Addressing the growing mental health workforce crisis: U of A Department of Psychiatry chairs advocate for action

Jordan Karp, MD, chair of the Department of Psychiatry at the College of Medicine – Tucson, and Ayman Fanous, MD, chair of the Department of Psychiatry at the College of Medicine – Phoenix, met with members of Congress and their staffers on Sept. 10, 2024, to discuss the profound current and upcoming disparities in mental health care and available providers. Their advocacy underscored the urgency of the situation and the need for immediate, substantial action to address this mental health care workforce crisis.

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They shared data from the Health Resources and Services Administration, which estimates that by 2025, there will be a shortage of over 250,000 mental health care professionals, including psychiatrists, mental health and substance abuse social workers, clinical and school psychologists and school counselors.

“The gap between need and access is especially pronounced in psychiatry, with more than half of U.S. counties lacking a single psychiatrist,” said Karp. “Projections show the nation will have a shortfall of between 14,280 and 31,109 psychiatrists by next year. 

“Additionally, more than 60% of active psychiatrists in the U.S. are older than 55,” said Fanous. “Over the next decade, without increasing the workforce, attrition from retiring psychiatrists will outpace newly graduated residents entering the field.”

While Congress has recently made important incremental progress addressing these shortfalls, the fact remains that fewer than half the individuals in the U.S. with mental health or substance use disorders are currently receiving treatment. This shortage and inequitable distribution of psychiatric and other high-need specialties limits patients’ access to cost effective, preventive care, and it will become more acute in the coming years if no action is taken – straining our health care system even further.

Solutions for our communities

Fortunately, there are several legislative acts in the works that could help alleviate this crisis. One of the most promising is the Resident Physician Shortage Act of 2023 (H.R. 2389/S. 1302), which proposes raising the number of Medicare-supported graduate medical education positions by 2,000 per year for seven years. This bill focuses on areas most affected by the mental health provider shortage, including rural regions and health professional shortage areas, as well as hospitals in states with new medical schools, such as Arizona. 

Karp and Fanous emphasized that this act would be a significant step in closing the gap between the growing need for psychiatric care and the availability of trained providers.

Another key act discussed was the Resident Education Deferred Interest Act (H.R. 1202/S. 704), which would allow medical residents to qualify for interest-free deferment on their student loans while completing their residency programs. This financial relief is crucial in encouraging more medical students to pursue careers in psychiatry, thus helping to expand the workforce.

Additionally, the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4942/S. 665) – which extends and expands a program allowing states to request J-1 visa waivers for foreign physicians – is essential to fill gaps in underserved areas. By increasing the number of available waivers and ensuring that states with high demand can access more physicians, this program plays a critical role in ensuring that rural and underserved communities can receive timely, effective mental health care.

Making the case to lawmakers

Karp and Fanous shared compelling cases and detailed to members of Congress the urgency of supporting these legislative initiatives. By passing the Resident Physician Shortage Act, the REDI Act, and the Conrad State 30 and Physician Access Reauthorization Act, lawmakers can make a significant impact in addressing the mental health crisis. Increasing the number of available psychiatric professionals will lead to better health outcomes for constituents across the country, particularly those in areas currently underserved by the mental health system.

Furthermore, both chairs stressed the importance of robust federal research funding. The National Institutes of Health plays a vital role in advancing research, diagnostics and treatments for mental health conditions. Continued investment in NIH programs, including the National Institute of Mental Health, is essential for improving the precision and effectiveness of care.

Karp and Fanous left Capitol Hill with the hope that their advocacy will help spur immediate action. As the mental health workforce shortage threatens to worsen, the time to act is now. Supporting these key legislative measures can ensure that our communities receive the care they deserve, and that there is a workforce prepared to meet the growing demand for mental health services in the coming years.