Morgan 1

Jason Morgan

Prof. Carter

English 1201

16 Dec. 2020

Research Essay

With the nation’s mental health crisis rising, the need for psychiatrists is imperative now

more than ever. It is important to understand and address this shortage before the mental health

field and many patients needing psychiatric treatment suffer. Much of America relies on

psychiatrists, and with barely anything or anyone assisting the psychiatrists, it can be devastating

to society. There is a girl that has had many issues getting in touch with psychiatrists in her area.

Due to the unavailability, she has had a lot of mental health problems that might have been likely

solved if the United States had dealt with the shortage sooner. Not only was this a problem for

her, but it affected many people in her life and caused a lot of anguish for people who didn’t

deserve it. It has made friends and family sad and depressed seeing her normality slowly drift

away from her. With a little assistance from The United States government, a lot of people can

be living happily and protected from any mental health problems that might affect the ones

around them. What does The United States have to do to improve the condition of psychiatrists?

The United States needs to support psychiatry for advertisements, for schools, and for jobs to

ultimately recruit more psychiatrists and help the mental health field shortage.

Much of psychiatry has been on the decline for some time now. According to Pallarito,

“It has slowly snowballed since the 1980s when state psychiatric hospitals were

deinstitutionalized” (4). Ever since then much of the people suffering from mental health

problems have had difficulties getting in contact with psychiatrists to resolve their conflicts. Not
 Morgan 2

to mention that in 1983, Conrad explains that psychiatry and psychiatrists “became the subject of

severe criticism in the medical community… [because they] were essentially custodial figures

divorced from the rest of medicine” (6). This quote furthermore shows the reason for the decay

in psychiatric workers as psychiatry back then wasn’t supported by the medical community.

With this as the foundation of downfall for the psychiatric workforce, much of society in later

years will soon discover the mistake of neglecting and letting the U.S. neglect psychiatry.

Flash forward to our current century where the inclusion of psychiatrists in the workforce

is imperative. According to Harrar, “There are about 30,451 practicing psychiatrists in the US…

that’s about 9 psychiatrists per 100,000 people, short of the nearly 15 per 100,000” (4). This

explains the overall condition of the shortage and just how inadequate the ratio of psychiatrists to

patients is.

Related to Stephen’s article, "psychiatrists were second on the list of most requested recruiting

assignments” (2). The demand for psychiatrists has increased and will continue expanding due to

the shortage in the workforce, and the increase in patients in need of psychiatric treatment will

also grow. Related to the article by Raphelson, out of “13.6 million [in need of psychiatric help,]

… Sixty percent of those adults received no mental health services in the past year” (5). This

information is frightening, not only because of the information that there is a lesser number of

patients treated than untreated, but the fact that the percentage of patients with no service will

only escalate with no support. Even with a little adjustment to the number of psychiatrists that

operate, it’s going to take a lot more than a minor change in psychiatrists. Moreover, what’s

“really driving the shortage is the baby boom," (Raphelson 4). This quote elaborates on the fact

that the shortage of psychiatrists is only going to get worse as many are most likely going into

retirement and leaving the workforce. Due to the range projected in the future, there is a lot that
 Morgan 3

must change, and for that change, it must take alterations in all aspects relating to psychiatry,

(Exhibit ES-1).

Exhibit ES-1:This graph shows the shortfall range for 2032 and how it is projected to be
between 47,000 and 122,000 physicians.
Psychiatry is being neglected and many people don’t/can’t process the significance of

psychiatry and how it can influence the U.S. to aid psychiatry. That’s where the necessity of

advertisements is crucial for this field. Many individuals that find out about the shortage of

psychiatrists are usually those in need of treatment of some kind. They uncover it through

research, a referral from another doctor, or even an acquaintance. That’s when they might

discover through cost and wait time how essential a psychiatrist is to society. As shown by

Harrar, “we couldn’t find child psychiatrists for kids coming out of a hospital mental health

program without waiting four months or longer,” (1). This quote details how this individual
 Morgan 4

found out about psychiatry, and how they had to suffer due to their lack of understanding. The

U.S. hasn’t confronted the complications of psychiatry, but the fact is that many aren’t aware of

the shortage and how they might have a beneficial impact is worrisome.

Many can have an impact on the crisis. There is an insufficient amount of advertising for

psychiatrists about the condition they are in and how the shortage has affected them. Due to this,

many people blindly consult their psychiatrists and ignore what it takes for them to be

confronted. If patients know how the shortage influences the area they reside in currently, they

might be able to adjust their schedules or do other means of helping the psychiatrists in their

area. Patients can better work with the psychiatrists and figure out what is best for both of them

as they have other patients to deal with daily. As a community, people can better help the

shortage by raising awareness to those that are patients, and even to those who aren’t, and make

the lives of psychiatrists more peaceful. Though, the U.S. should help the communities

understand by promoting and establishing certain programs of awareness or other means of

pulling in the community to further understand the mental health crisis. One way that would be

beneficial is a psychiatric job program that advertises psychiatry, and everything related to being

a psychiatrist, to those unaware of or interested in the job. Doing this would not only positively

adjust the likelihood of those going into the workforce, but it also will likely advertise the

condition of psychiatrists to others. Another would be a governmental supported charity service

where many could raise money and awareness for psychiatrists. This would be very beneficial

since a majority of problems for psychiatrists lie in the lack of funding necessary for

psychiatrists to properly perform their duties. Lastly, and likely one of the best methods to

addressing the shortage through advertisements, is to let patients know how to replace the role of

a psychiatrist with a profession that would better suit one of their needs. Detailed by Harrar,
 Morgan 5

“specially-trained advanced practice nurses, physician assistants and, in some places,

psychologists, are filling a looming mental health care gap” (19). If it were advertised that the

role of a psychiatrist was not needed for a person’s specific problem, it would impact the

shortage by minimizing the visits. The shortage can be positively altered not just by adding

numbers, but helping the psychiatrists deal with their schedule as it would most likely be too

demanding due to the excessive appointments.

The educational process to become a psychiatrist has been something that many

individuals have strived away from. Whether it is the many years it takes to become a

psychiatrist, how demanding those years will be, the amount of student debt one accumulates,

the absence of federal funding, etc., it’s enough to make anyone second guess themselves and

wonder if this is the career for them. School is the main place a student going to absorb the

wisdom to be able to operate as a psychiatrist, and it’s understandable with the condition the U.S.

has put psychiatrists under with school why there is a shortage in the first place. If the U.S.

addressed the obstacles in school, it most likely would translate to actual jobs and better help the

shortage. They can offer service by not deterring individuals from being psychiatrists with

financial issues that they ensue on them. Then furthermore aiding them by making the learning

process less atrocious.

The learning process that many psychiatrists must go through is one reason why there is a

shortage as this is something that the U.S. has to promote. As stated by Aftab, “The way they are

educated and trained, they are unaware of the systematic ways in which research studies and

guidelines are heavily biased and misrepresented” (1). This explains the fact of why the learning

process to become a psychiatrist isn’t perfect. Not only is this a problem for psychiatrists, but

their learning can also affect the patients. As described by Aftab, “psychiatrists have to rely on
 Morgan 6

their clinical experience when working with individual patients, which is subject to biases and

distortions of its own” (2). With this information, this means many psychiatrists will offer

different advice for their patients. With the way that the U.S. has supported this field and their

education explains why everything related to schooling is poor. For instance, federal funding

contributes to many issues of schooling and job ware in general for psychiatrists, and the lack of

federal funding has cost many dearly. Detailed by Raphelson “the federal government, which

funds medical residency programs, put a cap on them under the Balanced Budget Act of 1997”

(6). Although they have contributed with funding, they are damaging the industry by prohibiting

the excess amounts of spots being filled to benefit the crisis even it is one of the most wanted

professions. Not to mention that the funding for these programs and other medical health

services is poor. As explained by Stephens, “it's up to Congress to authorize more training costs

if psychiatry ranks are to grow.” (13). Much of what the U.S. government does isn’t good

enough to help the shortage. They need to step forward and take more of an initiative by

allowing more funding and better education for psychiatrists. Lastly, the problem

that needs addressed the most is the situation of psychiatrists in the workforce and how the U.S.

has affected it and promoted it to better help the state of jobs. Where most problems arise for

psychiatrists isn’t with how patients know of the state or the psychiatrist's condition in school,

but their position acting in the workforce. There is not only a lot of stress for the patients who

can’t get to a psychiatrist, but there is stress for the psychiatrist themselves. People look at the

fact that they or others can’t get to a psychiatrist and they don’t consider that it’s because the

psychiatrists are likely all occupied with their jobs. The psychiatrists one meets have to go

through at least 10 patients a day and even then, they have to determine their next visits and

other conflicts with their everyday schedules. With this alone, a psychiatrist has a lot on their
 Morgan 7

plate, but the condition the U.S. has set forth increases the stress plenty. It seems like many

psychiatrists are restricted from their actions and that translates over to how their performance is

in the workforce. As anyone can guess, it’s an unacceptable performance that isn’t fair to the

psychiatrist and the patients they have. The U.S. has to change what has already been set forth

for all psychiatrists to not only help the shortage that they are partly to blame for, but the

condition for all psychiatrists in general.

One main reason for the increased stress in the workforce is the lack of federal funding

for psychiatric services. According to Raphelson, “the lack of federal funding for mental health

services may be to blame” (1). Federal funding is crucial for psychiatry in general when relating

to treatment, drugs, and other means that a psychiatrist needs to perform tasks properly. Even

back in the 1980s where psychiatry first declined there were barriers with the U.S. granting

efficient funding. It's enough that psychiatrists have to consult patients left and right daily, but to

have a conflict with their methods is extremely hinder some. Another reason is the worksite that

psychiatrists have to operate. As mentioned by Raphelson, “there are more than 3,800

psychiatrists in California, but only 34 in all of Wyoming” (9). The number of psychiatrists in

some states, like Wyoming, is absurdly minuscule compared to other states, and whether or not

it’s because of the education or opportunities offered in other states for the psychiatrists, the U.S.

has some blame for permitting this to happen. Due to this unbalanced distribution of

psychiatrists, it has likely caused psychiatrists added stress dealing with so many patients or

dealing with so few, and patients stress as some are most likely in specific states where they will

have to venture far to find a psychiatrist. It can be so extreme as to “need a boat or plane to reach

one” (Harrar 4). The U.S. can effortlessly offer some service to increase the role of a psychiatrist

for a state that is lacking, but their assistance shows the neglect they show for psychiatry. The
 Morgan 8

U.S. would need to offer federal funding for psychiatry, guide psychiatry to be even in all states,

and allow more to be psychiatrists to tackle the shortage.

The U.S. undoubtedly is at blame for much of the failure with psychiatry in general.

Their faulty to promote certain aspects relating to psychiatry is why it’s in a crisis in the first

place. The U.S.’s actions dealing with certain matters also causes complications for the shortage.

Though, some may argue that the U.S. has done plenty for all aspects of psychiatry and that the

shortage is caused by normal and unavoidable occurrences. A reasonable argument would be the

baby boom and the fact that many are now retiring due to their age. Although this is true that the

baby boom is an unavoidable cause of the shortage, to replace the many retiring the U.S. should

have not put a limit on the number of new psychiatrists being able to go into the workforce.

Another controversial statement would be about federal funding, one of the main causes of the

shortage as it’s detailed as a problem in both jobs and schooling, and how it’s a reasonable

amount of money that medical services are rapidly consuming. Anyone could agree to this

argument only if there weren’t so many complications as a result of a reduction of federal

funding. If medical services were using the money as a way of promoting the look of their

offices, then of course the lack of federal funding would be reasonable. Though the fact of the

matter is there are too many issues pilling up on these medical services that can be fixed by the

federal funding offered to them currently. Finally, the last argument that others could conjure up

is the allegation about the fact that the U.S. has established many primary care institutions,

programs, and other factors of addressing the shortage. The U.S. is indeed beginning to not

neglect the shortage by setting up these tactics to better improve the situation for all growing and

established psychiatrists by narrowing in on weak areas within the medical field granting

financial subsidization and even allowing free training for the psychiatrists. However, the
 Morgan 9

medical field is an extremely valued profession and all that they are starting to do won’t have a

good enough impact that will truly affect the shortfall range leading up to 2032 (Exhibit ES-1).

Of course, the establishment of these programs and other factors are welcoming from the U.S.;

though, there is no telling that it will be both an improvement of America’s medical field crisis

and beneficial for the psychiatrist's work as well.

The girl that has had many complications getting in touch with psychiatrists in her area

and has suffered many mental health problems shouldn’t be in the state she is in now. Though, is

it likely that in the future there could be more like her? More that affect the many people in their

life and cause a lot of anguish for people who don’t deserve it. More that have made friends and

family sad and depressed seeing the normality slowly drift away from them. No one deserves

that and the U.S. can improve the condition of the shortage so others can get the assistance they

need by visiting a psychiatrist. The United States needs to promote psychiatry for

advertisements, schools, and jobs to ultimately recruit more psychiatrists and help the mental

health field shortage.

Works Cited

Aftab, Awais. “Psychiatry's Intellectual Crisis Giovanni Fava, MD.” Ebsco, Sept. 2020,

http://sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?

direct=true&db=ccm&AN=145452418&site=eds-live

Conrad, Jordan A. “A Black and White History of Psychiatry in the United States.” Ebsco, 2020,

http://sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?

direct=true&db=edssjs&AN=edssjs.A22EF7B0&site=eds-live

Exhibit ES-1. A Growing Crisis: Physician Shortage. 4 Nov. 2020, www.focusforhealth.org/a-

growing-crisis-physician-shortage/.

Harrar, Sari. “Inside America's Psychiatrist Shortage.” Psycom.net, 8 Sept. 2020,

www.psycom.net/inside-americas-psychiatrist-shortage.

Pallarito, Karen. “The Doctor Gap: Where Are All the Mental Health Care Providers?” U.S.

News & World Report, 18 Mar. 2020, www.usnews.com/news/health-news/articles/2020-

03-18/img-src-https-healthdaycom-img-logos-healthday-depthjpg-width-31-br-the-doctor-

gap-where-are-all-the-mental-health-care-providers.
 Morgan 11

Raphelson, Samantha. “Severe Shortage of Psychiatrists Exacerbated by Lack of Federal

Funding.” NPR, 9 Mar. 2018, www.npr.org/2018/03/09/592333771/severe-shortage-of-

psychiatrists-exacerbated-by-lack-of-federal-funding.

Stephens, Stephanie. “The Truth about the Psychiatrist Shortage.” Health ECareers, 8 July 2019,

www.healthecareers.com/article/career/the-truth-about-the-psychiatrist-shortage.