New data from APA’s Center for Workforce Studies (CWS) project that by 2030, the national demand for psychologists will increase by about 6%, to 101,000 full-time positions. In particular, demand is projected to increase for services with:
- Patients in hospitals, where overall population growth combined with increasing numbers of older adults will increase hospital stays.
- Hispanic populations, which are expected to grow from about 18% of the U.S. population to about 21%.
- Older adults, who will account for about 1 in every 5 U.S. residents, according to the U.S. Census Bureau.
- Americans living in southern states, for whom there are already fewer psychologists per person than in other geographic populations.
“We can have the right numbers of psychologists, but they also need to be in the right geographic areas, in the right work settings, and have the appropriate training to serve diverse populations and health needs,” says Karen Stamm, PhD, director of CWS.
The opportunity for psychologists could be even greater if some of the barriers that underserved communities face were reduced, Stamm adds. For example, the CWS projects that as many as 25,000 more psychologists could be needed by 2030 if racial and ethnic minorities used services at the same rate as the non-Hispanic white population.
Growth in hospitals
By 2030, hospitals are projected to have more inpatient visits, resulting in a 26% increase in psychologist positions from 2015—the largest projected increase of any psychologist work setting.
Also driving that increase is hospital administrators’ growing recognition of the behavioral and mental health aspects of health conditions that psychologists can address, from cardiac problems to substance use disorders, says Paul Kettlewell, PhD, ABPP, director of pediatric psychology and integrated behavioral health/primary care at Geisinger Health System in Pennsylvania. Geisinger has expanded the role of psychologists in specialty-care settings, including cardiology, sleep medicine and pediatric gastroenterology, and has added psychologists to primary-care teams.
“There are compelling reasons why integrated health-care systems like Geisinger, the Mayo Clinic, Cleveland Clinic and Intermountain Healthcare believe that behavioral health is critical to their system of care,” Kettlewell says.
Meanwhile, as health-care systems look for ways to improve the overall health of their populations, new leadership opportunities for psychologists are emerging, adds Jared Skillings, PhD, ABPP, APA’s chief of professional practice.
“These are areas that have been historically filled by physicians and business people that in fact more appropriately ought to be filled by psychologists,” he says. “It’s a new opportunity for psychologists to demonstrate the high-level, broad skill set we have.”
Cultural and language needs
The demand for bilingual and culturally competent psychological services for Hispanic Americans—defined as those with Spanish-speaking ancestry—will grow 30% by 2030, CWS projects. “It’s crucial for psychologists to better reach underserved populations,” says Skillings.
Yet, he points out, Hispanic Americans already struggle to find mental and behavioral health care, even in culturally diverse areas. Only 5.5% of psychologists can provide services in Spanish, and only 4.4% of psychologists are Hispanic. “The needs are dire,” says Lydia P. Buki, PhD, an associate professor and training director for the University of Miami’s counseling psychology program. The program’s bilingual training clinic serves more than 120 Latinx clients annually. (For others, see the June 2018 Monitor article “Spanish-Speaking Psychologists in Demand.”)
To grow the workforce, it’s essential to capture students early in their education, says Claudette Antuña, PsyD, MHSA, LICSW, a psychologist in Washington state who frequently works with immigrants. For example, we need more young Americans to learn Spanish and develop a deeper appreciation of other cultures, and at the same time, mental health professions could improve their outreach to Hispanic high school and undergraduate students to consider mental health careers, she and other psychologists say.
Older adults
The number of Americans 65 and older is projected to grow by 34% between 2015 and 2030—and by 2035, older adults will outnumber childrenopens in new window for the first time in U.S. history, according to the U.S. Census Bureau. As a result, by 2030, the demand for psychologists will increase by 40% for adults ages 65 to 74 and by 71% for adults over 75.
And that demand could be even higher. The middle-aged adults who will become older adults in the next 15 years have a higher prevalence of behavioral health problems and are more familiar with and use behavioral health services more often than today’s older adults, according to a paper led by Jennifer Moye, PhD, of the VA Boston Healthcare System and Harvard Medical School (Training and Education in Professional Psychologyopens in new window, Vol. 13, No. 1, 2019).
So far, the prospects for meeting that demand are not encouraging. A 2015 APA survey found that early career psychologists reported feeling less competent to work with older adults than other diverse populations, and only about 2% of psychologists say geropsychology is their primary or secondary specialty.
Graduate and undergraduate students who want to investigate such careers should visit APA’s Exploring Careers in Aging road map, an online resource developed by APA’s Committee on Aging.
The South
The U.S. Census Bureau defines the American South as the area from Texas to Delaware. According to the latest data available (2015), CWS estimates that the South had 22 psychologists per 100,000 people. By comparison, the Northeast averaged 49.
The South also includes the three states with the lowest proportion of psychologists: Mississippi, South Carolina and Louisiana. But even in southern states with more psychologists, such as Maryland, they aren’t evenly distributed: About 40% of Maryland’s counties are partially or wholly designated as mental health professional shortage areas by the U.S. Health Resources and Services Administration.
One of the best ways to bring health-service psychologists to a state is by offering graduate training and internships to them, psychologists say. For example, in the Rio Grande Valley of Texas, psychologist Joseph McCoy, PhD, and colleagues worked with the Texas Psychological Association and the Hogg Foundation to develop an internship consortium that led to an APA-accredited internship at the University of Texas Health Science Center at Tyler. Other psychologists are coming to rural areas thanks to the Public Service Loan Forgivenessopens in new window Program, which forgives certain kinds of loans when participants work in public service jobs for 10 years, and the National Health Service Corpsopens in new window, which brings mental health professionals to shortage areas in exchange for up to $50,000 in loan repayment.
In addition, a reportopens in new window from the South Carolina Institute of Medicine and Public Health recommends retaining psychologists and other behavioral health providers by improving reimbursement rates and offering more competitive pay for those working in public and community-based organizations.
“Everyone in our state should have access to the type of care they need when they need it—regardless of the health issue or their zip code,” says Kester S. Freeman Jr., the institute’s executive director.
