Supply and Demand in the Psychiatric Workforce
The Need: The United States is experiencing an alarming and well-documented disconnect between the demand for psychiatric services and the number of trained psychiatrists.
- Fifty-five percent of counties in the continental U.S. have no psychiatrists, and 77 percent have a severe shortage.
- Seventy percent of practicing psychiatrists are age 50 or older, and approaching retirement.
- Forty percent of practicing psychiatrists operate on a cash-only basis, meaning they accept no insurance.
- By 2025, the demand for psychiatry will outstrip supply by 15,600 psychiatrists, or 25 percent.
The Demand: Meanwhile, demand for mental health services is on the rise.
- Mental disorders topped the list of most costly medical conditions in the U.S. in 2013, at $201 billion.
- Estimates indicate one in four families are struggling with some aspect of mental illness.
- In hospital emergency rooms, lack of access to psychiatric care has reached crisis levels, with patients waiting an average of 23 hours for transfer to appropriate services.
The Consequences: Primary care practitioners are living with the fallout.
- An estimated 40 percent of patients seen in a primary care setting on any given day have an active psychiatric problem.
- A recent study found two-thirds of primary care clinicians reported difficulty accessing psychiatric services for their patients.
- Fewer than half of primary care patients with mental illness receive any
The Fix: Assembly Bill 1340 by Assemblymember Brian Maienschein would help ensure that the primary care providers on the frontlines of treatment recognize the signs of mental illness.
- Currently, the majority of primary care providers receive minimal training in psychiatric diagnosis and treatment as part of their medical education.
- The bill would require that the Medical Board of California consider including in its continuing medical education requirements a course on integrating mental and physical health care in primary care settings, especially as it pertains to children.
“Given the important and trusted roles that family physicians play in the healthy development of children, it is invaluable that our health care professionals have the capacity to identify and assess a wide range of mental health issues, including exposure to trauma. With the support of their family physicians, parents and caregivers can respond quickly, seeking additional services and referrals that change the lives of young people. Without this new guidance to the Board, we continue to risk that health care is delivered in disconnected segments, rather than in a coordinated and effective manner.”
Dave Neilsen, Senior Advocate, California Alliance of Child and Family Services
“Maternal mental health disorders are the most common medical problem for new mothers, and only 15 percent of women with postpartum depression receive treatment. Postpartum depression can interrupt bonding between the mother and infant, which can lead the infant to be more irritable, less active, less attentive, and to experience delays in language development. One of the solutions to addressing the problem is physicians being trained to diagnose and treat maternal mental health disorders.”
Lyn Elliott, March of Dimes Regional Director of Advocacy and Government Affairs
“Psychotic disorders like schizophrenia are associated with a high degree of disability if not treated promptly after the onset of the first symptoms. Early psychosis intervention programs have proven that they can arrest or reduce disability before it becomes pronounced. Early intervention is the difference between dropping out of the 9th grade and graduating with a shot at college.”
Randall Hagar, Director of Government Relations, California Psychiatric Association
— Compiled by the Steinberg Institute
For more information: Contact Executive Director Maggie Merritt, (916) 553-4167/maggie@steinberginstitute.org
