Mental health disorders are common in the United States, affecting some 44 million adults and 13.7 million children each year. Suicide is the eighth leading cause of death in the United States and 80 percent to 90 percent of people who die by suicide are suffering from a mental illness. Yet despite the facts that mental health disorders are as disabling as heart disease or cancer in terms of premature death and lost productivity, and most mental health disorders are treatable using medication and other therapies, fewer than half of adults and only one-third of children with a diagnosable mental disorder receive treatment.
Mental health remains a hidden health issue. It rarely receives public attention, is underfunded in both the public and private sectors, and was barely mentioned during the recent debate on health care reform.
The current shortage of mental health professionals, particularly psychiatrists, makes it inevitable that a considerable amount of mental illness care is provided in the nonmental health care sector.
Recent county-level estimates across the nation have identified widespread shortages of psychiatrists, and maldistribution of other mental health professionals, especially in rural areas.
The importance of the number of mental health professionals is reflected in the fact that, on average, the higher the number of psychiatrists, psychologists, and social workers per capita in a state, the lower the suicide rate.
The shortage of mental health professionals is highlighted not just by current unmet needs but by the fact that for those patients who do get treatment, current service use is not overly generous: Adult patients with a serious mental illness such as psychosis typically spend 10.5 hours per year with nonprescriber mental health professionals and 4.4 hours per year with prescriber mental health professionals or primary care physicians in mental health visits; adults with a less serious mental illness such as depression or anxiety spend about 7.8 minutes with nonprescriber mental health professionals and 12.6 minutes with prescriber mental health professionals or primary care physicians in mental health visits per year.
Suggested reforms for this issue include:
- Better long-term planning for workforce needs
- More incentives to encourage people to enter the mental health workforce
- Incentives to address the maldistribution of the mental health workforce
- Better use of telemedicine and IT
- Recognition of the important role of pediatricians
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