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.