By Jennifer Larson, contributor Apr 24, 2019
Looking for a psychiatrist job in 2019 or beyond? Your skills may be in
greater demand than you realize.
The United States needs more psychiatrists, especially in certain areas
of the country. And some specialized psychiatrist jobs are even harder to fill,
including child and adolescent psychiatrists and geriatric psychiatrists,
according to a December
2018 report from the University of Michigan.
Why is the demand so high? The report noted that the Affordable Care
Act expanded access to behavioral healthcare to more people. As a result,
“access to behavioral health services remains an issue, owing in part to
maldistribution of the workforce. The psychiatric workforce, in particular, is
in the middle of a professional shortage, which is projected to worsen by
Other research bears this out. Merritt Hawkins’ 2018
review of physician starting salaries and recruiting trends noted
that psychiatrists continue to rank among the most-requested searches, and called
the shortage of psychiatrists “an escalating crisis.” And a 2017
report on the psychiatric shortage from the National Council for Behavioral
Health (NCBH) noted that 77 percent of counties are underserved by
The problems with patient access are compounded by the fact that 40
percent of all practicing psychiatrists now work in private practice and accept
only cash payments. This puts their services out of reach for some patients,
even in areas with higher numbers of psychiatrists.
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The demand for child and
While adult psychiatrists are always in demand, experts predict that
the ongoing shortage of child and adolescent psychiatrists is expected to grow
even more critical.
This type of forecast isn’t new. In fact, in 2000, the U.S. Bureau of
Health Professions predicted that demand for child and adolescent psychiatrists
would increase by 100 percent from 1995 to 2020.
“You’ll have no trouble finding a job,” said Wun Jung Kim, MD, MPH, professor
and director of child and adolescent psychiatry at the Robert Wood Johnson
Medical School at Rutgers University, but he noted that psychiatrists who serve
this younger population may still grapple with reimbursement issues.
The University of Michigan report found that 9,956 child and adolescent
psychiatrists were practicing in the United States, per the latest data from
the American Medical Association Masterfile in May 2018. Like other types of psychiatrists,
they tend to be clustered in highly populated areas, such as the Northeastern
United States and parts of the West Coast.
The American Academy of Child and Adolescent Psychiatry (AACAP) maintains
an online series of state
maps of practicing child and adolescent psychiatrists, and a large
swath of the U.S. map is red, which indicates a severe shortage; in these
areas, there are 17 or fewer child and adolescent psychiatrists per 100,000
children under 18.
“Between the oceans, there are not many,” observed Kim, who headed the AACAP
Task Force on Work Force Needs from 1999-2001 and served on a steering
committee to address workforce issues afterward. That means children who live
in rural areas, as well as lower socio-economic areas, have less access to
Geriatric psychiatrists and addiction psychiatrists are also in high
“Given the current and projected psychiatrist shortages, these
high-demand populations will suffer from an uneven geographical distribution of
the few specialized psychiatrists in the country, with rural populations facing
a greater proportion of shortages,” the University of Michigan study authors
Addressing the psychiatrist shortage
So how can we solve the shortage of psychiatrists and the limited
access to mental health services? There’s not one single solution, experts
“The solutions cannot rely on a single change in the field such as
recruiting more psychiatrists or raising payment and reimbursement rates,”
wrote the authors of the NCBH report. “Rather, the solutions depend on a
combination of interrelated changes that require support from a range of
Increasing the supply and training new psychiatrists, including adding
residency training slots, will help. Addressing reimbursement challenges that
may propel some to practice in cash-only practices or not accept Medicaid
payments will also help. Finding other ways to increase access to psychiatric
care in underserved areas will also be required.
Ultimately, the authors of the NCBH report said, many different people
across a range of specialties will have to collaborate. They will have to
develop new and better models of mental health care delivery. Future careers in
psychiatry may need to look different than they do now.
In the meantime, healthcare systems and practices are searching for
psychiatrists to fill both permanent positions and short-term locum
tenens assignments, and the job outlook for psychiatrists remains
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