Burn Out: ” Working In Mental Health Is Making Me Mentally Ill”


I wish the author of this recent email that I received could have spoken at the White House summit held a few weeks ago or be heard by Rep. Tim Murphy’s House subcommittee investigating our mental health care system. Sadly, I get a lot of emails like this from dedicating and caring workers who simply get burned out.

Hi Mr. Earley.

I’m a family therapist in [deleted for privacy] having recently graduated from [a prestigious school]  I interned at a federal correction facility in its mental health unit and I currently work in a psychiatric residential treatment facility for children ages 6-12 who’ve been through complex trauma.

I’m beyond disgusted with our system.

I’ll be honest — the mental health treatment was better in the federal prison where I have worked than what I’ve witnessed in our community mental health system.

My agency recently hired new leadership. Our manager has  been onboard for more than a month but has not met any of our clients. It’s extremely sad, but again, based on my observations, people with mental illness are being warehoused.

As a fairly new clinician in the field, I can tell you that many mental health agencies do not offer any orientation or training to assist one in doing their job. I have to put my therapy notes in Microsoft Word because there isn’t a documentation system. I want to leave working in mental health because I live paycheck to paycheck, have to pay for clinical supervision out of my own pocket (the licensing boards are surreal), do not and have not received any training in how to implement therapy with any job I’ve had, and am emotionally spent because of these reasons.

The main reason I believe I’m burnt out is because I deal with children who dissociate from their flashbacks, become violent, and I can’t help them!

It’s not the clients, it’s the system that’s draining me!

My Master’s Degree taught theory and the professors claimed we’d learn how to implement therapy once on the job. I’ve worked for a couple of other agencies aside from my current one, and NONE of them trained me in anything. I was dropped into crisis after crisis and told to fix the problem. I’m at a point where I believe therapy is false and I feel like a phony telling people I provide therapy because I couldn’t even tell you what the hell therapy is!

And there’s nowhere for people to go.

My facility serves children from two states because there aren’t any places near their homes to send these children. I even had an inmate admit to me when I was working in a federal prison that he purposely committed a federal crime to be sent back to our mental health unit because the mental health care was better there than what he could get in the community.

I read your book Crazy while I was in graduate school, and have reread bits and pieces throughout my short career in mental health. It’s revolting that we can’t get people the treatment they need and deserve, and it’s absolutely disgraceful that those who work in mental health and do care to help are not trained to help.

I apologize for this extremely long vent session. I’m sure it’s things you already know plenty about. Working in mental health is making me mental ill. I’m emotionally, physically, and financially strained. I feel as though my education was a waste and that I’ve embarked on a career that made false promises to me and has me making false promises to others. I’m living out my pet peeve. I have no idea what to do; I want to escape and wish there was a way out of this twisted system.

Sign me Disgusted and Frustrated!

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.


  1. lpogliano says

    UGH. much thanks to this mental health worker for TELLING THE TRUTH about community mental health care systems. be careful who you take your child to for ‘therapy.’ question their credentials, their methods, their therapies, and their treatment goals. insist on specifics and being part of the plan. and for god’s sake, hire a good lawyer.

  2. Wow. Of all the issues, I find treatment to be the most confusing. I think that is because my loved one has no insight and therefore gets no treatment. To me it feels like treatment doesn’t exist. But I hear it works. This letter from someone on the other side of the treatment system makes me wonder if I am right. Maybe some just get better mostly by their own self determination. If that is true why fool ourselves?

  3. Bonnie Rice says

    Does learning theory really prepare one for the realities of mental illness?I wasn’t aware that therapists don’t always get practical training. That is scary.

  4. Children aged 6-12 should NEVER be in an institution.

    The notion that mental illness kicks in before age 12 is crazy!

    There is plenty of parental abuse and neglect and loads of everyday societal ills that can impact sensitive children and send them on the path to full blown mental illness in their teen and adult years.

    The issue is PREVENTION – home visite by experts in MH if our colleges are turning out any -, re-dedication to sound moral values, and education for parents, children and the largely ignorant society we currently endorse. Unless those children are severely developmentally disabled, they have no business being housed in some lame treatment center.

    Yes, the self-determined have a better chance with or without any treatment. A highly intelligent mind can and will cure itself. Its funny how elementary the notion that the human organism has capacities to heal itself. A simple cut will close up and scab over and disappear without our ever willing it! And so with the broken or mentally ill human mind. A lot of money and careers are made keeping the mentally ill and their families believing that wellness is not an option and means expensive drugs and treatments. Perhaps if the more seriously non-intuitive mentally ill got more nurturing and viable medical attention, instead of stigma and revulsion, our prisons and homeless shelters could go out of business!

    As for burn out – just get out. The last thing that the suffering mentally ill, and god-help-us, the children we’ve thrown away like used commodities, need is caregivers and treatment workers inept, and focused on themselves. Healing is an art form that is a natural gift and a way of life. You either have it or you don’t. To get into the health field for any other reason than the joy of facillitaing wellness, is wrong.
    To help, the mentally ill, you must walk and go where they are and sometimes join them in their suffering. And advocate – as in introducing them to the director. To do nothing to right wrongs in a residential treatment center is to perpetuate the wrongs yourself.
    Self-sacrifice is a term that the medical community needs to re-discover now that medicine is big ugly business.

    • Please do a little research before making sweeping generalizations about children under the age of 12 not being in an institution. We adopted our 2 sons soon after birth. I quit my job to stay at home with them. They both have a history of mental illness and addictions in their birth families. Our older son, in first grade, was having visual, aural, and active hallucinations. He would curl up in a fetal position asking us to let him die in peace. He would bounce the furniture and make whooping sounds like a siren when manic and tear all over the house. He was not abused in any way. Several doctors wanted us to hospitalize him when this started, but we couldn’t do it, he was so young. But, later, in 5th grade, we had to. I could not keep him safe. Do you know how it feels to be a mom who knows she cannot keep her 5th grader from killing himself? I doubt it. So, he was hospitalized, and then in residential treatment near our home (which we were fortunate to have), for about 7 weeks. He received excellent care and was stabilized. He is now about to enter 10th grade and he hasn’t had to be hospitalized since, but we would if it were necessary to keep him safe. So, please, refrain from your absolute statements.

      • I agree with Beth. If you don’t know, don’t make statement that HURT loved ones and more importantly those in need. ‘what we need’ is really stories, real places. Are you high? ‘A highly intelligent mind can and will cure itself.’ There is currently NO CURE! I’ve stopped crying for tonight – tomorrow I fight.

        I’m sorry, truly sorry for all well intended people who stick their necks out to get chopped off by people who know! The whole walk a mile in my shoes…

      • Please accept my apologies – I noted in extreme cases where children are severely developmentally disabled, and I almost typed in and rare cases of severe MI, there should be alternate living arrangements available for safety and treatment. Unfortunately, removing a child from home when not neccessary is overdone and harmful.

        You are an exception as you adopted children with full knowledge of the good possibility of providing them excellent mental health care. You should be commended, as many who adopt are very careful to scrutinize and steer clear of children whose parents have inheritable conditions.

        So, bless you, and I am so glad you chose them. I am the child of old-world parents who had no problem sending me to an institution for 6 years of my childhood for what is now a treatable mental illness where children rarely are locked behind bars.

        I appreciate you helping me to keep my learned bias in check. – Marabe

        • Marabe, Your response and my reaction reflect our own experiences. My heart hurts for your stolen childhood. I think most of the conflicts within the community of those with mental illness and caretakers (I am in both camps, by the way), would be ironed out if we listened to each other’s experiences and honored where we are all are coming from. As my husband says, we all have so much to gain if we all work together to achieve our common goals, particularly a better system of care for those with mental illness.

  5. I have tears running down my face. I miss my son. It’s such a long story that I’ll write more later. I LOVE YOUR BOOK! My husband and I adopted our son when he was 22. I met him when he was 15.5 yrs old and in foster care, I volunteered to be his advocate. Later and I knew something wasn’t right – he was diagnosed with Bi-Polar and Sycnoaffective and many (two-three-four) drug addictions. His younger life was cruel and now this mental illness is cruel. Still, My GOODNESS, I feel in love with the young kid who would make me laugh, tell me that if he wasn’t in foster care how could he have met me, and despite his unwillingness to take prescribed medicine – we all did “cheers” e.g. take our medicine together. He has a small trust, the Public Guardian failed to ask if he was his own payee (he is not) and allowed him to move into his own apartment – no supervision. It was not soon that he was drinking, then pot, now meth., and I don’t know what else he is doing! I know of NAMI, have called CIT 3’x. No-one wants to deal with him.
    I’m glad you wrote this book, your son was correct to say YES do if it will help others. It is helping me stay steady. I miss my little boy, I miss my young man, I miss his wit, his ability to perceive what I can not and articulate it. So is it silly that he asked to hold my hand for 3 minutes in court last week – NO, is it horrible that I have too celebrated his birthday and mine in locked pysch. facilities and begged for a basketball, I’m 5’2″ he’s 5’11” and in a caged in cement room throw the ball threw the hoop?
    Tahoe, Hawaii, Rooms where people walk around in circles and take their clothes off and scream, and piss on the floor. How will he ever get well? And I get so angry when people say to me let go – I can’t, how can I? How can I? I love him and I care about him, with tears rolling down my face.
    Thank you thank you thank you!

  6. Terri Wasilenko says

    Helping children and teens with emotional disturbances is a slow process not something that can be solved in limited number of therapy sessions. The individual writing this letter points out his/her disillusionment with the mental health system. The next step is to advocate for change, be a catalyst. I hope he/she can find the personal strength needed to speak up at work and not give up. It sounds like he/she puts a mental health bandaid on clients and sends them on their way. My family experienced the bandaid and no solution or direction to go in with our teenager 15 years ago. It is a system failure but without therapists and family members advocating for change the disservice will continue. Thanks for posting the letter, Pete.

  7. I wish I could talk to this person. He or she is definitely not alone. I am a MH professional and I can relate to feeling disgusted and frustrated with the system even though my problems were somewhat different from what this person had to face. I am sure there are many others who feel the same way and if we could form our support network it’d be very helpful to all of us and would enable us to make a difference.

  8. Freida Potter says

    Consider moving to Canada — my baby sis was born in Toronto and Sick Kids Hospital’s psych unit saved her life! She was diagnosed with anorexia and a panic disorder at 11. She was hospitalized six or seven times by the time she graduated high school (longest was 8 wks; average closer to 4 wks). Her doctors made house calls when she was too spooked to go to clinic and let her stay on as a patient til she was 21 (so she didnt have to find all new doctors when she went to college). The doctors and therapists at Sick Kids rock!!

    K is now 26 and a social worker — she still takes meds for her panic disorder but is otherwise a happy, healthy girl! Appropriate intervention saved her life — I cannot imagine where she’d be today if she had not received treatment when she needed it!!