A Health Care Shortage: Not Enough Psychiatrists; New Residency Program at UF Health Attempts to Address the Need

Article excerpt

Byline: Derek Gilliam

There is a shortage of psychiatrists in the United States, and the situation is worse in Florida.

Part of the state's problem is too few residency slots, said Rajiv Tandon, vice chairman of psychiatry at the University of Florida's College of Medicine in Gainesville.

About 135 residency positions are available across the state, with about 25 percent of those graduating in any given year, Tandon said.

Mounting debt necessary to become a doctor combined with psychiatrists earning less than other specialty degrees contributes to the shortage. Another issue is the stigma associated with the mentally ill. Doctors can make more money and have less personal interaction with patients if they specialize in something else.

At issue is there are just not enough psychiatrists to go around and that's a major problem. In the last three years, the Jacksonville Sheriff's Office was called to 32,988 cases involving a mentally ill person, according to information supplied by the jail. The majority of the time, police are forced to hospitalize people involuntarily under the state's Baker Act.

The medical community will soon have more locally produced psychiatrists from a residency program that began in July.

Jacksonville's first hospital-based psychiatric residency program at UF Health Jacksonville plans to produce three graduates a year.

Residency programs are advanced training for doctors after they graduate from medical school. Newly minted residency graduates are usually in their 30s and are settled in an area, said Steven Cuffe, chairman of the psychiatry department at UF's College of Medicine in Jacksonville.

The residents have completed about 75 percent of their first year. Three new first-year residents will join the program July 1.

Jason Altmire, senior vice president of public policy and community engagement at Florida Blue, cited a Washington Post investigation that found 89 million Americans live in places where they don't have access to a mental-health professional.

Another access issue involves insurance coverage.

Altmire, also a three-term former U.S. congressman, co-sponsored the 2008 Mental Health and Addiction Parity Act that requires insurance policies to treat mental illness the same as physical maladies. The problem was it applied only if insurance plans provided coverage for mental-health services, he said.

Many plans opted out of including those services.

The Affordable Care Act, commonly referred to as Obamacare, fixed that. It made mental-health services one of 10 "essential health benefits" that must be covered.

One issue with the "essential health benefits" is large group plans and plans that were grandfathered in aren't required to provide mental health coverage, Altmire said.

He said there's another concern with the acts. In 2010, about 50 percent of psychiatrists didn't accept insurance, according to the Journal of American Medical Association.

The Affordable Care Act also brings millions of people into the health-care system but doesn't provide for more doctors to treat those patients, Altmire said.

Altmire spoke about the topic and insurance-related mental health issues recently at the Jacksonville Community Council Inc.'s inquiry into mental health. …