Last updated 9/15/2023
On my very first day of graduate school, my advisor asked me to read an article. Written by a prominent academic psychologist, it shed light on what was called “the person power problem” in mental health—that is, that there are far too many people in need of mental health services and far too few professionals available to provide those services.
It called for a dramatic shift in the development and dissemination of evidence-based mental health interventions, away from the traditional model of one-on-one, weekly psychotherapy (the article focused on psychological interventions), and toward novel solutions that leverage technology, special settings, self-help, media, and more.
The problem continues to plague us—nearly a third the U.S. population lives in a mental health professional shortage area.
These are the states that are affected the most.
In the states with the greatest shortages, less than 11% (on average) of the population’s mental health needs are being met.
In the states faring best, about 60% (on average) of the population’s mental health needs are being met.
That’s a dramatic difference.
Mental health professional shortage areas are primarily based on the availability of psychiatrists.
Estimates from the Health Resources Service Administrators (HRSA) indicate a shortage of between 6,080 and 15,400 psychiatrists in 2025. Likely hundreds to thousands more psychologists, social workers, marriage and family therapists, and professional counselors are necessary, as well.
Mental health needs are only increasing, with over 20% of American adults living with some mental illness. And our inability to meet their needs is becoming a matter of life and death.
Provisional data from the Centers for Disease Control show that that the number of suicide deaths last year was the highest ever recorded—exceeding the previous record by over 1,000 deaths.
That article from grad school had a major impact on me, such that I have devoted my career to finding new and interesting ways to bring evidence-based care to those in need. It has now been over a decade since that article was published, and I do believe the mental health field has come a long way.
The mental health field has expanded the suite of interventions to include self-help, peer support, group therapy, and coaching. There are stepped-care delivery models that drive individuals to the least resource intensive yet effective intervention available. The care is based on individual preferences and clinical severity, allowing licensed and specialty providers to focus on those with higher acuity and severity.
We have also made it possible for individuals to receive care via telehealth. And we have advocated for legislative changes, such as the Psychology Interjurisdictional Compact (PSYPACT), that allow providers to practice telepsychology across state lines.
And as we work on this problem, let’s remember the ways in which those in need can currently find help:
By speaking with their primary care physician about their symptoms and treatment options.
By checking with their insurance carrier about mental health coverage and in-network options.
By looking into reputable mental health providers for convenient, private, and clinically rigorous care.
If you live in a location with limited access to licensed mental health providers, there are still ways to get access to evidence-based support:
Engage in digital self-help. Nowadays, there are hundreds of apps available to teach you evidence-based skills to manage your anxiety, depression, stress, and more. If you have trouble finding the right app, check out One Mind PsyberGuide, an organization that reviews apps with an eye on credibility, privacy, and user-friendliness.
Consider telehealth. Telehealth is an increasingly available option that enables those in need to access timely, convenient, evidence-based care. With telehealth, you have access to a wider pool of available providers, since you don’t have to worry about distance and transportation.
If you’re looking to engage in therapy, check whether your state belongs to PSYPACT. If it does, you can consider treatment from a provider who is licensed in a PSYPACT state, even if that provider is not in the same state as you.
It’s complicated, but here are some ideas.
Increase the adoption of telehealth services. Two-thirds of shortage areas are in rural parts of the country. Telehealth would make it more likely that individuals in those areas are able to access care. Furthermore, telehealth services are well positioned to overcome the barriers that often keep people from getting the care they need, such as long wait times and stigma.
Expand the existing provider workforce by creating incentives for individuals to specialize in mental health. Incentives can range from scholarship and loan repayment programs to mentorship programs to relocation programs.
Expand the pool of non-licensed professionals (coaches, community health workers, peer support specialists, etc.) who can be trained to educate and support individuals with mental health needs.
Continue to develop robust, user-friendly, evidence-based self-help resources that could help those with mild to moderate mental health concerns manage their distress.
Remember that everyone–including you–deserves access to quality care. We may be in the midst of a mental health crisis, and we may live in areas with a dire shortage of mental health providers. But know that there are options, and that you can play a role in making sure that you and others get the care you deserve.
How does your state stack up?
District of Columbia
Notes: Based on July 2023 data. Data for Vermont is unavailable.