As the pandemic, housing insecurity and the high cost of living have intensified the need for mental health care on Martha’s Vineyard, a growing shortage of trained professionals to help people in crisis has exacerbated the issue. Now, Martha’s Vineyard Community Services is taking new steps to attract and keep mental health clinicians.

Over the past year, the Island Counseling Center at MVCS has hired six clinicians — but 14 others have either left or reduced their hours, leading to a waiting list of about 75 Islanders in need of mental health care, MVCS chief executive officer Beth Folcarelli and ICC medical director Charles Silberstein said this week.

“The challenges of recruiting, onboarding and sustaining employees — regardless of sector, whether it is behavioral health or education . . . have become incredibly difficult,” Ms. Folcarelli said. “It is really the most significant challenge we face . . . the timeframe it takes to bring somebody new aboard.”

ICC medical director Charles Silberstein noted that need for mental health services for children is rising critically.

Jeanna Shepard

ICC medical director Charles Silberstein noted that need for mental health services for children is rising critically.

Jeanna Shepard

More than 75 per cent of counties nationwide have shortages of mental health professionals, Dr. Silberstein said.

At the same time, the need may never have been greater for Islanders, many of whom already were dealing with seasonal income slumps, uncertain housing and rising living costs when the pandemic thoroughly disrupted their lives. ICC provides outpatient mental health care to Islanders regardless of their insurance status.

“People are really hurting,” Ms. Folcarelli said. “There are a lot of sort of unexpected consequences to Covid that people are feeling now.”

The need is particularly great among children, Dr. Silberstein said.

“We’re really in a crisis in child psychiatry,” he said.

To attract more job candidates, MVCS is raising full-time salaries by at least $10,000 by this December, Ms. Folcarelli said. Working at the counseling center will still be less lucrative than private practice, Dr. Silberstein said, but there are some non-monetary advantages to being part of a clinical team that serves the most vulnerable Islanders.

“It is very emotionally rewarding,” he said. “It’s certainly what drew me here.”

Also, Dr. Silberstein said, “We’re tribal animals. The sense of losing that tribe in the setting of the pandemic [has made us] more and more aware of how much we need each other for our mental health.”

Most important, the team approach helps Islanders with multiple diagnoses and other complex concerns, Dr. Silberstein said.

“We see many people who can’t afford private treatment elsewhere, and they’re people who often have housing problems and substance abuse problems and issues of domestic violence and have traumatic histories, and what a community mental health center can offer that is hard to offer in private practice is a team,” he said. “So in many ways, people with those kinds of problems get much more comprehensive help in our setting than they would in a private process.”

To address the shortage in children’s services, the counseling center is now rebuilding its children’s behavioral health program, which went unstaffed for more than two years until psychiatric nurse practitioner Beth Muller was hired this month to work with younger clients. “She has decades of experience” working with children and adolescents at Yale, Dr. Silberstein said. “We’ll be able to offer a kind of service that is desperately needed on Martha’s Vineyard.”

Ms. Muller will work 20 hours a week, Ms. Folcarelli said, up from the 16 hours a month of child mental health care that was available before the pandemic

Other new hires at the counseling center include Jennifer Hawker, M.D., formerly of Mass General Brigham.

“She is a really smart psychiatrist,” Dr. Silberstein said. “I am just thrilled that she’s joining the medical staff.”

From closer to home, Island therapists Molly Purves and Gabrielle Chudnow have recently been licensed as mental health counselors, while former ICC staffers are being invited to consider returning to help the center get through the staffing crunch.

Numerous private therapists on the Vineyard have worked in training at the counseling center, Ms. Folcarelli said, and would be welcome back on even the most part-time basis.

“We supported many clinicians to their licensure,” she said.“Having some involvement with the private clinical community would help us stabilize while we [continue to hire].”

Stability for the counseling center means a core of staff — a backbone, in Ms. Folcarelli’s words — that can provide continuity in the center’s services.

“The work is not disrupted because somebody left the fold,” she said. “It continues on the backbone of the team.”

Whether seeing a handful of clients or coaching other therapists a few hours a week, working with the center can also be a benefit for the solo clinicians, Dr. Silberstein said.

“It gets lonely being a private practitioner out in the community,” he said. “There are fewer opportunities to learn and no opportunities to teach … I think it really enhances the team when we have people at all levels training.”

To further bolster its staff while hiring continues, MVCS has taken a three-year lease on a West Tisbury house where up to five master’s-level clinicians can live affordably while working in rotation at the counseling center and pursuing their licenses.

Three people are already booked for the house, which got a start-up boost from the Martha’s Vineyard Hospital and the West Chop Community Foundation, Ms. Folcarelli said.

“That provided us some initial funding to get the property ready and to pay on the lease when we didn’t have anybody occupying the rooms,” she said. “Eventually the housing will be supported by the rents.”

While acknowledging the challenges of hiring and retaining mental health staff on the Vineyard, both Dr. Silberstein and Ms. Folcarelli were upbeat about the counseling center’s future.

“We can be seen as a center of excellence, not as a center of last resort,” the doctor said.

“It’s very likely we will emerge better, because of the lessons learned on how essential our partnerships are,” said Ms. Folcarelli, noting collaborative efforts with both the hospital and the school system over the past two years.

“It’s a team across sectors as well, so we can support each other,” she said. “I’m very optimistic that we will emerge stronger, not weaker.”