Among the many impacts of the global pandemic, one of the most significant is the accelerated need for mental and behavioral health services. As a growing number of people suffered from higher levels of stress, anxiety, and depression from a range of factors associated with the fight against COVID-19, it only exacerbated the pre-existing shortage of behavioral health professionals – namely psychiatrists and mental health nurse practitioners (MHNPs).
As healthcare organizations, facilities, and practices continue to rebuild financially and operationally post-pandemic, behavioral health represents one area that not only requires more staffing to meet patient demand, but an additional revenue stream. To meet both these objectives, many are incorporating new recruiting and staffing strategies, including the use of MHNPs to shore up gaps and locum tenens to cost-effectively secure needed behavioral health talent either temporarily or as a bridge to ensure continuity of care while using a search firm to find a permanent professional.
A Growing Mental Health Crisis.
To put the dire need for mental and behavioral health services into context, consider that last fall a third of psychologists said they are seeing more patients since the start of the pandemic and of those who treat anxiety disorders, nearly three-quarters reported an increase in demand for treatment, according to the American Psychological Association.
Overall, the supply and demand issue becomes even more pronounced when you consider that:
- 20% of all Americans have mental health or substance abuse conditions, according to a 2017 report by the Kaiser Family Foundation.
- 40% of patients seen by primary care physicians have active psychiatric problems, according to the Steinberg Institute.
- There has been a 42% increase in patients going to emergency departments for psychiatric services, according to a three-year study by the National Council for Behavioral Health.
The global pandemic has also increased the demand for behavioral health services via telehealth, with a 27% increase in behavioral health outpatient care compared to pre-pandemic levels. As a result, 44% of human resource decision-makers and 27% of health plan leaders said that increased access to mental health services will become a long-term solution for their organization. Some 57% of health plan leaders said they had seen the value of mental health services increase more than for most other services and benefits as a result of the coronavirus.
The problem? Enough behavioral health professionals to fill that demand.
Critical Shortage of Mental Health Providers.
There was already an urgent need for more mental health providers before the pandemic, and the COVID-19 crisis has only underscored the importance of adequately supporting mental health services. Yet, a significant portion of those in need of treatment aren’t receiving it, due in large part to a lack of provider supply.
There are 45,580 psychiatrists in the U.S., which translates to roughly nine psychiatrists per 100,000 Americans, says the Association of American Medical Colleges (AAMC). Even more alarming:
- According to the Steinberg Institute, two-thirds of all primary care providers in the U.S. say they have trouble finding mental health specialists to refer patients to.
- In 2019, only 44.8% of people with any mental illness report reported receiving treatment, according to the National Institutes of Mental Health.
- By 2025, demand may outstrip supply by 6,090 to 15,600 psychiatrists.
The situation is even more critical in rural areas. Data released in April 2021 by the Health Resources & Services Administration (HRSA) finds shortage of 6,471 mental health providers impacting 124 million people living in the regions designated by the HRSA as “Health Professional Shortage Areas.”
In addition, of the more than 3,000 counties in the U.S., 60% have no psychiatrists at all. Zero. There is a large disparity in the availability of mental health by geographic locations. For example, there are about 612 psychiatrists per 100,000 people in parts of New York State – a 1-to-163 ratio – yet there are fewer than one per 100,000 in Idaho. There are more than 6,000 areas in the U.S. in which the population-to-provider ratio for mental healthcare is at least 30,000-to-1, says the HRSA.
Telehealth and Telepsychiatry Poised to Help Meet Demand.
If one silver lining came out of the pandemic, particularly for mental health patients, it is the emergence and adoption of remote therapy and treatment through telehealth, both in urban and rural areas. Almost immediately after the start of the pandemic, providers and patients were adapting to technology that allows for treatment for those in both densely and sparsely populated areas in the country.
With more than 60% of behavioral health patients now using virtual services, 97% of the people who accessed such services from March to May 2020 didn’t have a behavioral telehealth claim prior to then. In fact, primary care and behavioral services were the largest specialties utilized virtually in 2020 – nearly two-thirds of behavioral care was performed virtually.
Many experts are predicting that the increased use of telepsychiatry will last well into the future, given it’s early and swift adoption as well as the benefits of a virtual platform eliminating many traditional barriers such as, stigma that may hinder patients from following up with treatment.
Alternative Staffing Solutions to the Provider Shortage.
Roles such as MHNPs are poised to help shore up the supply-and-demand gap. In fact, psychiatry-mental health is one of the fastest growing, non-physician specialties in the healthcare field. While MHNPs and psychiatrists are not interchangeable, using some of these providers to deliver access to care and to fill in gaps is an increasingly attractive and viable solution.
For example, MHNPs can care for the needs of many patients, despite the varying state-by-state scope of practice laws. In states with independent practice authority for nurse practitioners, such as New Hampshire, MHNPs are able to provide significantly more mental health services when compared with NPs who practice in states without independent practice authority for NPs.
Another solution to the shortage of mental health providers is through the use of locum tenens. These qualified providers can be called into service to expand access to care, as many were during the height of the pandemic. Locum tenens psychiatrists and MHNPs are often willing to work in rural or other underserved areas where there is a high demand for their services.
As a trusted staffing partner to leading healthcare organizations across the U.S., Cross Country Locums continually monitors and analyzes key market dynamics of the mental health sector. To learn more about current labor trends for psychiatrists and MHNPs, download our latest Market Snapshot.
