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Psychiatric Services 'Crisis' Spurs Call for Reform

By Christopher Cheney  
   March 30, 2017

Recommendations from the National Council for Behavioral Health include payment reform, workforce expansion, training reforms, and more widespread use of telemedicine.

Psychiatric services are in a state of crisis nationwide, and stakeholders across the healthcare industry have roles to play in fixing the multifaceted problem, the National Council for Behavioral Health (NCBH) says.

A report released this week was prepared by the nonprofit's Medical Director Institute and a 27-member expert panel drawn from providers, payers, government agencies, and psychiatric organizations.

During a conference call Tuesday with members of the media, Joseph Parks, MD, medical director of the NCBH, said there is a national shortage of psychiatrists that is threatening to spiral out of control.

In 77% of U.S. counties, healthcare officials are reporting a severe psychiatrist shortage, and the aging psychiatrist workforce also poses a daunting challenge, he said.

"The average age of a practicing psychiatrist is in the mid-50s. This is compared to the average age of other medical specialists and primary-care physicians in their mid-40s. They will be aging out rapidly."

The shortage imposes a nightmare scenario on many psychiatric patients and the healthcare providers trying to serve them, said Parks, who is chairman of the NCBH Medical Director Institute.

"Two-thirds of primary care physicians report that they have trouble getting psychiatric services for their patients. So, they go to the emergency room. There has been a 42% increase in the number of patients going to the emergency room for psychiatric services in the past three years, but most of them are not staffed with psychiatrists."

"People end up stuck in emergency rooms for hours and at times days." Parks said.

"Finally, they try to get into an inpatient psychiatric bed, but hospitals have been closing their psychiatric units because they can't find psychiatrists to hire and staff to run them. It is truly becoming a crisis."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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