As the baby boomer population ages, demand for medical professionals to care for them is expected to spike. Among this group, psychiatrists are the second most highly recruited physicians, according to a 2017 Review of Physician and Advanced Practitioner Recruiting Incentives. Coming in after family physicians, the report states that this reflects a “severe shortage of mental health professionals nationwide,” with 77% of U.S. counties reporting a severe psychiatrist shortage.
In a white paper from 2015, Merrit Hawkins states that the dearth of psychiatrists is a “crisis” that’s due to many factors, including:
- An aging psychiatrist population
- Few medical school graduates choosing psychiatry residency programs (4%)
- Mental healthcare models that stress patient volume over value of care
- Pervasive stigmas about mental illness in the U.S.
- Mental health issues require long-term treatment instead of a one-time procedure
- Psychiatry is not a profit center for hospitals
The demand for psychiatrists is driven by the growing need. One in every five adults in the U.S. experiences some form of mental illness, according to the National Alliance on Mental Illness, and one in 25 experiences a serious mental illness that substantially interferes with their life.
Mental health is a critical facet of health, according to the Surgeon General, and with their medical expertise, psychiatrists are uniquely equipped to apply medical understanding to treatment plans for people suffering from mental disorders. This medical background is what distinguishes a psychiatrist from a psychologist, as psychiatrists attend medical school and complete a residency, with an emphasis in psychiatry. In addition to conducting psychotherapy, which psychologists also apply in the treatment of mental disorders, psychiatrists can prescribe medical approaches as well, either through prescription medication or other medical treatments. Alternatively, psychologists train extensively in either research or clinical practice, most often with an advanced degree in clinical psychology, and treat patients with psychotherapy.
Ultimately, psychiatrists address patient cases. To do so, they must assemble and keep up patient records and information, either directly from the patient or from medical professionals, relatives, or others who may have this information. Psychiatrists must evaluate data and test findings to provide a diagnosis and establish the magnitude of a mental disorder. They then create a customized care plan for the patient, often with an array of treatments. They may prescribe, oversee or administer psychotherapeutic treatment or medication as part of a treatment plan for a mental, emotional or behavioral disorder.
Treating patients may also require collaboration across medical specialties, from other psychologists, social workers, physicians, psychiatric nurses or other medical professionals to review the treatment plan and monitor progress. Throughout treatment, the psychiatrist would meet with the patient regularly to monitor the treatment plan. According to the American Psychiatric Association (APA), psychiatric patients possess diverse reasons for seeking help: some may have suddenly begun suffering from issues like panic attacks, hallucinations, suicidal thoughts, or hearing “voices.” Others may suffer from long-term issues like perpetually feeling sad, hopeless, or actions that have begun to inhibit everyday function.
Psychiatry Job Environment
Psychiatrists can practice a variety of specializations and in an array of settings, ranging from private practices, general hospitals, psychiatric hospitals, university medical centers, courts and prisons, nursing homes, government, rehabilitation programs, emergency rooms, hospices, and community agencies – and for some, it may be a combination. Over half of psychiatrists operate a private practice.
In May 2016, the BLS estimated psychiatrists earn a median annual wage of $194,740. The top-earning industries are home health care services, local and state governments, outpatient care centers, and residential intellectual and developmental disability, mental health, and substance abuse facilities.
The Bureau of Labor Statistics (BLS) predicts job growth of 13% through 2026 for psychiatrists, citing a population that is both growing and aging. And for those interested in locating to a rural or low-income area may be even higher as those positions can be more challenging to fill. The need for close proximity from professionals through residency requirements also mandates growing numbers of psychiatrists to train future professionals.
Education and Skills
To launch this career path, students must first obtain a bachelor’s degree. Aspiring psychiatrists must then graduate from medical school, pass a written state license exam to practice medicine, and then complete a four-year psychiatry residency. Most often, the first year of a residency occurs in a hospital with patients, and is followed by three years studying psychotherapy and psychiatric medication and treatments across in-patient, out-patient, and emergency room environments. During this time, training will include mentorship from practicing psychiatrists and partnership with other residents along with clinical training.
Once residency is complete, psychiatrists can apply for a board certification from the American Board of Psychiatry and Neurology. Following residency, some psychiatrists may elect to pursue a specialty, including one of the following:
- Child and adolescent psychiatry
- Geriatric psychiatry
- Forensic (legal) psychiatry
- Administrative psychiatry
- Additional psychiatry
- Emergency psychiatry
- Consultation psychiatry
- Community psychiatry and public health
- Military psychiatry
- Pain and sleep medicine
To span therapy and medicinal treatment, psychiatrists must possess knowledge of therapy and counseling, psychology, medicine and biology. Soft skills are also essential, as the majority of a psychiatrists’ time is spent with patients – about 60%, according to the APA. As a result, skills like active listening, social perception and speaking are valuable in patient interactions. Psychiatrists must then synthesize the data they compile to establish a personal treatment plan, which requires both critical thinking skills as well as sound judgment and decision making.