A growing shortage of psychiatrists and a huge demand for mental health care (2023)

One in 5 people in the United States had a mental illness in 2019 — in total51.5 million people. Then COVID-19 hit.

Fear of contracting the deadly virus, the loss of loved ones, painful social isolation, economic setbacks and other powerful stressors eroded the well-being of communities across the country. At the height of the pandemic40% of adultsreported symptoms of anxiety or depression — compared to 11% pre-COVID. Over time, this rate dropped to 33% in June 2022, still higher than pre-pandemic levels.

Yet the United States does not have nearly enough mental health professionals to treat everyone who is suffering. Already,more than 150 million peopleliving in areas with a federally designated shortage of mental health professionals. Within a few years, the country will fall shortbetween 14,280 and 31,109 psychiatrists, and psychologists, social workers and others will also be overburdened, experts say.

"We have a chronic shortage of psychiatrists and it will continue to grow," said Saul Levin, MD, CEO and medical director of the American Psychiatric Association. “People can't get care. It affects their life, their ability to work, socialize or even get out of bed.”

In addition, the gap between need and access is wider in some populations, including in rural areas. In fact, more than half of the US countiesnot miss a single psychiatrist. In Nebraska, "you may have to wait months for an appointment — even for people who are moderately ill," says Howard Liu, MD, MBA, a psychiatrist at the University of Nebraska Medical Center (UNMC) in Omaha.

(Video) Shortage Of Psychiatrists Brings Mental Health Concerns

Several factors fuel the deficiency. "The U.S. population has grown, there's a lot of need for mental health, especially with the pandemic, and we don't have enough residency slots to educate people," said Anna Ratzliff, MD, PhD, program director of psychiatry at the University of Washington (UW) in Seattle. There is also a pension drain since more than 60% of psychiatristsare 55 years or older.

“People can't get care. It affects their life, their ability to work, socialize or even get out of bed.”

Saul Levin, MD
American Psychiatric Association

In response to the dramatic need, leaders in the field are working hard to find effective solutions. Some use telemedicine to meet with patients wherever they are. Others focus on recruiting and training a new crop of psychiatrists.

And still others focus on training and supporting primary care providers (PCPs), the primary care physicians who treat most mental health patients. Such a collaborative, interprofessional approach is crucial to filling the gap in psychiatry, experts say.

The need for collaboration boils down to numbers, says Daniel Gih, MD, director of the UNMC psychiatry residency. “Even if every medical student chose psychiatry, unfortunately we would still be quite short in this country,” he says.

Get more psychiatrists

While training more psychiatry assistants alone won't fully address increasing mental health needs, it remains essential, experts say.

“Creating new residency slots is critical. After all, it's the only way to produce more psychiatrists," says Art Walaszek, MD, a psychiatrist at the University of Wisconsin School of Medicine and Public Health in Madison, who co-authoreda 2021 study on the matter.

But providing residency training is costly and government funding is limited. In 2020, legislation increased the number of Medicare-supported residency slots for the first time in decades. The move added 200 slots annually for five years across the country and all medical specialties. In addition, the proposed law to reduce the shortage of GPs, if passed, would add 2,000 annually for seven years. Mostly thoughindividual institutions foot the billfor all new psychiatry slots.

Sometimes residency expansion means more places in existing programs. Sometimes it's aboutcreate brand new programs.

(Video) Texas' Critical Shortage of Psychiatrists, Mental Health Professionals

Building a new program is no sinecure. “There are many accreditation rules and regulations that you have to learn. You also need to figure out how to give [treating] physicians time for the educational and administrative work of the training. It's like managing a small workforce,” says Gih.

At UW, which recently added an additional 16 psychiatry places, the expansion includes building a new behavioral health learning facility with larger rooms to accommodate more interns. The slots and building are down to state dollars, another common source of residency funding.

The question then arises: if you build it, will there be students?

In the past, it was a bit of a challenge to attract psychiatry applicants, but that is changing. In fact, the number of psychiatric residentshas increased by 21%in recent years, and in 2022 there werealmost twice as many applicants as there are slots for them.

Gih points to a generation change. “People now want careers that offer a better work-life balance. They also want to work in disciplines where they can look at patients more holistically. They think more about things like trauma, social justice and a person's ability to function and their place in society,” he says.

“Creating new residency slots is critical. After all, it is the only way to produce more psychiatrists.”

Art Walaszek, MD
University of Wisconsin School of Medicine and Public Health

Of course, any residency program must attract and retain teachers. That can be difficult, because academia can involve more bureaucracy and less revenue than private practice, says Walaszek. “It is important to find ways to deal with burnout and increase flexibility. Otherwise, the faculty may reduce their hours or leave altogether.

If they do, the field will be in trouble, says Walaszek. “These are the people we need to train future psychiatrists and to enthuse medical students for a career in this field.”

Digital doctors

As in other fields of medicine, the pandemic pushed mental health care online. But while telemedicine returned to a thin segment of total care – 5% – the share of mental health services provided through telemedicine hashas remained high— at 40%.

(Video) Shortage of psychiatrists in Maine near 'crisis levels'

That's remarkable, given that virtual care could also help expand the workforce, experts say.

"Telemedicine lets you escape the confines of a physical clinic that's open 8 to 5 so you can work more hours," says Matt Mishkind, PhD, an assistant professor of psychiatry at the University of Washington's Anschutz Medical Campus. Colorado in Aurora. It can also help reduce burnout by reducing commute times and providing healthcare providers with diverse patients they otherwise wouldn't be able to treat, experts say.

Expanding services to underserved communities is one of the biggest benefits of telemedicine, says Jessica Thackaberry, MD, a UC San Diego Health psychiatrist who treats many patients in Southern California remotely.

Some of Thackaberry's patients live in areas without access to psychiatrists, and some have traveled to Mexico seeking care. For such individuals, telemedicine can be life-changing, she says.

“I had a patient whose fear caused him to act. He would have ended up in a hospital far from his family. But seeing him through telepsychiatry allowed me to make a simple medication adjustment and keep him home.”

Such care is achievable thanks to recent flexibility in telemedicine rules. For example, Medicare lifted several telehealth payment restrictions during the pandemic and made some changes permanent. But experts continue to monitor other obstacles, including states ending pandemic-related waivershired foreign doctorsprovide telecare.

Meanwhile, other experts are exploring additional digital resources to increase access to care.

One option is online cognitive behavioral therapy (CBT) modules, which can be taken at your own pace, an approach supported by a growing body of research, says Mishkind. This type of tool not only increases access for patients, it also opens up time slots for providers. "The patient can do their CBT training and then meet with the provider for 20 minutes instead of 50 minutes, so the therapist sees two patients in the time they could only see one." There's also a proliferation of mental health apps that can help expand access, but Mishkind notes their quality is uneven.

At Emory Healthcare in Atlanta, Brandon Kitay, MD, PhD hopes to combine access and quality by bringing a mental health app into the home. The digital platform – which Emory is deploying with the help of a third-party technology company – will include capturing patient data to monitor need, provide self-directed therapy and enable providers to provide brief online support.

Emory's app should be ready to roll out within a year and will undergo two years of research in a pilot project, says Kitay. "We need to see if this is going to work, but this is the kind of thing we need to try if we're going to expand healthcare."

(Video) Mental healthcare worker shortage causing crisis among young people

Crucial Collaborations

Experts say that if you want to help as many patients as possible, you should reach them where they frequent: primary care offices. In fact,nearly 60% of patientswho receive mental health care treatment, do so through their general practitioner.

Of the various options for offering psychiatric expertise through PCP offices, the evidence-based Collaborative Care Model is often the preferred approach.

Here's how it works: a GP screens a patient for anxiety or depression. After a positive result, the doctor may walk the patient down the hall to a behavioral health manager (BCM) - usually a psychologist or social worker - who can further investigate the patient's symptoms. In general, the care manager provides therapy, monitors patient progress, and proactively reaches out to those who are not improving. The PCP team meets regularly - usually once a week - with the affiliated psychiatrist to get input for medication management, for example.

“In my psychiatric clinic, I can see one patient per hour, but with the help of Collaborative Care I can help treat 10 to 12 patients in the same amount of time,” said Rachel Weir, MD, chief of mental health integration. the University of Utah Health in Salt Lake City. "That's a very dramatic expansion of access."

For UW's Ratzliff, one of the benefits of the model is that patients get the care they need quickly. She recalls a doctor noticing signs of depression in a patient during a physical exam. The patient met with the BCM the same day and was soon on psychiatrist-controlled medication and therapy. "It's unlikely he would have been treated elsewhere," says Ratzliff. "Patient's mother credits [Collaborative Care] with saving her son's life."

“I can see one patient in an hour, but with Collaborative Care I can help treat 10 to 12 patients at the same time. That is a very dramatic expansion.”

Rachel Weir, arts
Utah University of Health in Salt Lake City

Establishing Collaborative Care can require quite significant infrastructure and training, so some psychiatrists are pursuing other interprofessional options. These include eConsults - electronic consultations - which allow specialists to share expertise in short distance exchanges.

At Emory, Kitay explains, "We've set up a mechanism for answering questions that's formal, rather than a hallway conversation between doctors who happen to know each other. There's a code for getting your time reimbursed, and the notes from the psychiatrist become part of the patient's medical record, so that other healthcare providers can also view it.”

At the University of Utah Health, leaders are preparing to launch an electronic health record feature that will automatically provide providers with treatment options when patients screen positive for mental health issues — "instead of just, 'You figure out what to do.'" says Weir.

(Video) Shortage of mental health counselors

Support for GPs also comes in the form of Project ECHO sessions offered by several teaching hospitals across the country. In it, a psychiatrist presents a topic like LGBTQ+ mental health, and remote participants learn both from the lecture and from discussing issues they encounter in their practice. And then there are call lines where a GP can get advice from a psychiatric expert. For example, two years ago UW set up one that runs 24/7.

In all of this work, educators also focus on training future psychiatrists to collaborate with their PCP colleagues. In fact,more than halfof psychiatry programs reported teaching interns to work with clinicians from other disciplines.

“We tell interns that your role as a psychiatrist is no longer just to provide care to individual patients,” says Ratzliff. "An important part of your role is to teach and be a resource to colleagues."


Is there a shortage of psychiatrists and other mental health providers? ›

Already, more than 150 million people live in federally designated mental health professional shortage areas. Within a few years, the country will be short between 14,280 and 31,109 psychiatrists , and psychologists, social workers, and others will be overextended as well, experts say.

Why is there a shortage of mental health professionals in the US? ›

The causes of the shortage are complex and include inadequate funding, lack of incentives and the stigma associated with mental illness. The shortage also poses challenges to existing mental health providers, including increased stress and limited options for patients.

Is the psychiatrist field growing or decreasing? ›

According to the U.S. Bureau of Labor Statistics, employment of psychiatrists is forecasted to grow 9 percent from 2021 to 2031, substantially higher than other physician specialties. The industries with the highest levels of psychiatrist employment include: Physician offices.

Why are therapists leaving the profession? ›

Therapists have discussed with me the “deep drag” of burnout resulting from overscheduling, personal conflicts, health struggles, and compassion fatigue. Some have made it to the other side, by taking time off and creating a regimen for rejuvenation. Others have realized that this field is not for them any longer.

Why are so many psychiatrists out of network? ›

Low reimbursement rates: Insurance companies typically pay lower rates for mental health services than they do for physical health services. This can make it difficult for psychiatrists to cover their costs and make a living while accepting insurance.

Why is it so hard to get in with a psychiatrist? ›

Psychiatrists are specialists, and their waiting lists are often long because more people need their services than the doctor can see in one day. If you're having an emergency with your anxiety, you can go to the emergency room, or call a psychiatric facility and check yourself in voluntarily.

What is the biggest mental health problem in the United States? ›

The most common are anxiety disorders major depression and bipolar disorder. Below is more information on these disorders and how ACCESS can help. Remember you are not alone, and medical experts are here to support you.

What is the future of psychiatry? ›

The future of psychiatry will likely be increasingly personalized — and patients may not even need to leave their homes to access care. Already, virtual therapy websites set patients up with online sessions, allowing them to access therapeutic support they otherwise might not receive.

How bad is the mental health crisis in America? ›

In 2019-2020, 20.78% of adults were experiencing a mental illness. That is equivalent to over 50 million Americans.

Where do psychiatrists make the most money? ›

Highest-paid psychiatrist jobs by state
  • New Hampshire: $279,080 per year.
  • Washington: $278,540 per year.
  • Connecticut: $276,109 per year.
  • New Jersey: $271,687 per year.
  • Arkansas: $268,139 per year.
  • Tennessee: $257,158 per year.
  • Arizona: $255,359 per year.
  • Texas: $254,808 per year.
Mar 3, 2023

What is the highest paid field of psychiatry? ›

High Paying Psychiatrist Jobs
  • Attending Psychiatrist. Salary range: $194,500-$326,000 per year. ...
  • Staff Psychiatrist. Salary range: $96,000-$299,500 per year. ...
  • Locum Tenens Psychiatrist. Salary range: $240,000-$281,500 per year. ...
  • Adult Psychiatrist. ...
  • Geriatric Psychiatrist. ...
  • Clinical Psychiatrist. ...
  • Psychiatric Counselor.

Will psychiatry become obsolete? ›

Are they going to become obsolete? No. As we continue to learn more about the brain, the body, how the brain works, get better scans, learn more about psychotherapy, psychiatry is poised to become a much greater player in the health arena.

Is it draining being a therapist? ›

Your job can be emotionally draining.

You often hear shocking stories and relive traumatic experiences as you help them feel better about their lives. Sometimes, looking at the patients' problems can affect you so much that you start to think about your own life.

Are therapists burnt out? ›

A 2020 study offered some deeply concerning findings regarding the psychological wellness of mental health practitioners. In an online survey of 298 qualified therapists, 78.9% suffered from “high burnout,” and 58.1% experienced “high disengagement” (Johnson et al., 2020).

What percentage of therapists quit? ›

Therapists do have a high turnover rate, with about 35% staying in a job for just 1 to 2 years. Another 24% of therapists quit their jobs after less than a year, meaning that over 50% of the population remains in one job for less than 2 years. 29% of therapists stay in one job for between 3 and 7 years.

What is the most controversial psychiatric therapy? ›

Aversion therapy, also called aversive therapy or aversive conditioning, is a controversial type of treatment.

What percent of psychiatrists are happy? ›

Yes, most psychiatrists are happy.

In fact, one recent study published by the Journal of Psychiatric Practice recorded that 86% of psychiatrists reported being satisfied in their careers. This also indicates that psychiatrists have one of the highest satisfaction rates among all medical specialties.

Why do psychiatrists drop patients? ›

Termination of the treatment relationship is appropriate for any number of reasons, including when there is a lack of agreement on a treatment plan, the patient no longer requires treatment, the psychiatrist is closing his or her practice, or the psychiatrist or the patient is moving away.

Will psychiatrist be needed in the future? ›

Currently, there are 27,900 psychiatrists practicing in the country today, and those numbers are expected to grow. According to the Bureau of Labor and Statistics, the overall demand for medical practitioners is expected to increase by 10% through 2029, and psychiatry specifically is estimated to grow 12%.

How competitive is psychiatry now? ›

No, psychiatry isn't a competitive residency. The probability of a person matching is about 76%. Recent data shows that psychiatry had 2,486 applicants and 1,858 spots. However, when it comes to M.D. seniors, it is even less competitive for them.

What is the #1 most diagnosed mental disorder? ›

Depression. Impacting an estimated 300 million people, depression is the most-common mental disorder and generally affects women more often than men.

What is the hardest mental illness to live with? ›

Individuals with Borderline Personality Disorder (BPDs) become overwhelmed and incapacitated by the intensity of their emotions, whether it is joy and elation or depression, anxiety, and rage. They are unable to manage these intense emotions.

Why is mental illness on the rise? ›

Mental illness has risen in the United States, with about 20% of people in the country experiencing some form of it. The increase is due to the rise in social media, the COVID-19 pandemic, and societal trends that have resulted in smaller family units and less community involvement.

Is psychiatry a stressful career? ›

Working in the field of psychiatry can be highly stressful. Day in and day out, you are helping mentally ill patients, which can lead to extremely emotional sessions. This can lead to burnout and a secondary trauma response. Over time you will run the risk of becoming unhappy in your career.

What are the challenges in the future of psychiatry? ›

The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry).

What is the life of a psychiatrist? ›

As a clinical psychiatrist, you'll be seeing patients, doing therapy, and generating treatment plans. If practicing inpatient, you'll see patients admitted to the psychiatric ward or consult service, meaning those treated primarily in other areas of the hospital, but requiring secondary psychiatric care.

What country has the worst mental health? ›

World Health Organization global study

The United States, Colombia, the Netherlands and Ukraine tended to have higher prevalence estimates across most classes of disorder, while Nigeria, Shanghai and Italy were consistently low, and prevalence was lower in Asian countries in general.

What country has the highest rate of mental illness? ›

1. Greenland
  • Rate of Depressive Disorders: 6.61%
  • Rate of All Mental Disorders: 17.85%

What are the top three mental health issues faced by Americans? ›

A Look at The Three Most Common Mental Illnesses
  • Anxiety Disorders. Anxiety disorders are characterized by underlying feelings of extreme fear or worry. ...
  • Depression. One of the most misunderstood mental illnesses, depression affects over 17 million American adults every year. ...
  • PTSD.
Nov 22, 2021

Which degree is most commonly earned by a psychiatrist? ›

Psychiatrists must hold a medical degree and a license to practice. After earning a bachelor's, psychiatry students then enter medical school to earn their M.D., followed by a residency period.

What is the average net worth of a psychiatrist? ›

Three out of 10 psychiatrists (31%) reported a net worth below $500,000, while only 8% declared a net worth over $5 million.

What is the highest paid Dr? ›

Neurosurgeons are the highest paid physician specialists, earning an average of $788,313 annually, according to Doximity's "2023 Physician Compensation Report."

Is psychiatry a competitive major? ›

Among US Seniors, the unmatched percentage was 7.8%, making it less competitive among US residencies. The match rate for psychiatry is considerably better than the most competitive specialties like plastic surgery, orthopedic surgery, or otolaryngology.

Is psychiatry a happy career? ›

Psychiatrists are slightly happier as a group than physicians overall, 59% of whom state they are happy outside of work.

Why does psychiatry pay so well? ›

Market forces dictate how professionals are paid. An MD must get accepted into medical school, complete an internship and a residency. The supply of psychiatrists doesn't meet the demand, thus giving them an advantage in their worth and subsequent higher salary than their counterparts in psychology.

Do people regret becoming psychiatrists? ›

But that doesn't really make sense when you look at career regret across all the listed specialities. 16.9% of psychiatrists regret becoming a doctor but it's not so far off the average of ~14%.

Will psychiatrists be replaced by robots? ›

Our visitors have voted that there is very little chance of this occupation being replaced. This assessment is further supported by the calculated automation risk level, which estimates 0.0% chance of automation.

Will artificial intelligence eventually replace psychiatrists? ›

Therefore, it is very unlikely that AI systems will be successful in solving any diagnosis task because psychiatrists often disagree and therefore there is no ground truth to measure model performance against. Furthermore, AI is very different from human intelligence.

Why are therapy sessions so short? ›

It Helps With Logistics

There are many logistical factors keeping session lengths around this time frame, rather than a full hour. For clients, this timing may make it easier to see a therapist during a lunch hour or just before work.

What is a vulnerability hangover after therapy? ›

A vulnerability hangover is the crash that often follows the high, elation, or relief we experience after disclosing. We can experience this somatically, with muscle tension, an upset stomach, or racing heart, or emotionally with negative thoughts, anxiety, and fears.

How common is therapist burnout? ›

Before this study, another reported a range of 21% to 48% of general mental health workers as having high emotional exhaustion.

How many clients can a therapist see in one day? ›

“It's not uncommon for therapists to see an average of 6-9 clients per day and up to 20 plus per week. But, of course, it's encouraged to assess and review with supervisors or clinical support groups ongoing to ensure fidelity in your work and also for the benefit of your health and well-being as a clinician.”

Why therapists are leaving? ›

Therapists have discussed with me the “deep drag” of burnout resulting from overscheduling, personal conflicts, health struggles, and compassion fatigue. Some have made it to the other side, by taking time off and creating a regimen for rejuvenation. Others have realized that this field is not for them any longer.

Why are therapists so tired? ›

Therapists do more than listening.

Therapists are constantly processing communication. They do this all the time. Truthfully speaking, the average person can only process about 1.6 conversations efficiently. That means that therapy is more of a cognitive overload, which in turn, can also lead to mental exhaustion.

Why do therapists pause so much? ›

Done supportively, silence can exert some positive pressure on the client to stop and reflect. Non-verbal signals of patience and empathy by the therapist can encourage the client to express thoughts and feelings that would otherwise be covered up by too much anxious talk.

How many clients a week do therapists have? ›

The number of clients a full-time therapist sees in a week depends on the therapist and the number of hours you want to work per week. If you aim for a 40-hour workweek, you could see up to 30 clients per week and then spend 10 hours writing notes and doing other paperwork.

Will therapists always be in demand? ›

Employment of relationship therapists, clinical social workers, mental health counselors and psychiatric mental health nurse practitioners is projected to grow 23% from 2020 to 2030, much faster than the average for all occupations overall, according to the U.S. Bureau of Labor Statistics.

Is there a shortage of therapists in the United States? ›

Using various care models to guide their calculations, SAMHSA estimates that we are about 1.8 million therapists short of what's needed to effectively treat serious mental illness and substance use disorders. On the other hand, using different methodology, HRSA estimates a shortage of about 238,000 therapists by 2025.

Is psychiatry competitive now? ›

No, psychiatry isn't a competitive residency. The probability of a person matching is about 76%. Recent data shows that psychiatry had 2,486 applicants and 1,858 spots. However, when it comes to M.D. seniors, it is even less competitive for them.

Is there a lack of psychiatrists in rural areas? ›

There is a significant lack of access to specialty mental health care in rural areas in the USA [5]. It is estimated that as many as 65% of nonmetropolitan counties do not have psychiatrists [6], and over 60% of rural Americans live in designated mental health provider shortage areas [13].

Is there a mental health crisis in America? ›

In 2019-2020, 20.78% of adults were experiencing a mental illness. That is equivalent to over 50 million Americans.

What state pays therapists the least? ›

California has the highest therapist salary of $72,873. Missouri has the lowest therapist salary of $44,095. The national average salary for therapists is $55,943. The national hourly pay for therapists is $26.9.

What are the best states to be a psychiatrist? ›

Highest-paid psychiatrist jobs by state
  • New Hampshire: $279,080 per year.
  • Washington: $278,540 per year.
  • Connecticut: $276,109 per year.
  • New Jersey: $271,687 per year.
  • Arkansas: $268,139 per year.
  • Tennessee: $257,158 per year.
  • Arizona: $255,359 per year.
  • Texas: $254,808 per year.
Mar 3, 2023

Is psychiatry a hard specialty to match into? ›

Psychiatry is moderately IMG-friendly, with an overall 46% match rate and 15% of spots filled by IMGs in the 2022 Match. In 2022, 390 US IMGs and 281 non-US IMGs applied to psychiatry; 178 US IMGs and 128 non-US IMGs matched.

What state has the most psychiatrists? ›

The state with the highest number of psychiatrists was California (5,935) and the state with the fewest was Wyoming (42) (Table 1). The national average was 806.5 psychiatrists per state.

Where do psychiatrists work the most? ›

Psychiatrists work in a variety of settings, including private practices, clinics, general and psychiatric hospitals, academic health centers, community agencies, courts and prisons, nursing homes, industry, government, military settings, rehabilitation programs, emergency rooms, hospice programs, and many other places ...

Which country needs the most psychiatrists? ›

Monaco is one the world's hotspots for the super rich but it's also the country with the most psychiatrists per capita worldwide. In 2014, the tiny principality had 41 shrinks per 100,000 of its population, according to the World Health Organization.


1. Mental Health Provider Shortage in the U.S. with Dr. Mankar
(Mind by Mind)
2. Artificial Intelligence and the Future of Psychiatry
3. Mental health nurses could help shrink psychiatrist shortage
(KGW News)
4. Mental Health Provider Burnout | Opportunities for Psych NPs
(My PMHNP Journey)
5. Lack of adequate mental health care places heavy burden on young people
(PBS NewsHour)
6. Psychiatrist shortage is a crisis in U.S., Oregon
(KGW News)


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