Psychologists, social workers and psychiatrists: too many or not enough?

Ask researcher Jessica L. Kohout, PhD, how many psychologists there will be in coming years, and you?ll get a simple answer: No one knows.

The U.S. government doesn?t know either. Data from the U.S. government haven?t helped much and can even be misleading. The U.S. Department of Labor?s Bureau of Labor Statistics (BLS) includes BA- and MA-level psychological personnel in its counts and relies on employees? and employers? personal definitions of the job title 'psychologist.'

Further, federal counts are for the field as a whole, rather than for the portion that engages in direct-service activities. This methodology makes it difficult to interpret the data accurately and to tease out the implications for supply and demand at the various degree levels in psychology.

The data for social workers are similarly muddied. And the bureau lumps psychiatrists in with physicians as a whole.

Hints about what the future will bring can be found, however.

Psychologist Brett N. Steenbarger, PhD, editor of a Web site called psycOH! Behavioral Health Online (www.psycoh.com), believes that important clues can be found in U.S. Center for Mental Health Services data.

When Steenbarger first saw 'Mental Health, United States, 1996' he was alarmed. He was even more concerned when he realized that current enrollment in training programs meant that the number of behavioral-health providers could increase by 25 percent in coming years.

Steenbarger extrapolated from the data to find out just how bad the situation might be. According to his calculations, average utilization under managed-care suggests that the nation needs only 70 behavioral-health practitioners per 100,000 citizens. The nation already has 113 per 100,000 population, suggesting an oversupply of practitioners.

But that?s only part of the story, emphasizes Steenbarger, an assistant professor of psychiatry at the State University of New York Health Science Center in Syracuse.

'These figures don?t reflect the absolute need for mental health services,' he says. 'If you look at epidemiological norms, there?s not an oversupply of mental health professionals at all.'

After examining data about the prevalence of mental and emotional disorders, Steenbarger realized that the nation would actually need 250 behavioral-health practitioners per 100,000 population to handle the true need for services.

'[That?s] more than twice the U.S. average of 113,' he wrote in a psycOH! article. 'By this standard, we have a shortage of mental health professionals!'

?Rebecca Clay