Shrinks Are Shrinking In Number—Some States Are In Trouble

Across the country, a shortage of mental health professionals is putting individuals with mental illness at risk. In states like Minnesota, Maryland, Wisconsin, and Montana, the drought of psychiatrists is causing real concern among patients, providers, and lawmakers.  The lack of access is so alarming in Minnesota that 37 mental health practitioners, state officials and university administrators formed a panel and produced a 226 page report to convince the state legislature that the workforce shortage is severe—so severe, in fact, that the report calls for immediate steps to encourage young people to take on psychiatry careers.


According to the report, a Mental Health Workforce Plan developed by HealthForce Minnesota and Minnesota State Colleges and Universities, in Minnesota, the situation is dire. The HHS Health Resources and Services Administration (HRSA) has declared 9 of Minnesota’s 11 geographic regions “mental health professional shortage areas.” The results are similar elsewhere, for example, the Mental Health Association of Maryland released a report, in January 2015, revealing that only 14 percent of the 1154 psychiatrists listed in 2014 Qualified Health Plans sold through the Maryland state Exchange, were accepting new patients or available for an appointment within 45 days.  Similarly, the Great Falls Tribune reported that in response to a “chronic workforce shortage” the mental health center at VA Montana in Fort Harrison would be temporarily closing.  The workforce shortage was reportedly due to recent psychiatrist resignations at VA Montana.


In Minnesota, the Mental Health Workforce Plan report includes 24 separate recommendations to assist the state with developing mental health professionals to resolve the workforce shortage there.  Among the recommendations are suggestions to:

  1. expose middle and high school students to mental health career opportunities;
  2. improve the collection and dissemination of information pertaining to the workforce supply problem;
  3. require commercial insurers to reimburse mental health trainees;
  4. increase the number of psychiatric residency programs and fellowships;
  5. support the expansion of mental health telemedicine;
  6. increase nursing and medical school student exposure to mental health experiences;
  7. ensure that all psychology internships at state institutions earn American Psychological Association accreditation;
  8. promote team based mental health care delivery models;
  9. provide for loan forgiveness for mental health professionals; and
  10. increase mental health reimbursement rates.

The Steps Ahead

Whether any or all of these approaches are the right ones is a question that states like Minnesota are being forced to ask. With a shrinking population of mental health professionals and a constant need for their services, either more professionals will need to be found, or patients will go unserved.  Efforts like the Mental Health Workforce Plan are one step towards solving the problem, but, for many states, there are still leaps ahead.