psychiatrist shortage

This map shows a widespread shortage of psychiatrists.

Patients nationwide are having trouble getting psychiatric treatment in a timely fashion, and severe shortages of mental health care professionals isn't the only reason, the National Council for Behavioral Health says.

In a new report drawing on numerous prior studies, the council said increasing coverage of and demand for psychiatric services "is occurring at the same time as a growing shortage of outpatient and inpatient programs," and the lack of access has created a frustrating and expensive crisis.

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The report cited research that says the nation is currently 6.4 percent short of the psychiatrists it needs, and that the shortfall is projected to grow to 12 percent by 2025.

It also cited research saying 77 percent of counties nationwide have severe shortages of behavioral health professionals.

County numbers were not included, but a map in the report showed Pennsylvania among the majority of states that had only one to 17 psychiatrists per 100,000 residents. 

Additionally, the report said, increasing numbers of psychiatrists who don't take insurance is making the problem worse.

Cash-only private practices "now make up 40 percent of the workforce, the second highest among medical specialties after dermatologists," it said, and the pool of psychiatrists working with public sector and insured populations "declined by 10 percent from 2003 to 2013."

There is no need, the council said, for more psychiatrists who don't accept insurance, refuse to take Medicaid patients, exclude patients with severe and persistent mental illness from their caseload, and do not work with other behavioral health, primary care, peer counselors and family members in integrated treatment teams.

In addition to making mental health jobs more attractive and training more people to fill them, the council suggested tackling the problem by reforming payment models, increasing emphasis on team-based care, and reducing barriers to video-based services known as telepsychiatry.