American Journal of Orthopsychiatry, Vol 95(6), 2025, 599-612; doi:10.1037/ort0000813
As mental health treatment seeking has increased recently, U.S. public mental health therapists have been asked to do more with less. Facing growing work demands, many have left the workforce, exacerbating existing mental health workforce shortages and mental health inequities. However, a growing share of therapists have sought to improve their working conditions through labor organizing. This qualitative study explored how unionized public mental health therapists in New York City and Chicago experience and seek to address their workplace challenges. Participants (N = 30) were interviewed for 60–90 min to gain their in-depth perspectives; interviews were analyzed using thematic analysis. The research team identified four main themes. First, public mental health therapists described that their underresourced and diverse patients have complex social service and clinical needs—needs therapists are highly motivated to address. Second, therapists described significant workplace challenges (e.g., staffing shortages, demanding workloads, low pay, insufficient clinical support). Third, therapists described that these workplace challenges negatively impact them emotionally and negatively impact the care their underresourced patients receive. Fourth, therapists described reasons for and benefits to labor organizing including improving their work conditions and the quality of services. Findings revealed that public mental health therapists are intrinsically motivated to support their underresourced patients but that their labor conditions often hinder them from offering the high-quality care they feel their patients deserve. Public mental health therapists across both cities view labor unions as a vehicle through which they can improve their working conditions and the treatment conditions of their patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved)