Recent research published in psychiatric services suggests that the United States faces a severe and critical shortage of physicians specializing in adult mental health care. This study provides evidence that the demand for these medical professionals will increase rapidly over the next decade, while the available supply will decrease. This decline in the workforce is expected to make it increasingly difficult for adult patients to access mental health care, especially in rural areas.
The demand for mental health treatment in the United States is steadily increasing as the public becomes more aware and more people seek help. At the same time, the majority of currently employed physicians are approaching retirement age. This combination of factors puts enormous pressure on the entire healthcare system.
Within mental health care, physicians who specialize in treating adult mental illnesses play a very special and necessary role. These professionals have the ability to prescribe medications and manage complex mental illnesses that cannot be treated by other mental health professionals alone.
Recent observations suggest that fewer of these specialists are choosing to participate in health insurance networks. This lack of insurance coverage makes it difficult for the average patient to find affordable treatment. Barriers to accessing professional medical care can lead to poor health outcomes for vulnerable populations. However, few recent assessments have assessed whether a country actually has enough of these professionals to meet growing needs.
Because of this knowledge gap, the authors wanted to assess the current and future state of this particular workforce. “We were interested in investigating the growing disconnect between mental illness and mental health care providers,” said Dr. Jason Silvestre, a researcher and physician at the Medical University of South Carolina in Charleston. The authors aimed to analyze the supply, demand, and overall sufficiency of physicians specializing in adult psychiatry.
Scientists hypothesized that the ratio of active professionals to patient demand would shrink over time. They also expected to see geographic disparities, with certain states and local regions experiencing more severe shortages than others.
To examine these trends, researchers analyzed data from a government-run forecasting tool called the Health Workforce Simulation Model. The simulation tool is managed by a federal agency that tracks health care workers across the country. This model relies on a microsimulation approach. That is, it uses large amounts of real-world data to predict future trends. Data is obtained from trusted sources such as the U.S. Census, state medical licensing boards, and the American Medical Association.
The authors extracted all relevant forecasts from 2024 to 2037. The analysis focused specifically on psychiatrists who treat adults. To make accurate calculations, the researchers measured labor force in full-time equivalents. This concept accounts for the fact that some doctors work part-time or split their hours. For example, two physicians who devote 20 hours a week to patient care are equivalent to one full-time equivalent professional.
The researchers calculated workforce adequacy by dividing the expected supply of full-time physicians by the expected patient demand. They investigated patient demand under two different scenarios. The first is the status quo scenario, which assumes that current healthcare utilization patterns remain exactly the same. The second is an improved access scenario, which models what would happen if systemic barriers to care were removed and more people had free access to mental health treatment.
The findings detail a decline in the number of medical professionals available over the next decade. Researchers predict that the national supply of full-time adult psychiatrists will decline by 12.3 percent. In raw numbers, the workforce is expected to decline from 37,260 full-time equivalents in 2024 to 32,660 full-time equivalents by 2037.
Over the same period, the need for these services is expected to increase rapidly. In the business-as-usual scenario, patient demand is expected to increase by 43.7 percent, from 53,100 full-time equivalent patients in 2024 to 76,320 full-time equivalents in 2037. In the improved access scenario, demand jumps by 47.4 percent. Under this model, the United States would need 111,430 full-time professionals by 2037 to adequately treat its adult population.
As demand increases and supply decreases, overall workforce adequacy is expected to decline sharply. In the current situation, the country’s workforce is only 70.2% full, which means there is already not enough doctors. By 2037, this sufficiency rate is expected to fall to just 42.8 percent. As patient access to care improves, the fill rate will worsen, falling from 49.3 percent in 2024 to 29.3 percent in 2037.
Scientists also showed evidence of deep geographic divisions across the country. In 2024, labor adequacy in non-metropolitan rural areas remained significantly lower at 33 percent compared to 74.3 percent in urban areas. The region’s disadvantage is expected to continue, with the sufficiency rate expected to fall to just 20.9% by 2037. A comparison of regions reveals that the South and Midwest tend to have the lowest labor sufficiency, while the Northeast tends to have the highest.
By disaggregating the data by state, the study identified specific regions with the most severe staffing shortages. Researchers found that 42 states will have a workforce sufficiency rate below 100 percent in 2024. The states with the lowest fill rates at the time were North Dakota, New Mexico, and Oklahoma. Simulations show that by 2037, 43 states will have unmet patient needs. The states expected to face the most severe shortages in the future are Idaho, Nevada, and Alaska.
“The average reader needs to understand that the adequacy of the psychiatrist workforce is declining, especially in certain geographic regions,” Silvestre noted. This conclusion highlights the practical reality that where a person lives greatly influences their ability to receive psychiatric treatment.
To provide a broader perspective, the scientists compared adult psychiatry to the top 20 largest medical specialties in the country. The adult psychiatry field ranked last in workforce adequacy in 2024. Projections show that this specialty will remain at the bottom of the list until 2037, both under current conditions and under improved access scenarios. “We were surprised by the expected deficiencies in adult psychiatrists, especially compared to other specialties,” Silvestre added.
The authors suggest several strategies to address these pressing shortages. Expanding residency training programs has the potential to increase the supply of future specialist physicians. Medical school graduates must complete a training program to practice psychiatry, a specialty that is highly competitive. Many qualified applicants are turned away each year simply because there is a shortage of training positions. Increasing funding for these programs could lead to more qualified professionals.
State governments may also implement targeted incentives to attract medical professionals to areas experiencing the greatest shortages. These incentives could include student loan forgiveness programs and expanded visa options for foreign doctors. Expanding training programs in states like Idaho and Alaska could also strengthen the local workforce, as residents often choose to practice in the same geographic area in which they completed their training.
Expanding telehealth services is another potential solution discussed by the authors. During the recent pandemic, the medical field has seen a significant increase in virtual care. With the right laws and interstate licensing agreements, physicians can treat patients in far-flung and underserved states without physically relocating.
Researchers also note that modern psychiatrists increasingly prefer hospital employment and part-time schedules, which is changing the way care is delivered. Temporary contract work, known as locum tenens, is also becoming more common in the medical field. Administrative and financial burdens also play a major role in shaping this workforce.
Lower payment rates from public insurance programs such as Medicare may deter doctors from accepting new patients. Over time, these bureaucratic frustrations can lead to career burnout and cause some professionals to retire early or leave the medical field altogether.
The authors also noted that the demographics of the specialty are changing. More women and individuals from racial and ethnic minority backgrounds are participating in psychiatry training programs than in previous years. Researchers suggest that monitoring these demographic changes is essential to understanding the future preferences and career paths of the incoming workforce.
There are several limitations to keep in mind when interpreting this study. The findings rely on simulation models, so predictions are only estimates based on current data. Unanticipated changes in health care laws, demographic shifts, or sudden public health crises could cause these projections to change.
Although this model assumes that current trends are stable, real-world events often introduce unpredictable variables into healthcare systems. State-to-state differences in government insurance programs, such as Medicaid, can also change patient demand in ways that are difficult to predict.
Additionally, this study specifically focuses on physicians who prescribe psychiatric medications to adults. The study did not measure the supply and demand for non-prescribing mental health professionals, such as psychologists and certified therapists. Also, the expanded role of advanced practice providers, such as specialized nurses, was not fully considered. These nursing professionals are often able to practice independently and can help fill gaps in medication management.
Future research is needed to explore how these other specialists can fill the anticipated physician shortage. A broader understanding of the entire mental health workforce will help policy makers design better solutions. Government agencies and medical institutions need to closely monitor these changes to ensure patients receive appropriate care. Continuously tracking these trends will help healthcare leaders adjust their strategies as the population’s needs evolve.
The study, “The Impending Psychiatrist Shortage: Projected Deficiencies in the U.S. Adult Psychiatric Workforce,” was authored by Jason Silvestre, Sidney Seeger, Charles A. Reitman, and Benoît Dube.
