Insufficient Dollars and Qualified Personnel to Meet United States Mental Health Needs
Abstract
The American populace currently supports the need for providing additional mental health services for adolescents who frequently express anger and mood instability and maybe are at risk for major psychiatric disorders and behavioral problems; Vietnam, Iraqi, and Afghanistan veterans or military personnel still on duty diagnosed with posttraumatic stress disorder, depression, or other similar combat-related disabilities; the approximately 1 million prisoners currently incarcerated primarily because of substance abuse and needing medically related rehabilitative services; and senior citizens who experience dementia and depression and require improved therapeutics. The problems outlined herein are as follows: far too limited monies are being spent for mental health services (5.6% of total US expenditures for health or roughly one fifth of what is consumed for hospital care); effective therapies are often lacking; and there is a shortage of qualified mental health personnel except in upscale urban and suburban areas. Unfortunately, these problems are so immense that, even with enhanced prioritization of our available resources, they are still not entirely solvable. The American public may continue to impart lip service when attempting to respond to our nation's mental health needs or may decide to spend vastly more money for such care. The latter choice may not be forthcoming in the near future for various cultural-societal-clinical-fiscal reasons.
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Unmet need for mental health care would persist because of a national shortage of qualified mental health clinicians.
“Even if all patients had the resources to seek appropriate care, unmet need would persist because of a national shortage of qualified mental health clinicians [15].”
From A Digital Mental Health Intervention in an Orthopedic Setting for Patients With Symptoms of Depression and/or Anxiety: Feasibility Prospective Cohort Study (2022) · cites this paper as [15]
Cites
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391 · see citing works
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.629 · Cited by 2,695 · cited 1× · see citing works
“The National Comorbidity Survey Replication study (Wang et al., 2005), now somewhat out of date (2001–2003), reported on the historical trend of the far greater use of pharmacotherapies and physicianadministered psychotherapies.”
BackgroundDE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
Prevalence and Treatment of Mental Disorders, 1990 to 2003
Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., Wang, P., Wells, K. B., & Zaslavsky, A. M. (2005) · New England Journal of Medicine · doi:10.1056/nejmsa043266 · Cited by 1,910 · see citing works
County-level estimates of mental health professional shortage in the United States.
Thomas, K., Ellis, A. R., Konrad, T., Holzer, C., & Morrissey, J. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.10.1323 · Cited by 589 · see citing works
The Prevalence Of Treated And Untreated Mental Disorders In Five Countries
Bijl, R. V., de Graaf, R., Hiripi, E., Kessler, R. C., Kohn, R., Offord, D. R., Üstün, T. B., Vicente, B., Vollebergh, W., Walters, E. E., et al. (2003) · Health Affairs · doi:10.1377/hlthaff.22.3.122 · Cited by 322 · see citing works
Aging and mental health in the decade ahead: What psychologists need to know
Karel, M. J., Gatz, M., & Smyer, M. A. (2012) · American Psychologist · doi:10.1037/a0025393 · Cited by 228 · see citing works
The Geographic Distribution of Physicians Revisited
Rosenthal, M. B., Zaslavsky, A. M., & Newhouse, J. P. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00440.x · Cited by 224 · see citing works
Carpenter-Song, E., Chu, E., Drake, R. E., Ritsema, M., Smith, B., & Alverson, H. (2010) · Transcultural Psychiatry · doi:10.1177/1363461510368906 · Cited by 159 · see citing works
Improving Access to Mental Health Services for Youth in the United States
Cummings, J. R., Wen, H., & Druss, B. G. (2013) · JAMA · doi:10.1001/jama.2013.437 · Cited by 139 · see citing works
Zeller, S., Calma, N., & Stone, A. (2014) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2013.6.17848 · Cited by 136 · see citing works
Mental Health Care For Iraq And Afghanistan War Veterans
Burnam, M. A., Meredith, L. S., Tanielian, T., & Jaycox, L. H. (2009) · Health Affairs · doi:10.1377/hlthaff.28.3.771 · Cited by 127 · see citing works
County-Level Estimates of Mental Health Professional Supply in the United States
Ellis, A. R., Konrad, T. R., Thomas, K. C., & Morrissey, J. P. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.10.1315 · Cited by 114 · see citing works
Monetary costs of dementia in the United States.
Yang, Z., Lin, P.-J., & Levey, A. (2013) · New England Journal of Medicine · doi:10.1056/nejmc1305541 · Cited by 107 · see citing works
Citters, A. D. V., & Bartels, S. J. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.11.1237 · Cited by 105 · see citing works
The mental health professions: Workforce supply and demand, issues, and challenges
Robiner, W. N. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.05.002 · Cited by 90 · see citing works
Trends in Mental Health Services Utilization and Stigma in US Soldiers From 2002 to 2011
Quartana, P. J., Wilk, J. E., Thomas, J. L., Bray, R. M., Olmsted, K. R., Brown, J. M., Williams, J. G., Kim, P. Y., Clarke-Walper, K. M., & Hoge, C. W. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.301971 · Cited by 84 · see citing works
Mark, T. L., Levit, K. R., Yee, T., & Chow, C. M. (2014) · Health Affairs · doi:10.1377/hlthaff.2014.0163 · Cited by 57 · see citing works
Hospital Psychiatry For The Twenty-First Century
Sharfstein, S. S., & Dickerson, F. (2009) · Health Affairs · doi:10.1377/hlthaff.28.3.685 · Cited by 52 · see citing works
Trends in Behavioral Health Care Service Provision by Community Health Centers, 1998–2007
Wells, R. S., MORRISSEY, J. P., Lee, I.-H., & Radford, A. D. (2010) · Psychiatric Services · doi:10.1176/ps.2010.61.8.759 · Cited by 45 · see citing works
Changes In Mental Health Financing Since 1971: Implications For Policymakers And Patients
Frank, R. G., & Glied, S. (2006) · Health Affairs · doi:10.1377/hlthaff.25.3.601 · Cited by 42 · see citing works
The Occupational Transformation Of The Mental Health System
Scheffler, R. M., & Kirby, P. B. (2003) · Health Affairs · doi:10.1377/hlthaff.22.5.177 · Cited by 33 · see citing works
Levit, K. R., Mark, T. L., Coffey, R. M., Frankel, S., Santora, P. B., Vandivort-Warren, R., & Malone, K. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1065 · Cited by 30 · see citing works
Mueller‐Stierlin, A. S., Herder, K., Helmbrecht, M. J., Prinz, S., Walendzik, J., Holzmann, M., Becker, T. M., Schützwohl, M., & Kilian, R. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-163 · Cited by 22 · see citing works
The Changing Face of U.S. Mental Health Care
Druss, B. G. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10091258 · Cited by 18 · see citing works
Insurance coverage and the treatment of mental illness: effect on medication and provider use.
Mulvale, G. M., & Hurley, J. (2008) · PubMed · Cited by 17 · see citing works
Datapoints: Medicaid as a Payer for Services Provided by Psychiatrists
Jacobs, S., Wilk, J., Chen, D., Rae, D. W., & Steiner, J. L. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.11.1356 · Cited by 8 · see citing works
Mulvale, G. M., & Hurley, J. (2007) · RePEc: Research Papers in Economics · Cited by 1 · see citing works
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Cited by
Sorted by citations
Na, P. J., Yaramala, S. R., Kim, J. A., Kim, H., Goes, F. S., Zandi, P. P., Voort, J. L. V., Sutor, B., Croarkin, P. E., & Bobo, W. V. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.02.045 · Cited by 247 · see citing works
McClintock, M. K., Dale, W., Laumann, E. O., & Waite, L. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1514968113 · Cited by 132 · see citing works
Dysbiotic drift: mental health, environmental grey space, and microbiota
Logan, A. C. (2015) · Journal of PHYSIOLOGICAL ANTHROPOLOGY · doi:10.1186/s40101-015-0061-7 · Cited by 79 · see citing works
Leo, A. J., Schuelke, M. J., Hunt, D. M., Metzler, J. P., Miller, J. P., Areán, P. A., Armbrecht, M. A., & Cheng, A. L. (2022) · JMIR Formative Research · doi:10.2196/34889 · Cited by 70 · see citing works
Economides, M., Ranta, K., Nazander, A., Hilgert, O., Goldin, P. R., Raevuori, A., & Forman‐Hoffman, V. L. (2019) · JMIR mhealth and uhealth · doi:10.2196/14284 · Cited by 51 · see citing works
Steinglass (2017) · doi:10.1002/da.22624 · Cited by 54 · see citing works
The Microbiome and Mental Health: Looking Back, Moving Forward with Lessons from Allergic Diseases
Logan, A. C., Jacka, F. N., Craig, J. M., & Prescott, S. L. (2016) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2016.14.2.131 · Cited by 51 · see citing works
Leo, A. J., Schuelke, M. J., Hunt, D. M., Miller, J. P., Areán, P. A., & Cheng, A. L. (2022) · JMIR Formative Research · doi:10.2196/36203 · Cited by 41 · see citing works
“Barriers include orthopedic providers’ lack of time and available mental health resources to offer; patients’ financial resources, transportation, time, and stigma-related barriers to seeking mental health care, especially in person; and a national shortage of qualified mental health providers [9-11].”
BackgroundEffectiveness of a Cognitive Behavioral Coaching Program Delivered via Video in Real World Settings
Lungu, A., Boone, M. S., Chen, S. Y., Chen, C., & Walser, R. D. (2020) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2019.0313 · Cited by 45 · see citing works
Chapman, S. A., Phoenix, B. J., Hahn, T. E., & Strod, D. C. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.01.045 · Cited by 36 · see citing works
Puffer, E. S., & Ayuku, D. (2022) · Perspectives on Psychological Science · doi:10.1177/17456916211049362 · Cited by 35 · see citing works
Zhang, W., Singh, S. P., Clement, A., Calfee, R. P., Bijsterbosch, J. D., & Cheng, A. L. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.20520 · Cited by 31 · see citing works
Stewart, R. E., Mandell, D. S., & Beidas, R. S. (2021) · Psychiatric Services · doi:10.1176/appi.ps.202000209 · Cited by 31 · see citing works
Johnson, S. B., & Marrero, D. G. (2016) · American Psychologist · doi:10.1037/a0040439 · Cited by 28 · see citing works
Group Psychotherapy as a Specialty: An Inconvenient Truth
Whittingham, M., Lefforge, N. L., & Marmarosh, C. L. (2021) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20200037 · Cited by 21 · see citing works
Cheng, A. L., Anderson, J., Didehbani, N., Fine, J. S., Fleming, T. K., Karnik, R., Longo, M. T., Ng, R., Re’em, Y., Sampsel, S., et al. (2023) · PM&R · doi:10.1002/pmrj.13085 · Cited by 18 · see citing works
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Wells, M. J., Dukarm, P. D., & Mills, A. (2021) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2020.12.009 · Cited by 17 · see citing works
Miller, J. G., & Peterson, D. J. (2015) · Academic Psychiatry · doi:10.1007/s40596-015-0411-0 · Cited by 11 · see citing works
Wilkins, K. M., Forester, B. P., Conroy, M. L., & Kirwin, P. D. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0704-6 · Cited by 11 · see citing works
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Martin, B., Phoenix, B. J., & Chapman, S. A. (2020) · Nursing Outlook · doi:10.1016/j.outlook.2020.04.002 · Cited by 11 · see citing works
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Pessoa, T. M. G., & Almeida, T. C. (2024) · Crime & Delinquency · doi:10.1177/00111287241242478 · Cited by 10 · see citing works
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Nguyen, A., Trout, K. E., Chen, L., Madison, L. S., Watkins, K., & Watanabe‐Galloway, S. (2016) · Rural and Remote Health · doi:10.22605/rrh3645 · Cited by 10 · see citing works
Common and Costly Hospitalizations Among Insured Young Adults Since the Affordable Care Act
Bain, A. M., Wong, C. A., Slap, G. B., Polsky, D. E., Merchant, R. M., Antwi, Y. A., Rubin, D. M., & Ford, C. A. (2016) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2016.03.013 · Cited by 9 · see citing works
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Self-citationBernstein, E. E., LeBlanc, N. J., & McNally, R. J. (2022) · Journal of American College Health · doi:10.1080/07448481.2022.2098036 · Cited by 5 · see citing works
Jones, N., Rosen, C., Helm, S., O'Neill, S. J., Davidson, L., & Shattell, M. M. (2018) · American Journal of Orthopsychiatry · doi:10.1037/ort0000341 · Cited by 4 · see citing works
Broekman, M., Brinkman, N., Davids, F., van den Bekerom, M. V. D., Ring, D., Doornberg, J., Ramtin, S., & Jayakumar, P. (2024) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-23-00962 · Cited by 5 · see citing works
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Economides, M., Ranta, K., Nazander, A., Hilgert, O., Goldin, P. R., Raevuori, A., & Forman‐Hoffman, V. L. (2019) · doi:10.31234/osf.io/mh38y · Cited by 2 · see citing works
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Alafaireet, P. E., & Houghton, H. (2016) · Springer eBooks · doi:10.1007/978-3-319-46412-1_7 · Cited by 1 · see citing works
Lorena, R.-S., Alonso, M.-R., Erik, B., Jeffery, B., Tim, P., & Daniel, C.-M. (2022) · Research Square · doi:10.21203/rs.3.rs-2339086/v1 · Cited by 1 · see citing works
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Salway-Jensen, B. K. (2016) · UA Campus Repository (The University of Arizona)
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Strong, T. (2017) · Springer eBooks · doi:10.1007/978-3-319-56699-3_9
Scaling-up Child and Youth Mental Health Services: Assessing Coverage of a County-wide Initiative
Hooley, C. (2019) · Open Scholarship Institutional Repository (Washington University in St. Louis) · doi:10.7936/dbhw-y076
Thomas, Y. T., Andrabi, S., Moukaddam, N. J., Shah, A. A., Buehler, G., Carnell, J., Bicette, R., Dark, C. K., & Bezek, S. (2021) · Journal of Hospital Administration · doi:10.5430/jha.v10n5p24
Zhang, W., Singh, S. P., Clement, A., Calfee, R. P., Bijsterbosch, J. D., & Cheng, A. L. (2023) · medRxiv · doi:10.1101/2023.02.12.23285824
- Authors
- Weil, T. P.
- Corresponding author
- Weil, Thomas P.
- ORCID
- Weil, Thomas P.
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2015-04
- Volume
- 203
- Issue
- 4
- Pages
- 233-240
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2061730825
- Cited by
- 50
- References
- 28
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 9 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 9 · 2015: 3
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Keywords
- mental health services, mental health funding, mental health workforce shortage, adolescents, post-traumatic stress disorder, veterans, incarcerated individuals, substance abuse, dementia, geriatric depression, mental health care costs, healthcare resource allocation
- MeSH terms
- Workforce, Adolescent, Adult, Child, Preschool, Health Services Needs and Demand, Humans, Mental Health Services, United States
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