Texas Takes Unprecedented Action to Attract Mental Health Professionals

As an already overextended mental healthcare system attempts to deal with an excess of cases and a shortage of providers, one state is offering significant incentives to attract mental healthcare providers to areas with the most need. Mental health agency officials in Texas cite a “chronic maldistribution” of providers across the state’s 254 counties as a major public health emergency. Of these 254 counties, roughly 200 are designated as mental health provider shortage areas – or roughly 1 psychiatrist to over 30,000 people. At this ratio, it is nearly impossible for individuals in need to get a referral to a mental health specialist. Alarmingly a survey conducted in April found that 185 of Texas’ counties lacked even a single certified psychiatrist. This shortage is especially prevalent in rural communities where many mental health professionals simply don’t want to practice. Andrew Keller, executive vice president for the Meadows Mental Health Policy Institute for Texas explains the rural shortage: “We really do have special challenges in rural areas, because you go to school, you get a couple hundred thousand dollars of debt, you feel like you should at least have a Starbucks near you, but there’s a statewide dearth across the board. It’s psychiatrists, it’s social workers – it’s everybody.” To address this pressing issue Texas has allocated nearly 3 million dollars to help pay off mental health professionals’ student loans if they choose to practice in underserved areas. For graduates of expensive medical schools, this incentive may attract them to areas with the greatest need. The shortage however is a multi-faceted issue which is exacerbated by the fact that Texas’ Medicaid system pays mental health professionals at lower rates than private insurers. These lower rates coupled with the fact that Texas has the highest prevalence of uninsured individuals in the United States (24% compared to the U.S. average of 15%), means that many of Texas’ mental health clinics operate on tight budgets. This issue is further compounded by many psychiatrists who refuse to accept new Medicaid patients. The Texas Medical Association estimates that 1,100 mental health professionals would need to be hired to begin to quell the existing shortage. This number is likely to grow as the state’s population is increasing rapidly, and the average age of male and female psychiatric workers stands at 57 and 50 respectively. As the gap between available providers and patients in need grows, states will have to look to innovative staffing solutions to meet their growing needs. Solutions like telepsychiatry and locum tenens staffing at Barton Associates are good examples of ways in which states with similar needs as Texas can remedy their mental health staffing problems.