Policy brief outlines recommendations to address California’s psychiatric workforce shortage

A recent policy brief from California Health Policy Strategies outlines the current status and future outlook for the state’s pipeline for new psychiatrists. According to the brief, California’s behavioral health workforce shortage, which is already considered a crisis, is expected to worsen in the coming years.

 

 

A 2019 analysis from the Kaiser Family Foundation found that in California’s health professional shortage areas (HPSAs), only 29% of mental health care needs are being met. This is only slightly better than the US average of 27% and places California 26th in terms of percent of psychiatric care needs being met. In just the HPSAs, the state would need an estimated 405 additional psychiatrists to close the gap.

For the state as a whole, the shortage is expected to worsen in the coming years as an aging psychiatry workforce retires and demand continues to increase. According to the UCSF Healthforce Center, the number of psychiatrists in the state is expected to decrease 34% between 2016 and 2028.

To address these shortages, the policy brief identifies three recommendations for policymakers and stakeholders to consider:

  • “Increase the number of residency positions in California.” According to the brief, 77% of residents who graduate from residency programs in California are likely to remain in the state. However, with only 178 psychiatry residency positions currently offered in California, the number of positions has not kept up with demand. The policy brief describes this as a “critical bottleneck.” About 30% of all students applying to psychiatry residency programs in the US apply to California schools, and the residency shortage means qualified applicants are often turned away or redirected to other states.
  • “Prioritize California students for California psychiatry residency positions to increase retention rates.” Just over one-third of individuals in California’s residency programs attended California medical schools. To improve retention rates, the brief recommends adding additional weighting for California applicants in determining who receives residency positions.
  • “Create a public, accurate database on the number and characteristics of currently practice psychiatrists in California.” Without a publicly accessible database that tracks information about practicing psychiatrists, it’s difficult to guide the state’s response to the workforce shortage, reads the brief. It recommends that the Medical Board of California make available additional information organized be specialty in its annual report. This includes data on the number of physicians in each specialty, demographics like age or race/ethnicity in each specialty, geographic location, and types of practices.

California Health Policy Strategies’ full policy brief is available here.