghetti, repeatedly tossed at a wall.... I am a tuning fork, finely attuned to any vibrations, any disturbances-and I have not stopped humming since 2020," Dr. Ahona Guha, clinical and forensic psychologist told the Guardian.
These are the stories that don't make it into wellness infographics or LinkedIn posts. And yet they shape the therapist's day-to-day reality.
The myth of the therapist as an infinite well of empathy only makes things worse. Many mental health professionals are reluctant to admit they're struggling, fearing judgment or loss of credibility. As a result, they isolate-ironically, while advocating connection to their clients.
In reality, therapists aren't emotional superheroes. They're human beings doing an extraordinary job under increasingly impossible conditions. And when they start to break, it's not a personal failure. It's a systemic one.
Broken Systems: Low Pay, High Pressure
For all the emotional intensity therapists manage, the financial compensation often doesn't come close to reflecting the labour involved. I’ve written about this before.
Take licensed clinical social workers: their average salary hovers around $60,000 a year in the US, and in the UK, the average is around £35,000. That's significantly less than what physical therapists earn in the US, around $100,000 annually, and in the UK, where average salaries are around £40,000. That’s despite both roles requiring training, clinical hours, and licensure.
Private practice therapists often appear more financially independent, but the reality is messier. In addition to seeing clients, they shoulder the burdens of running a small business: overhead costs, insurance billing, compliance with state licensing boards, and hours of unpaid administrative work. For many, the strain of chronic underpayment combined with bureaucratic overload becomes unsustainable.
Matt Hussey
Even those employed by large healthcare systems aren't spared. The 2022 Kaiser Permanente mental health strike, where over 2,000 clinicians in Northern California walked off the job, was a watershed moment. Therapists cited "impossible caseloads" and unsafe working conditions, with some reporting over 40 patients per week and waitlists stretching into months. "You cannot ethically serve clients under these conditions," one clinician told AP News.
Meanwhile, other health adjacent professions, where better pay, clearer career pathways and better protections, report turnover rates a fraction of those found in the mental health space.
These aren't isolated complaints-they're systemic design flaws. The therapeutic profession, for all its cultural importance, remains structurally undervalued and economically unsustainable for many of the people who enter it.
What Quitting Actually Looks Like
Therapist burnout doesn't always announce itself with a resignation letter. Often, it's a slow, quiet retreat-hours shaved off, client loads reduced, the inbox left unanswered just a little longer. This isn't dramatic-it's survival.
In 2022, 2,000+ mental health clinicians at Kaiser Permanente went on strike, not for higher wages, but for better staffing and manageable caseloads. Many reported being unable to ethically provide care under current conditions. "I was expected to help suicidal patients with just one session every six weeks," one clinician shared. The walkout, one of the largest of its kind, was a public flare from a profession rarely known for protest.
Matt Hussey
But most departures don't look like that. They look like therapists quietly switching to life coaching-uncertified, unregulated, and freed from insurance paperwork. They look like professionals letting their licenses lapse, or closing full practices to take salaried jobs with lighter emotional demand. They look like "quiet quitting"-not from the job entirely, but from the hardest parts of it.
This often means stopping intake for new clients, avoiding high-needs populations, or reducing session frequency. For many, it's a matter of necessity, not neglect. "You start turning people away not because you don't care, but because you do-and you have nothing left to give," wrote one clinician in a piece for Psychotherapy Networker.
The result? A field where even those who stay are pulling back, creating a ripple effect across the system. The exit may be invisible-but its consequences are anything but.
The Consequences of Therapist Attrition
When therapists leave the field-or scale back their availability-the ripple effects aren't theoretical. They show up in real lives, in real-time. The first and most obvious consequence? Waitlists ballooning into months-long delays, especially in community clinics, schools, and rural areas.
In 2023, the American Psychological Association reported that 56% of psychologists said they couldn't meet patient demand, and nearly three-quarters said they had no room for new clients. For people in crisis, that delay can mean the difference between stabilization and escalation. For marginalized communities-BIPOC, LGBTQ+, disabled, or low-income populations-the barriers are even steeper.
A Mental Health America report shows that states with the most severe provider shortages also tend to have larger populations of uninsured individuals and higher rates of youth mental illness. When providers drop out, these communities are often first to feel the gap and last to see it filled. In the UK it’s a similar picture: mental health services concentrate in wealthy areas, and deplete in poorer ones.
Matt Hussey
And here's the paradox: stigma around mental health has never been lower. More people are seeking therapy than ever before-openly, without shame. But access has become the new barrier. The cultural permission to ask for help now collides with the logistical reality that help isn't always available.
This shortage doesn't just stretch the system-it erodes trust in it. When someone finally gathers the courage to reach out, only to be told there's a three-month wait-or worse, no availability at all-that moment of vulnerability is met not with care, but with absence. It’s what I wrote about last week: in the gaps, a new type of helper emerges. One that is less-regulated, and more willing to pursue money over quality of care.
And in mental health, absence can be dangerous.
Is Help on the Way?
As therapist burnout reverberates globally, both the U.S. and the U.K. are testing responses, but their strategies reveal differing scales of ambition, investment, and urgency.
In the US:
- Tech-enabled relief: Platforms like Headway, Grow Therapy, and Alma aim to ease administrative burdens-streamlining billing, scheduling, and credentialing-so therapists can shift focus back to client care. Yet some critics argue these models mimic gig economies, potentially prioritizing profit over clinician wellbeing.
- Community models: Therapist-led co-ops and group practices are emerging as resilient alternatives, offering peer support, shared resources, and a counterweight to solitary practice burnout.
- Policy nudges: Medicare's 2024 expansion now includes counselors and therapists previously excluded-potentially widening access, especially in underserved communities.
- Professional advocacy: Organizations like Mental Health America and the National Council for Mental Wellbeing are pushing for higher reimbursement rates, loan forgiveness, and parity in insurance coverage.
Matt Hussey
In the UK:
- Big public investment: The government is pledging £680 million this year to bolster mental health access, especially via expanded talking therapies and reduced waiting times.
- Smart economic rationale: Research from Lancaster University suggests that trimming waiting times by just one month could help 300,000 people access treatment annually, saving the government about £1 billion per year in lost earnings and benefits.
- Strategic infrastructure: The UK government's 10-Year Health Plan earmarks:
- £120 million for 85 specialized mental health emergency departments (MHEDs)
- £750 million for mental health units across hospitals
- The rollout of AI-powered virtual therapy tools and enhancements to the NHS app for self-referral capabilities
- 8,500 new mental health hires, and mental health support teams in every school by 2029-30
- Tackling workforce strain:
- A striking 12% of NHS mental health staff resigned in 2021-22-17,000 people citing work-life imbalance, up from 14,000 pre-pandemic. Meanwhile, days lost due to mental health-related sickness has doubled over the past decade.
- Vacancy rates, especially among child and adolescent psychiatrists, remain alarmingly high-one in three consultant posts are unfilled in England as of late 2024. Emergency referrals have surged by over 50%. The Guardian
- Pilot programs for early intervention:
- The WorkWell initiative is funding GP offices in 15 regions to offer job coaching, social prescribing, and health support instead of just issuing "fit notes." The aim is to help up to 56,000 people by 2026 stay in or return to work-reducing both stigma and economic burden.
Matt Hussey
But across both systems, one theme is consistent: meaningful change must go beyond individual resilience. It demands systemic reform-equitable compensation, administrative support, accessible care options, and a recognition that therapist wellbeing is central to public mental health.
Who Heals the Healers?
We ask therapists to be endlessly empathetic. To sit calmly in the presence of pain. To show up, session after session, regardless of their own grief, anxiety, or exhaustion. And for a long time, many did-quietly carrying the emotional weight of a society in crisis.
But now, the cracks are visible. The exodus is real. And the question isn't just "How do we keep therapists from quitting?" it's "What does it mean to take care of the people we rely on to take care of us?"
We've normalized conversations around mental health, but we haven't extended the same compassion to the professionals at the heart of that movement. We celebrate their work, yet expect them to operate in systems that are financially unsustainable, emotionally depleting, and structurally broken.
Matt Hussey
The burnout crisis among therapists isn't a side effect of a strained healthcare system, it's a mirror. It reflects how little we invest in emotional labor, how deeply we undervalue care work, and how fragile our mental health infrastructure truly is.
And the consequences are already unfolding: Overburdened systems. Skyrocketing waitlists. Vulnerable populations left behind.
The way forward isn't simple. It requires rethinking how therapy and mental health support is funded, delivered, and integrated into broader public health efforts. It demands that we see mental health workers not as infinite wells of empathy, but as human beings with limits-deserving of rest, resources, and recognition.
If we want therapy to be there when we need it, we must fight for the conditions that allow therapists to stay. That means better pay. Less bureaucracy. More community. And above all, a cultural shift that stops romanticizing self-sacrifice and starts honoring sustainability.
Because the truth is: the people who help us heal can't do it alone. They never could.
