Psychiatric Care Shortage: What the Future Holds

Jeffrey A Lieberman, MD


September 02, 2010

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Hello. This is Dr. Jeffrey Lieberman of Columbia University speaking today for Medscape. Recently I saw a news report that stated that of all medical subspecialties it's projected that the greatest need in the future to meet the healthcare needs of the US population is in psychiatry. That is of all of the medical subspecialties, there is a shortage of psychiatrists to meet the needs of the population in the future. This is interesting because I've long felt that there was really an understaffing of the workforce of mental health professionals to meet what we know to be the public mental health need for mental illness. This is something that would be apparent to anybody who understands the epidemiology of mental illness.

If we look at the frequency at which major mental disorders occur, schizophrenia to mood disorders, anxiety disorders, addictions, dementias, the pediatric disorders, -- attentional, neurodevelopmental -- it's clear that a substantial proportion of people in the population will be affected in their lifetimes. Only a fraction of those who the epidemiologic frequency rates project actually ever receive treatment, which means either that people are not recognizing the need for treatment or they can't find it because there is no available access; hence, the need for enhancing our workforce of mental healthcare providers.

To do this, it begins with psychiatrists. Psychiatric physicians need to be trained in order to understand whatever the need is for treating patients with mental illness in our population, and then the additional paraprofessionals need to be trained to work with psychiatrists to be able to provide these services. In order to be able to do so, there will probably also need to be a reconfiguration of the way mental health services are delivered. Most services currently are either hospital, clinic-based, or in private offices. In the future it's likely that there will need to be an effort to try and reach into the community and to engage or integrate mental healthcare services at the screening, and then potentially the diagnosis and treatment level in the primary care system, potentially in the educational system, and other community-based agencies and organizations.

So, I think for people who are in the field of mental healthcare, psychiatry, and students or trainees who are considering what to go into, psychiatry is an important area to consider because it is an area that is fast developing and growing in its knowledge base, and it's also something that there is an increasing need for in the future in terms of population demand and the public health needs. That's all I'm going to say today. For Medscape, this is Dr. Jeffrey Lieberman from Columbia University. Thank you.


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