Category: Opinion

The Looming Shortage of Texas Psychiatrists

The demand for mental health services grows daily; it’s estimated that nearly one in five Americans suffer from a form of mental illness, of which only 41 percent receive the necessary treatment.  And while many factors contribute to this lack of care, perhaps the most significant culprit is the drought of qualified physicians. 

Texas’ Health Professional Shortage Areas

Hundreds of counties across the U.S. are absent psychiatric professionals, with Texas leading the pack.  A 2015 study by the North Texas Regional Extension Center found that 185 of Texas’ 254 counties did not house a general psychiatrist.  Texas, generally, is ripe with Health Professional Shortage Areas (HPSAs).  A 2018 review by the Henry J. Kaiser Family Foundation placed Texas right behind California in number of mental health care HPSAs: 430 areas with a combined population of over 12 million people whose needs go unmet, dependent upon an influx of almost 600 practitioners in order to satiate demand.

The Physicians’ Struggle

Medical professionals are concerned.  Joseph Parks, M.D., of the National Council for Behavioral Health, was quoted in 2017 as having said:

“Two-thirds of primary care physicians report that they have trouble getting psychiatric services for their patients. So, they go to the emergency room. There has been a 42% increase in the number of patients going to the emergency room for psychiatric services in the past three years, but most of them are not staffed with psychiatrists … people end up stuck in emergency rooms for hours and at times days … finally, they try to get into an inpatient psychiatric bed, but hospitals have been closing their psychiatric units because they can’t find psychiatrists to hire and staff to run them. It is truly becoming a crisis.”

Psychiatry Careers Are Dwindling

This division of care will continue to grow.  Merrit Hawkins’ 2017 Review of Physician and Advanced Practitioner Recruiting Incentives notes that of the approximately 30,000 active psychiatrists in the U.S., 60% are fifty-five years of age or older, and “set to retire soon”.  New American Economy’s The Silent Shortage: How Immigration Can Help Address the Large and Growing Psychiatrist Shortage in the United States (2017) emphasizes that “just 4 percent of medical students decide to practice psychiatry each year … the number of psychiatrists has only increased by 12 percent since 1995, not enough to keep up with the growing U.S. population.” 

Texas’ own Department of State Health Services announced in its Texas Projections of Supply and Demand for Primary Care Physicians and Psychiatrists, 2017 – 2030 (July, 2018) that each of Texas’ eight primary regions, already experiencing shortage, will not produce enough psychiatrists to meet the scaling population demand by 2030. 

Solutions

What can be done?  One recommendation, as outlined by the Association of American Medical Colleges in Physician Supply and Demand Through 2030: Key Findings (April, 2018), is a multi-faceted approach, of which “innovative delivery” and broadened applications of technology are pillars.  Perhaps now more than ever, clinicians, schools, and other medical service providers should look towards telemedicine for solutions.  As medical schools and state/federal governments work from within to better incentivize psychiatric residencies, providers at the ground level should use the tools currently available to them.  In doing so, those seeking care can receive care.