Article

County-Level Estimates of Mental Health Professional Shortage in the United States

Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 1.99). 10/2009; 60(10):1323-8. DOI: 10.1176/appi.ps.60.10.1323
Source: PubMed

ABSTRACT This study examined shortages of mental health professionals at the county level across the United States. A goal was to motivate discussion of the data improvements and practice standards required to develop an adequate mental health professional workforce.
Shortage of mental health professionals was conceptualized as the percentage of need for mental health visits that is unmet within a county. County-level need was measured by estimating the prevalence of serious mental illness, then combining separate estimates of provider time needed by individuals with and without serious mental illness derived from National Comorbidity Survey Replication, U.S. Census, and Medical Panel Expenditure Survey data. County-level supply data were compiled from professional associations, state licensure boards, and national certification boards. Shortage was measured for prescribers, nonprescribers, and a combination of both groups in the nation's 3,140 counties. Ordinary least-squares regression identified county characteristics associated with shortage.
Nearly one in five counties (18%) in the nation had unmet need for nonprescribers. Nearly every county (96%) had unmet need for prescribers and therefore some level of unmet need overall. Rural counties and those with low per capita income had higher levels of unmet need.
These findings identified widespread prescriber shortage and poor distribution of nonprescribers. A caveat is that these estimates of need were extrapolated from current provider treatment patterns rather than from a normative standard of how much care should be provided and by whom. Better data would improve these estimates, but future work needs to move beyond simply describing shortages to resolving them.

Download full-text

Full-text

Available from: Joseph P Morrissey, Jun 11, 2015
3 Followers
 · 
136 Views
  • Source
    • "The church and leaders within the faith community shape the way many parishioners understand society in general (Lee 2003) and influence their perceptions of mental health in particular (Stanford 2007). Pastoral care is also integral to the lives of those in rural, southern communities where formal mental health services are sparse (Hendryx 2008; Thomas et al. 2009, 2012). It is important to note though that differing viewpoints of illness and approaches to healing can impact the individual seeking help and possibly increase tension and mistrust between the clergy and healthcare providers (Neighbors et al. 1998, 1999). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The history of the relationship between religion and mental health is one of commonality, conflict, controversy, and distrust. An awareness of this complex relationship is essential to clinicians and clergy seeking to holistically meet the needs of people in our clinics, our churches, and our communities. Understanding this relationship may be particularly important in rural communities. This paper briefly discusses the history of this relationship and important areas of disagreement and contention. The paper moves beyond theory to present some current practical tensions identified in a brief case study of VA/Clergy partnerships in rural Arkansas. The paper concludes with a framework of three models for understanding how most faith communities perceive mental health and suggests opportunities to overcome the tensions between "the pew" and "the couch."
    Journal of Religion and Health 06/2013; 53(4). DOI:10.1007/s10943-013-9731-0 · 1.02 Impact Factor
  • Source
    • "This variable was operationalized differently depending on the model. For all models except the one involving permanent caregiver receipt of substance abuse treatment, this variable was operationalized as the percentage of unmet mental health needs within the county, including those for providers with and without prescription authority (Thomas, et al., 2009). For the model involving permanent caregiver receipt of substance abuse treatment, data from the 2000 National Survey of Substance Abuse Treatment Services on the total number of behavioral health care facilities in the county, which was collected by the U.S. Department of Health and Human Services Substance Abuse and Mental Health Administration (SAMHSA) were utilized as a measure of local provider availability. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although performance-based contracts have become increasingly popular in child welfare, administrators are developing these contracts with little empirically guided information about how internal work conditions may influence the services families receive. This study examines how child welfare caseworker role overload moderates associations between child welfare agencies' use of performance-based contracting and services provided to families. Analyses using data from the National Survey of Child and Adolescent Well-Being suggest that when caseworkers experience high role overload, use of performance-based contracts may decrease caregivers' likelihood of receiving necessary social and behavioral health services. These findings and their implications are discussed.
    Administration in Social Work 11/2011; 35(5):453-474. DOI:10.1080/03643107.2011.614195 · 0.36 Impact Factor
  • Source
    • "Prescriptive authority allows psychologists to address a compelling and demonstrable need. The same analysis that concluded most counties across the nation have enough nonprescribing mental health professionals also found that 96% of counties face a shortage of prescribers competent to address psychological and behavioral disorders (Thomas et al., 2009). In those states where psychologists can prescribe, the shape of clinical practice has already started to change. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Two paths have been suggested for the future evolution of professional psychology. Prescribing psychology has already been legally authorized in two states, the military, and the Indian Health Service. Primary care psychology does not require legal recognition and has been slowly growing as a career option for psychologists across the nation. Both paths have their obstacles and limitations, but both are also associated with great potential. This article provides a brief summary of the strengths and weaknesses of each path and suggests an integrated perspective for planning the future of the profession. Each is seen as complementary to the other and providing a basis for pursuing the other. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Professional Psychology Research and Practice 03/2011; 42(2):113-120. DOI:10.1037/a0022649 · 1.34 Impact Factor
Show more