No one questioned Valladares about his drinking until he entered a master’s program in psychology at SF State when he was 23 years old. The program encourages students to see a therapist. When his therapist asked him why he drank so much, he became defensive and dismissed her concerns.
He went from only drinking with friends on the weekends to frequently drinking at home on weeknights. Then he started canceling plans because he was too hungover. As he approached his 30s, he realized he needed to change.
“I was able to shake off (my alcohol addiction) for years,” he said. “I started to get older and realized that my patterns had not only changed, they had gotten worse. The biggest part was meeting my wife. She was not okay with my lifestyle.
When he decided to seek help, his insurance company denied him coverage for therapy and suggested he try a support group. He paid out of pocket for a therapist for about two years and has been in recovery for seven years.
His graduate program opened his eyes to the undiagnosed mental health conditions he had observed in his family and how they lacked the understanding and vocabulary to talk about their problems. His mother never described herself as anxious, but often said, “I just worry a lot.”
“My mother was an anxious person and I was an anxious child, and we bonded over that,” he recalls. “Years later, alcohol helped me calm down.”
His experience overcoming substance use disorder taught him that even for someone working in the mental health field, access to care is still a challenge. It also illustrates how valuable therapy can be.
“If I hadn’t gone into mental health, I would have just accepted and assimilated that it was part of who I was,” he said. “It really makes me believe in what we’re doing. I don’t think there are enough of us. But I have great faith that there are people who still want to help.
Lack of parity
Elected officials in California also recognize that the state needs to expand its mental health workforce. One strategy is to hire more counselors and behavioral coaches—roles that require less education than psychiatrists and psychologists.
On August 18, Governor Gavin Newsom announced a plan to add 40,000 mental health professionals across the state. At least half of these positions will be primarily in schools. Newsom said the missing component to helping children is “people who are willing to do the work.” Others say the system isn’t working as it should.
The federal Mental Health Parity Act, passed in 1996, mandates that insurers’ dollar limits for mental health benefits cannot be lower than their physical health equivalents. But “that’s not in place for most insurance companies across the country,” said Naomi Allen, CEO and co-founder of Brightline, a Palo Alto-based behavioral health startup that provides virtual therapy to children.
She was so frustrated trying to find therapists for her three children using commercial insurance that she co-founded Brightline in 2019.
“What we have is a situation where year after year more and more therapists are not available through insurance. They go off the grid. They are in private practice,” Allen said. “And so we have this scenario that existed before COVID where care was essentially unaffordable for the vast majority of families.”
Patricia Alvarado is one of those practitioners. She founded her online practice, Alvarado Therapy, about five years ago and now employs a team of mostly bilingual therapists serving Latino clients.
“We are a private pay organization,” she said. “Sometimes it can be really hard to get paid (from insurance companies). It can take many months. There are a lot of limitations…like you can only work with a client for X amount of sessions and that’s it, and the client might need more.’
Some patients who have insurance end up paying out of pocket just to speed up the process of getting care.
“A lot of time goes by and that can take away the motivation to want to seek services,” Alvarado said. “It shouldn’t be as hard as it is.”
Valladares provided therapy until he burned out. He then moved on to managing programs for nonprofits like Family Connections, which work with families who don’t qualify for lower-income programs and can’t afford to pay out-of-pocket.
“As families have expressed interest in mental health services, we’ve been able to provide them with those services, which has been really great,” he said.
Switching to an administrative job helped Valladares stay in the field, make more money and have time to spend with his wife and two children, ages 5 and 1.
“I still want to be in a position where I can affect change and support families in a different way,” he said. “I make it a point to go out there and make a connection with the people that my organization serves and definitely not lose sight of why I do what I do.”
Blanca Torres reported this story while participating in the USC Annenberg Center for Health Journalism’s 2022 California Fellowship.