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Think about it: Psychiatrist shortage affects mental health care in Wisconsin

Professors push for initiatives to help psychiatry students
Think+about+it%3A+Psychiatrist+shortage+affects+mental+health+care+in+Wisconsin
Emily Shullaw

As the demand for mental health care rises, a shortage of psychiatrists plagues Wisconsin.

The shortage particularly affects rural areas of Wisconsin, Michael Peterson, assistant professor and director of hospital psychiatric services at University of Wisconsin Hospital and Clinics, said. The wait time for new referrals is long there, and some insurance companies find it difficult to refer people to psychiatrists.

“I think that ends up creating a situation where people can’t get the kind of care that would be best for them,” Peterson said.

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Peggy Scallon, child and adolescent psychiatrist at UW Hospital and Clinics, said the lack of psychiatrists creates a situation where primary care doctors, such as family practitioners and pediatricians, prescribe treatment for mental health disorders. This can be an uncomfortable experience for the primary care doctors, she said.

Scallon said the current wait time for children who are new referrals to a psychiatrist is seven-and-a-half weeks. Only 8,300 child and adolescent psychiatrists are working throughout the nation, she said, with many of them nearing retirement.

Peterson said a partly state-funded telepsychiatry program at UW could provide support for pediatricians in parts of the state where there are few or no child and adolescent psychiatrists. He said health care laws that treat and fund mental health care as much as other types of medical care are essential.

Angela Janis, director of psychiatry at University Health Services, said the psychiatric field can pose some challenges for medical students.

Janis said slots for psychiatry residency, a program medical students have to complete if they are pursuing psychiatry, is federally funded, but funding has not increased for several years.

“Those [residency funding] levels have been pretty flat for a while, so there aren’t necessarily more places for medical students to go once they like psychiatry,” Janis said.

Peterson said some people do not pursue psychiatry because they might have some misunderstandings and stigmas about mental illness. He said psychiatry is often not regarded as highly as other medical specialties.

UW recently increased the number of annual residents they take in so more students can be trained in psychiatry, Peterson said.

“Hopefully, with people training in the state and getting familiar with it here, some of them will want to stay and practice in Wisconsin,” Peterson said. “That will hopefully relieve some of the shortage.”

Scallon said UW is taking a number of initiatives to increase interest in psychiatry. For instance, psychiatry student interest groups have medical students meet practicing psychiatrists professionally and socially.

UW is also changing its curriculum so medical students have more exposure to what psychiatrists do in their clinics, instead of just in the hospital, Scallon said.

“We’re hoping that that will help with the recruitment and will make them see the clinic work might be more appealing than just hospital-based work,” Scallon said.

Wisconsin Psychiatric Association began a mentoring program allowing medical students to connect with practicing psychiatrists, Janis said. She mentioned other creative solutions involving primary care doctors, who would partner with psychiatrists to co-manage their mental health cases and reach more patients.

“We can talk to them and tell them all the wonderful things about psychiatry and why we love the jobs that we do,” Janis said.

Currently, medical students face student loan debts that can range from $200,000 to $300,000, Janis said. This often forces students to make a decision based purely on financial aspects. Psychiatry is also on the lower end of pay in comparison to other medical specialties, she said.

Since psychiatry requires a few more years of training after medical school, many students are in their early 30s and face pressure from these loans, Scallon said.

Scallon said UW is pushing for an initiative for medical school loan repayment that could reduce pressure on medical students.

But Peterson said the psychiatry shortage increases job security for potential psychiatrists because of the abundance of opportunities.

“I think [that is an] advantage that can make people aware and more likely to consider psychiatry for a career,” Peterson said.

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