County-Level Estimates of Mental Health Professional Supply in the United States
Abstract
OBJECTIVE: This study compiled national county-level data and examined the geographic distribution of providers in six mental health professions and the correlates of county-level provider supply. METHODS: Data for six groups--advanced practice psychiatric nurses, licensed professional counselors, marriage and family therapists, psychiatrists, psychologists, and social workers--were compiled from licensing counts from state boards, certification counts from national credentialing organizations, and membership counts from professional associations. The geographic distribution of professionals was examined with descriptive statistics and a national choropleth map. Correlations were examined among county-level totals and between provider-to-population ratios and county characteristics. RESULTS: There were 353,398 clinically active providers in the six professions. Provider-to-population ratios varied greatly across counties, both within professions and overall. Social workers and licensed professional counselors were the largest groups; psychiatrists and advanced practice psychiatric nurses were the smallest. Professionals tended to be in urban, high-population, high-income counties. Marriage and family therapists were concentrated in California, and other mental health professionals were concentrated in the Northeast. CONCLUSIONS: Rural, low-income counties are likely candidates for interventions such as the training of local clinicians or the provision of incentives and infrastructure to facilitate clinical practice. Workforce planning and policy analysis should consider the unique combination of professions in each area. National workforce planning efforts and state licensing boards would benefit from the central collection of standardized practice information from clinically active providers in all mental health professions.
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Rural regions have a long-standing lack of mental health specialists.
“Rural areas face a persistent shortage of mental health specialists such as psychiatrists, psychiatric nurse practitioners, psychologists, social workers, and counselors.”
From Task-sharing approaches to improve mental health care in rural and other low-resource settings: a systematic review (2018) · cites this paper as [2]
Rural counties account for two-thirds of US counties and roughly one-fifth of the population, yet under 10% of mental health workforce practices are located there.
“Rural counties make up two-thirds of all counties and about 20% of the US population,1 but fewer than 10% of the mental health workforce practices are in these settings.2”
From Task-sharing approaches to improve mental health care in rural and other low-resource settings: a systematic review (2018) · cites this paper as [2]
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Marijic, P., Murawski, M., Maier, W., Hamacher, K., Laub, O., Lang, M., Grill, E., & Schwettmann, L. (2021) · Academic Pediatrics · doi:10.1016/j.acap.2021.12.026 · Cited by 3 · see citing works
Laboe, A. A., Steinhoff, M. F., Vendlinski, S. S., Kreynin, A., Johnson, S., Heyrman, A., Kreckler, S., Ruud, C., & Schaumberg, K. (2025) · European Eating Disorders Review · doi:10.1002/erv.70049 · Cited by 2 · see citing works
Providing School-Based Mental Health Services in Rural and Remote Settings
Capps, R. E., Michael, K. D., Jameson, J. P., & Sulovski, K. (2021) · Springer eBooks · doi:10.1007/978-981-15-6631-8_27 · Cited by 2 · see citing works
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Parikh, S. V., Bostwick, J. R., Bastida, M. E., & Taubman, D. S. (2019) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12466 · Cited by 2 · see citing works
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Trauma-Informed Strategies for Rural Schools
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Women’s Behavioral Health Needs
Becker, M., & Lynn, V. (2019) · Foundations of Behavioral Health · doi:10.1007/978-3-030-18435-3_9
A primary care guide to bipolar depression treatment
Youssef, N. A. (2020) · The Journal of Family Practice · doi:10.12788/jfp.0043 · Cited by 1 · see citing works
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- Authors
- Ellis, A. R., Konrad, T. R., Thomas, K. C., & Morrissey, J. P.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Psychiatric Services
- Published
- 2009-10
- Volume
- 60
- Issue
- 10
- Pages
- 1315-1322
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W4241858169
- Cited by
- 114
- References
- 8
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 11 · 2021: 11 · 2020: 9 · 2019: 15 · 2018: 8 · 2017: 5 · 2016: 8 · 2015: 8 · 2013: 5 · 2012: 1
- FWCI
- 7.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Geographic Society
- Health Resources and Services Administration
- U.S. Public Health Service (230200532038C)
- Center for Substance Abuse Treatment
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- mental health professionals, licensed professional counselors, marriage and family therapists, psychiatrists, psychologists, social workers, urban-rural differences, low-income counties, workforce planning
- MeSH terms
- Adolescent, Adult, Female, Health Workforce, Humans, Licensure, Male, Mental Health Services, Middle Aged, Primary Health Care, Rural Population, United States, Urban Population, Databases as Topic, Young Adult
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