By Debra Wood, RN, contributor Feb 20, 2018
High-profile suicides, mass shootings, harassment victims, anxiety disorders and opioid addictions have filled the airwaves in recent months. Yet America’s mental health crisis isn’t anything new.
The demand for behavioral health services continues to increase, as a national shortage of psychiatrists persists and is expected to worsen. These pressures are creating innovation in the field—and more opportunities for psychiatrist job seekers.
“We are about to face a bigger challenge than we have so far,” said Joe Parks, MD, medical director of the National Council for Behavioral Health in Washington, D.C. “The shortage is going to get significantly worse before it gets better.”
The National Council reported that from 2003 to 2013, the number of psychiatrists working with public sector and insured patients decreased by 10 percent. And physician recruiters, like those at Staff Care, report that psychiatrist jobs are consistently one of the most requested positions by healthcare facilities.
These factors translate to good news for practitioners seeking a new place to practice — both permanent and locum tenens psychiatrist jobs and psychiatric nurse practitioner jobs are plentiful!
Here is a look at some of the key factors driving demand and expecting to impact psychiatry jobs in the immediate future.
8 trends to watch in psychiatry careers
1. A shrinking psychiatry workforce
Parks indicated that compensation for time spent with psychiatric patients is a drawback for new physicians considering a psychiatry career. They graduate with high debts and seek a specialty that will enable them to pay the debts off quickly. Forty percent of psychiatrists take cash only, no insurance.
“The commercial insurance rate and Medicare/Medicaid rates have not kept up with the increased price psychiatrists get because of the shortage,” Parks said.
Practitioner burnout and restrictive regulations add to the issues. Another factor contributing to the shortage is an aging psychiatrist population. The average age of psychiatrists is mid- to late 50s.
“In the next five to 10 years, a whole bunch of psychiatrists will stop practicing,” Parks said.
2. Increasing demand for psychiatry practitioners
The National Institute of Mental Health reports that 44.7 million people in the United States, or 18.3 percent of the population, suffer from a mental illness. Yet, only 43.1 percent of these people have received mental health treatment for anxiety, depression, substance abuse and more serious conditions including schizophrenia and bipolar disease.
Parks said the stigma of seeking psychiatric therapy has decreased as people realize psychiatric therapies work, increasing the demand for psychiatrists and psychiatric nurse practitioners.
“People have a clearer understanding that treatments are effective,” Parks said.
Psychiatric nurse practitioners and physician assistants see some patients, and in a few states, psychologists can prescribe drugs.
As the shortage continues, trends in psychiatry seek to address the growing need for mental health care.
“Any one of the solutions is unlikely to help,” Parks said. “It’s going to take a combination of solutions.”
[DISCOVER how part-time and full-time locum tenens jobs help practices meet demand and can enhance your psychiatry career.]
3. Mental health apps
Hundreds of apps have been developed to assist patients with mental health problems. Some monitor patient symptoms, and some offer interventions.
“It’s an evolving space, with everything changing rapidly,” said John Tourous, MD, lead of the American Psychiatric Association’s Apps Evaluation Work Group and co-director of the digital psychiatry program at Beth Israel Deaconess Medical Center in Boston.
“People are curious about this. We are beginning to see psychiatrists and clinicians becoming interested, because we are beginning to see more data that [mental health apps] are useful and can achieve better outcomes,” Tourous added.
Little regulation currently exists in this field, and some apps may be collecting private data. The APA working group is assessing the apps and developing guidelines. Currently, most of the apps do not send data to clinicians. Tourous expected newer apps will be more innovative and be able to integrate data.
“It’s a new and young field,” he said. “It is not going to go away. It will get bigger.”
Telepsychiatry has proved beneficial to patients in rural and underserved communities. Although more payers reimburse for telepsychiatry, requirements that the provider be licensed in the state where the patient is located creates a barrier to greater use of telepsychiatry.
“Insurance still favors face-to-face treatment,” Tourous said. “There is more acceptance of video visits. We will see an expansion of video visits, especially as healthcare payment models recognize the value.”
5. Open-access scheduling
One problem in psychiatry is a no-show rate of 30 percent to 40 percent, Parks said. That often comes about because appointments are set 60 days to 90 days out, and other things come up in the lives of patients with mental health issues that make it difficult to keep the appointment.
“When you can give patients appointments the next day or week, they are more likely to show up,” Parks explained.
6. Using nurses for better care and efficiency
Many psychiatrists room their own patients and fax prescription refills to pharmacies, which cuts down on the time they can spend with patients. A nurse can assist with rooming patients, taking vital signs and helping with paperwork and prescription refills.
“Psychiatrists should have a nurse,” Parks recommends. “Then the psychiatrist is less likely to feel so stretched out.”
7. Shorter appointment times
Psychiatry visits are getting shorter. Sometimes they are as brief as 10 to 15 minutes, in order for the psychiatrist or psychiatric nurse practitioner to try to see as many patients as possible. That time does not allow for psychotherapy.
“It’s better to limit my practice to diagnosis and medications and referring to others for psychotherapy,” Parks said.
8. Collaboration with primary care
Many psychiatrists see patients referred by primary care physicians, who have tried one or two medications and now realize the patient needs psychiatric care.
The AIMS Center at the University of Washington in Seattle has developed a collaborative care model, adding a case manager and psychiatric consultant to the primary-care team, providing patient-centered, population-based care. A nine-question anxiety and depression survey is administered at each visit.
Psychiatrists working in the same office as primary care providers is a “steadily increasing trend,” said Parks. He encourages primary care physicians to add a psychiatrist to their practice and psychiatrists to find a primary care physician with whom to practice and collaborate.
[RELATED: The Keys to Integrated Health Care]
“It’s more relaxing, more fun and you can give more care,” Parks concluded.
The future of psychiatry remains strong, with increased opportunities, numerous psychiatrist jobs and creative solutions developing to address the shortage of practitioners.
CONTACT Staff Care, an AMN Healthcare company, about short- and long-term psychiatry jobs for physicians and advanced practitioners nationwide.