As a psychiatrist and the chief medical officer of Acadia Healthcare, I am passionate about attracting more clinicians to the field of behavioral healthcare to support the increasing need for treatment. The growing demand for mental healthcare is undeniable, and we must provide greater support for clinicians and make psychiatry an appealing field of medicine.
Over my 20 years in this field, I have witnessed many ‘a-ha’ moments when young medical students find their calling to this challenging field. I remember the moment when I walked into a state psychiatric facility for my first rotation and saw the doctors and staff doing near miraculous work to help patients. Fast-forward to today, modern psychiatry and behavioral healthcare are light years ahead of when I started. The resources, programs, and medications are remarkably advanced and effective, and our understanding of the brain grows each day.
Despite the big gains the field has made, the push for equity between behavioral health and medical-surgical (med-surg) hospitals is as important as ever. This includes both perceptual hurdles and operational barriers.
Decades of stigma and misinformation – while slowly dissipating – still remains. Visions of old-school facilities, treatments, and conditions are no longer true. People famous for their accomplishments are coming forward to discuss their battles with mental health, helping to demystify the field and make it more commonplace to admit the need for help.
On the operational front, behavioral health hospitals have long languished behind med-surg hospitals in government funding and consideration. This includes the subsidies for electronic medical record (EMR) technology in the industry, ensuring that the next generation of clinicians has the tools they need to treat the whole patient. The integration of EMR systems can facilitate better communication and collaboration between mental health professionals and primary care providers.
Below are some trends that continue to gain steam in the industry and will help attract the next generation of healers.
Partnerships with Health Systems
Large med-surg health systems are realizing more and more that behavioral healthcare is a critical service they need but are not typically equipped to provide optimally. Psychiatric floors in med-surg hospitals are often repurposed medical floors, not designed specifically for psychiatric treatment. Moreover, throughput from the emergency department to these floors is often problematic, and emergency rooms can often be the worst environment for treatment.
It is incumbent that behavioral health providers work with premier health systems to provide their existing medical schools with state-of-the-art psychiatric hospitals. Such facilities would foster a learning environment that promotes health and hope and, in turn, inspire medical students to specialize in psychiatry. Additionally, this could lead to the development of behavioral health hospitals in other areas, potentially in more rural and underserved areas, which would enable young doctors to return to their hometowns and serve their own communities.
Psychiatry has evolved significantly in recent years, with several different avenues now available to practitioners, including acute care, crisis stabilization, substance use disorder treatment, and eating disorder treatment. Despite this, there are still not enough psychiatrists to meet the demand. Partnerships with primary care providers can help bridge the gap by incorporating mental health services into traditional medical settings.
Better Treatment Options
The opioid crisis and increasing suicide rates have further highlighted the importance of mental healthcare. As a result, pharmacology has become more sophisticated, and there is now a growing body of evidence supporting various therapeutic modalities. For instance, eye movement desensitization and reprocessing (EMDR) has gained traction for treating trauma, while specialized programs for military personnel and first responders have emerged as well. We must continue to increase the number of professionals who have expertise in these evidence-based therapies in order to ensure the delivery of truly comprehensive mental healthcare.
Purposefully Designed Hospitals
The physical environment in which behavioral healthcare is provided also plays a role in attracting clinicians to the field. Beautiful, modern buildings can make a significant difference in promoting a positive atmosphere for both patients and providers. Additionally, modalities such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are now delivered in an environment akin to other medical procedures, signaling a shift in the way mental healthcare can be perceived and delivered.
By developing specialized facilities and fostering collaboration between mental health professionals and primary care providers, we can address this issue and provide patients with the care they need.
Lastly, it is worth noting that psychiatrists now often earn more than primary care physicians due to supply and demand dynamics. According to Medscape, psychiatrists averaged earnings of approximately $287,000 in 2022. Psychiatry was just behind rheumatology, allergy and immunology, and neurology in terms of salary—and just above internal medicine, infectious diseases, and diabetes and endocrinology.
In conclusion, the growing demand for behavioral healthcare underscores the need to attract more behavioral health clinicians to the field. By implementing best practices such as providing state-of-the-art facilities, promoting partnerships between behavioral health and med-surg hospitals, continuing to advance innovation in the field, and fostering pay equality, the field of psychiatry can continue to flourish and provide the care, hope, and healing so many desperately need.
Dr. Michael Genovese is a clinical psychiatrist, addiction specialist, and the chief medical officer of Acadia Healthcare.