Why Counselors Are Quitting: Burnout, Broken Systems, and
the Mental Health Crisis Inside Federally Qualified Health Centers
Jan 20, 2026
I Quit My Job Today—And It Broke Me
I quit my job today. After everything, I finally hit my
limit. I wish I could say it was liberating. I wish I could say I felt proud.
The truth? It felt like defeat. It felt like losing a fight I’ve been in for
years—the kind of fight you take on because you believe you can make things
better, and then realize the rules were never fair to begin with.
But let’s back up. This didn’t happen out of nowhere.
The Build-Up: When “Support” Is Just a Slogan
Some days, the exhaustion isn’t just physical—it’s
emotional, bone-deep, and it follows you home.
For months, I tried to speak up. I raised concerns about moral, direction and
communication. I talked about the front desk mistakes, the burnout, the ways we
were being stretched thinner and that we seemed to have no real leadership.
Every time, the message was the same: I will let someone know… well, that
someone finally answered, and it was “It’s your job to fix it. You’re
the expert. If there’s a conflict, compromise.” They then drew a fish
skeleton on the board and talked about taco pizza.
There was no offer of support. No help. Just the sense that
we were supposed to handle it all ourselves, while the people with the power to
change things stood back and watched or told us that things don’t work that
way.
I tried to be vulnerable with my new Director of Substance
Abuse (poor thing) and the COO—who, by the way, comes from dental, not
behavioral health. Why are we working with directors and upper management with
no experience in behavioral health and SUDs?
I explained what was really happening, how it felt to see
substance use services treated as an afterthought in an organization with
dental and primary care that talks a big game about “community.” But I didn’t
feel heard. I walked away with the sinking feeling that, to them, we’re all
just replaceable. Fall in line, or move the fuck on.
The Breaking Point: Boundaries and Ultimatums
I volunteered for over a year to drive two hours out of town
so clients could see someone in person. Monthly, I showed up for a community
that had nobody else. But yesterday, after a meeting that left me sick to my
stomach, I drew a line: I told my work I would no longer make that
drive.
Why? Because after all that sacrifice, leadership stripped
away the remote days we’d fought for, told us to fix our own problems, treated
us so disrespectfully, and made it clear that our well-being was not even on
their radar. When I finally said “enough,” I was told, flat out, that if I
didn’t drive the two hours, I’d be voluntarily terminating my job. Even though
I was willing to work in my regular office. By this time, I had to ask, are you
just trying at this point to get me to cover tomorrow because it’s a shitshow
for you now? What happens on Thursday when I am back at my normal office? Then
I was told something about theft of time, and how all of a sudden there was
some type of concerns about me wasting time at work, or doing other stuff. Mind
you Before our last amazing director of substance abuse left in Oct of this
year, I had NO issues with my employment at all. Now it’s attendance, theft of
time, and no more remote days because we can’t trust any of you and there are
too many empty spots on your calendars.… blah blah blah.
So I gave my resignation right then and there. Not because I
wanted to walk away—but because I couldn’t keep betraying myself, my
boundaries, and, ultimately, my clients.
The Ugly Truth About Stress in Recovery (and the Lies We
Tell Ourselves)
There’s a myth that once you have enough time sober,
enough experience, enough credentials, you’ll be bulletproof.
That you’ll have this magical shield against burnout, guilt, or the kind of
stress that makes you question everything. It’s a lie. I’m living proof. Ten
years sober. All the letters after my name. All the “you’re so strong”
comments. And still, I found myself sitting in my car, shaking, after being
told my only choices were to burn myself out further or walk away from the
job—and the clients—I love.
The System Is Rigged Against Us
This isn’t just my story. This is the story of every
clinician, front desk worker, nurse, and case manager who’s been told their
boundaries are “inconvenient.”
Who’s been made to feel like caring too much is the real problem. Who’s been
gaslit by leadership that talks about “community” and “resilience” while
gutting every support we have.
I watched as management meetings fixated on “no-shows” and
other easy targets—complaining about chaotic schedules and empty appointment
slots—while ignoring the real reasons behind the mess. No-shows aren’t the core
problem; they’re just a symptom of a system that’s running on fumes,
chronically understaffed and under-supported. Yet every time we brought up
issues, the message from leadership was always the same: “If
something’s broken, it’s your job to fix it.”
And the silence. The way management pretends not to notice
as another good counselor packs up, as another client loses their lifeline, as
another staff member goes home sick with shame and rage because they feel
guilty for not protecting their team more.
The Human Cost: Moral Injury and Collateral Damage
What’s happening here isn’t just burnout, it’s moral
injury.
We are being forced to choose between our ethics and our survival. We’re told
to “do no harm” while working in environments that guarantee we will—because
there just aren’t enough hours, or staff, or support to do it right. We watch
clients fall through the cracks and are told to “document it and move on.” We
watch each other break, and are told to “practice self-care,” as if a bubble
bath or a gratitude journal can fix what’s being done to us.
Leaving isn’t just about saving ourselves. It’s
about refusing to be complicit in a system that chews up the people it claims
to serve, and the people who serve them.
I feel guilty for leaving my clients behind. But I also know I can’t keep
pouring from an empty cup, or keep pretending that “just trying harder” will
make a difference.
The Evidence: Broken by the Numbers
Let’s be brutally honest: the numbers back this up.
Federally Qualified Health Centers (FQHCs)—the backbone of care for
millions—are plagued by relentless turnover. In some behavioral health
settings, annual turnover rates for counselors soar as high as 35–60% (Rural
Health Info). This isn’t an accident. Federal funding, which is supposed to
guarantee care for the underserved, comes with so many strings attached that
clinics are often forced to meet impossible quotas and documentation
requirements. These federal grants—like Section 330 funding—require clinics to
serve everyone, regardless of ability to pay, and comply with a mountain of
administrative rules (Section
330 info).
What does this mean in practice? Clinicians are run
ragged, constantly asked to do more with less, and forced into
one-size-fits-all models—including, sometimes, a heavy push toward 12-step
recovery or manualized care, because that’s what the funding expects or will
reimburse (NHCHC
White Paper). While 12-step programs help many, they aren’t the answer for
everyone, and this rigidity can leave both staff and clients feeling trapped.
And when counselors burn out and leave, it’s not just a
staffing problem—it’s a care crisis. There’s a direct line between these
funding structures, the revolving door of clinicians, and the broken
relationships and missed care that follow (Commonwealth
Fund).
What Needs to Change: Stop Letting Employers Get Away
With This
We have to stop normalizing this. We have to stop pretending
that martyrdom is a job requirement. Here’s what needs to happen:
- Call
out the bullshit. Stop letting leadership hide behind “policy” or
“budget” when they’re really just choosing not to care. Make noise.
Document everything. If you’re being pushed to do harm, say so. Out loud.
In writing. To anyone who will listen.
- Demand
real support. Flexible schedules, real sick leave, mental health
care for staff. Not as perks, but as non-negotiables. Refuse to accept
“that’s just the way it is.” It doesn’t have to be.
- Insist
on ethical leadership. Leaders should know our field, value our
work, and put staff and clients over optics and profit. We need directors
who will fight for us, not just manage us.
- Unionize,
organize, mobilize. If your workplace is broken, talk to your
colleagues. Organize. Push for a seat at the table, or make your own
table. We are not powerless unless we act alone.
- Share
your story. Stop hiding your pain to protect a system that’s
hurting you. Write about it. Talk about it. Shine a light on the cracks.
- Push
for systemic change. This isn’t about one bad boss. It’s about a
healthcare system that’s been gutted by bureaucracy and profit motives,
leaving the most vulnerable to fend for themselves. We need policy,
funding, and a radical re-centering of human beings—both clients and
staff.
To My Clients: I’m Sorry, and This Is the Truth
This is where the heartbreak lives.
If you are a client reading this—if you’re one of the people who sat across
from me and trusted me with your story, your pain, your hope—I need you to hear
this: I am so, so sorry. I wanted to be the steady hand, the
safe space, the counselor who wouldn’t leave.
I know what it feels like to have people give up on you. I
know how hard it is to trust, to start over, to believe that someone will stay.
I promised myself I’d never be the one to let you down. But the truth is, this
system is built on the backs of people like me and you—people who give until
they’re empty and then are told to give more. I tried to make it work. I tried
to fight for you. But I can’t keep pretending that my boundaries don’t matter,
that my exhaustion isn’t real, that my own recovery and sanity don’t count.
Leaving doesn’t mean I don’t care. It means I care enough
not to become someone who is numb, resentful, or broken.
It means I refuse to be part of a system that sets both of us up to fail. It
means I believe you deserve a counselor who isn’t hanging on by a thread, who
isn’t being pressured to compromise their ethics or their health.
You are not the problem. The system is. And you deserve so
much more.
Ethics and Boundaries: Why We Have to Walk Away Sometimes
Ethically, I can’t stay in a job that forces me to betray
my own values.
I can’t be the person who says “just hang in there” when I know the support you
need isn’t coming. Boundaries are not abandonment—they’re survival. They are
what keep us from doing harm, to you and to ourselves.
I am so protective of you all because I know how often this
happens—how counselors leave, how care is interrupted, how you are left to pick
up the pieces. That shouldn’t be normal. That shouldn’t be okay. I hope you
know that even as I step away, I am still rooting for you. You are my
heartbreak and my hope.
A Call to Action: Let’s Stop Accepting This
If you’re a clinician, a client, a policy maker—anyone who’s
been hurt by this system—it’s time to speak up. Reach out to me. Share
your story. Let’s connect and fight for something better together.
If you’re in leadership, here’s your challenge: listen
to your staff. Value your clinicians. Put people before paperwork. Advocate for
flexibility, for real support, for funding models that don’t burn us out or
force us into one-size-fits-all care.
If you’re a client, know your worth. Demand
better—not just from your counselor, but from the system itself. You
deserve stability, safety, and care that doesn’t vanish every time the budget
shrinks.
Resources & Next Steps
References
**Reach out. Tell your story. Demand more.
This field is broken, but we don’t have to be. Together, we can start to change
it.
