Psychiatrists are not spread across the country evenly. Nationally, the psychiatrist per 100,000 population ratio stands at about 16.5 per 100,000. That ratio, which reaches its high in Massachusetts at 31.1 per 100,000, bottoms out at 4.6 per 100,000 in Idaho. Counter-balancing the five states with the highest ratios Massachusetts, New York, Pennsylvania, California, and Texas are the five states with the lowest ratios: Idaho, Wyoming, South Dakota, North Dakota, and Alaska. The Western states have the lowest per capita supply.
Health insurance
Adding to the problem are the vagaries of insurance company practices and public health care systems. Some psychiatrists will only see patients with private insurance. Others who are employed by regional behavioral health associations which care for patients on the states Medicaid program. Arizona Health Care Cost Containment System will not see patients who have private insurance. And, there are some psychiatrists who will not accept any insurance plans.
Many private health insurance plans will only pay for a limited amount of mental health care.Mental health problems are singled out by insurance plans, and ongoing care may not be covered despite persistent need. If a patient is still in need of care for depression, for example, but their plan only allows for three mental health visits a year, they are forced to either discontinue care or pay for the care themselves. This is a major issue for physicians in Arizona who feel that mental illnesses should be covered by insurers just like any other disease. For example, insurers typically will pay for as many outpatient visits and hospitalizations needed to effectively manage a diabetic patient, but the same insurer will limit their coverage despite the need for ongoing care if the patient who has a mental health disorder.
While some of the mental health needs of patients can be managed by psychologists, some patients may be too ill and in need of an MD who can prescribe medication, something a psychologist cannot do. Over the years, physicians and mental health advocates have strongly lobbied for mental health parity, that insurance companies treat mental illnesses like any other medical condition, thus leading to a greater availability of services for people with mental health problems.
Cost
The emotional cost of mental illness is incalculable, but the monetary one is not. According to a report by the U.S. Surgeon General's office, in 1996 the United States spent more than $99 billion for the direct treatment of mental disorders. In 1990, the most recent year for which estimates are available, the indirect cost of all mental illness was at $79 billion, with most of that amount coming from loss of productivity due to premature death, incarceration and time spent by family members caring for the ill.
Primary Care Alternative to Psychiatry
Primary care physicians are attempting to compensate for the insurance void by learning how to care for such patients themselves. Because those primary care physicians know they don't have anywhere to send such patients, and the patient is going to keep coming back to them for care anyway, it behooves the doctors to expand their skills to cover these kinds of problems. However, many insurers refuse to reimburse pay primary care physicians for mental health services and only cover such services if provided by a psychiatrist.
Sources: The Centers for Disease Control and Prevention, School of Health Management and Policy at the W. P. Carey School of Business.
![[Valid RSS feed]](http://www.articledirectoryzone.com/images/icon_Rss.png "XML Feed For RSS"){kind=icon}
Category Rss Feed
Print This Article
Add To Favorites
