The demand for behavioral health care and substance use disorder services has increased, and the factors prompting this higher demand directly impact psychiatric workforce capacity. The behavioral health workforce, and specifically the psychiatric workforce, has been unable to keep up with this increased demand due to shortage and maldistribution of professionals.
Addressing psychiatric shortage requires consideration of how the multiple professions capable of providing mental health services and elements of psychiatric care can collectively achieve sufficient workforce capacity. To better understand the distribution of the psychiatric workforce, the BHWRC researchers assessed national supply and distribution of psychiatrists, psychiatric mental health nurses, physician assistants, and board-certified psychiatric pharmacists.
The BHWRC chose to estimate the size of the psychiatric workforce through board certification counts. The American Board of Medical Specialties was selected for psychiatrists estimates, the American Nurses Credentialing Center was chosen for psychiatric nurse estimates, the American Academy of Physician Assistants was chosen for psychiatric physician assistants and the College of Psychiatric and Neurologic Pharmacists was chosen for board-certified psychiatric pharmacists. To add context to these estimates, rates of providers per 100,000 residents were calculated for each state, with state population estimates from the U.S. Census Bureau.
Reports of provider maldistribution and lack of access to psychiatric services in the United States prompted this study. In 2018, board certification data were gathered for psychiatrists, psychiatric nurse practitioners, psychiatric physician assistants, and psychiatric pharmacists. In total, 47,046 providers were identified and mapped nationwide.
Key findings include:
- Psychiatrists make up the majority of the psychiatric workforce (70.5%) and are most concentrated in the northeast United States
- Psychiatric nurse practitioners make up the next largest segment of the workforce (26.3%) and are most heavily concentrated in the Northeast and Pacific Northwest
- Psychiatric PAs make up 1.7% of the workforce, and were concentrated in the central states
- Psychiatric pharmacists make up 1.5% of the workforce and were concentrated in central and northern states
Building pipelines between residency programs and professional shortages areas, increasing federal incentives for providers to train/practice in shortage areas, and expanding state regulations to allow providers to practice to the full extent of their training could alleviate psychiatric provider maldistribution.