Hilary decided to seek counseling for her deepening depression. A recovering alcoholic, she knew she needed help to stay sober and mentally reach a better place. She spent several hours online, researching and making phone calls to get an appointment with a counselor. By the end of the day, she found no one available. If she wanted to, Hilary could go on a waiting list and hopefully get an appointment…in a year or so.
Our nation is experiencing a dangerous imbalance. The National Council for Behavioral Health reports that 77 percent of counties across the country have severe shortages of behavioral health professions. Many who desperately need support are being left out in the cold. For instance, residents of Chicago who need counseling may wait a year or more before they see a specialist. A Harvard University study recently found just 17 percent of phone calls placed to get an appointment with a mental health counselor were successful.
Nationwide, we’re currently 6.4 percent short of the psychiatrists we need, and this shortage is predicted to nearly double by 2025. In 2013, the demand for behavioral health practitioners reached nearly 57,000, yet, there were less than 46,000 available. By 2025, the expected demand will top 60,000, creating a shortage of over 15,000 professionals.
The Health Resources and Services Administration reports that we “need to add 10,000 providers to each of seven separate mental healthcare professions by 2025 to meet the expected growth in demand.”
Why Don’t We Have an Adequate Number of Therapists?
First up is the average age of these professionals. Many are reaching retirement age, with too few young graduates to replace them. The average age of a psychologist is late 50’s; a psychiatrists’ average is late 60’s. In fact, the Association of American Medical Colleges reports nearly 60 percent of psychiatrists are 55 or older.
A second major cause is salary. For many, the field of mental health isn’t a lucrative one. Substance abuse counselors earn about $40,000 a year. Twenty percent in this field leave their jobs each year due to the low pay.
Psychiatry, in particular, faces unique pay challenges. Among medical specialties in Modern Healthcare’s 2016 Physician Compensation Survey, psychiatry ranked fourth lowest. Additionally, psychiatrists receive low reimbursement rates by commercial and government payers. As a result, roughly 45 percent of psychiatrists take cash-only reimbursement for services. (For comparison, just 11 percent of physicians in all other specialties are cash-only.)
Paul Gionfriddo, CEO of Mental Health America sums it up: “Despite the fact that these folks have a significant amount of professional training, the salaries don’t often track with other healthcare specialists. It’s discouraged people from entering those particular specialties.”
Where Do We Go From Here?
While the gap continues to grow, some efforts are being made for increased access to mental health professionals. The recently enacted 21st Centuries Cures Act included $12.7 million to train culturally competent mental health professionals, $15 million for the Graduate Psychology Education Program, and $10 million in grants to improve screening/treatment of behavioral health and substance use disorders and expand access in underserved communities.
Will this be enough? Probably not. Experts suggest additional steps to boost the number of professionals in this field, such as:
- Offering scholarships with loan forgiveness
- Boosting the pay
- Providing continuing education and support for counselors to keep them engaged in their field
- Revising payment models to make reimbursements easier and more common for these professionals
- Increasing access to video-based services (telepsychiatry)
It’s only after we make these efforts that Hilary – and the thousands like her across the nation – will truly be able to get the support they need.
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