Worldwide Psychiatrist Shortage A Pressing Issue

By Keri Blakinger 04/30/18

One expert says the growing number of Baby Boomers is driving the shortage of psychiatrists.

psychiatrist talking to patient

A widespread shortage of psychiatrists could be making it harder for would-be patients to receive mental health care, experts say. 

“There is a worldwide shortage of consultant psychiatrists,” Jim Daly, the Irish Minister of State for Mental Health, told the Irish Times last week. 

It’s not just a problem across the pond, though; experts stateside have been sounding off on the issue, too.

Seventy-seven percent of U.S. counties are currently seeing a serious psychiatrist shortage, according to a Merrit Hawkins report released in recent months.

“It is one of the areas where we are most at risk,” said Dr. Nathaniel Clark, who oversees behavioral health care at Vanderbilt Psychiatric Hospital. 

That’s because only 3 to 5 percent of med-school graduates end up going into psychiatry—and it’s an aging workforce.

There are more than 28,000 psychiatrists nationwide, but three out of five are over 55, according to American Psychiatrist Association figures. “Psychiatry is one of the sub-specialties with one of the oldest groups of physicians currently in practice,” Clark said.

And while doctors are beginning to age out of the workforce, Baby Boomers are ramping up their medical needs.

"The thing that's really driving the shortage is the baby boom," Association of American Medical Colleges president Dr. Darrell Kirch told WBUR earlier this year. "Every day we have 10,000 baby boomers turning 65. The population is growing, but this segment of the population growing the most are those over 65, and they have the highest health care needs and that includes mental disorders."

The problem isn’t distributed evenly, however. While there are more than 4,500 psychiatrists in California, only 32 are practicing in Wyoming, according to the Merritt Hawkins report. 

"The people who are affected first are those who are typically underserved: people who live in more remote rural areas, people in some less advantaged urban areas, people who lack health insurance," Kirch said.

There are a number of factors that could be feeding into the widespread shortage of mental health providers, experts say. 

For one, there are simply more people seeking treatment. Aside from the growing needs of the Baby Boomers, there’s a growing awareness of the need for mental health care, according to the Association of American Medical Colleges. 

And, mental health providers are typically reimbursed less than other health providers and see care spread out over a longer timeframe. 

“While other medical specialties such as cardiology and orthopedic surgery offer healthcare providers profit center-based care where patient illnesses can be treated with medical procedures or tangible interventional care, mental health coverage often requires long-term management without a defined ‘cure’ that often is not profitable,” the Merritt report notes. 

“Thus, mental healthcare is not as desirable a service line for many hospitals and other providers as are other specialties.”

Psychiatrists also work in a field still plagued by negative perceptions. “Stigma and misunderstanding of mental illness have led to insufficient attention to this issue,” said Dr. Anna Ratzliff of University of Washington School of Medicine.

Clark pointed to the depiction of psychiatrists in the classic film One Flew Over the Cuckoo’s Nest as particularly stigmatizing. 

"The film depicted psychiatry itself as being oppressive and totalitarian, not really valuing what the patient had to say,” he told WKRN. “That’s an image that has persisted for many years in the popular media.”

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Keri Blakinger is a former drug user and current reporter living in Texas. She covers breaking news for the Houston Chronicle and previously worked for the New York Daily News and the Ithaca Times. She has written about drugs and criminal justice for the Washington Post, Salon, Quartz and more. She loves dogs and is not impressed by rodeo food. Find Keri on LinkedIn and Twitter.