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Analysis: The Current Psychiatry Shortage

The psychiatrist shortage in America is estimated by some to be as high as 40,000, more than the total number of psychiatrists currently practicing. This shortage is only increasing as a result of multiple factors. A flood of new patients are entering the insurance rolls as a result of the near universal coverage from the insurance mandate imposed by the Affordable Care Act. This event will add up to 30 million new patients overall, potentially over seven million with mental health disorders.

The aging of the Baby Boomer generation will bring with it an increase in the mental health issues typical of a geriatric population. Each day 10,000 baby boomers reach retirement age.

Whereas only 37.5 percent of physicians are 55 years old or older, 55 percent of psychiatrists are 55 or older. As a result, the current pool of psychiatrists is not being replenished as quickly as it has in the past. The number of medical students enrolling in psychiatry residency programs is decreasing, and over the past decade psychiatry residency programs have decreased. The Mayo Clinic has made news by recruiting medical students earlier in an effort to increase psychiatry residents.

By many accounts, the practice of psychiatry has shifted from a combination of medication management and psychotherapy to increasingly less and less psychotherapy. The NIMH reports that only 11 percent of psychiatrists practice psychotherapy.

On the other hand, a large percentage of psychologists and psychiatric nurse practitioners and physician assistants have the requisite training in psychopharmacology to prescribe medicine to psychiatric patients but do not have the authority from the states to do so.

While the Affordable Care Act makes incentives to increase the supply of psychiatrists, they are far too few to make a significant impact.  It will take a multi-pronged effort in both the public and private sector and at the state and national level to resolve this issue. It is yet to be seen whether we have the collective will to tackle this problem.