Is There a Demand for Psychologists?
After receiving the news item "BEA Requests Funds to Increase APA-Accredited Internship Programs," one of our colleagues raised strong doubts that any demand for new psychologists exists. As the implementation of the Affordable Care Act occurs, work force needs for psychologists have become apparent.
Dr. Ben Miller has published and will continue to publish about this issue in his blog, Occupy Healthcare. He drafted a specific response to the question, "Is there a demand for more psychologists since there aren't enough employment possibilities?" His response follows:
A Demand for Psychology?
For decades we have known that you cannot separate the "mental" from the "physical," yet we have a health care system that is built around this notion. Despite repeated calls for integration in health care, fragmentation persists. This fragmentation is seen in the way we train our health care providers, pay for our health care services and most significantly in the way we deliver our care.
However, the emphasis on building a highly effective and efficient system in the current health care paradigm opens up new and exciting opportunities for psychology and behavioral health. Since it is well established that health care cannot continue its cost trajectory, various stakeholders are looking to "bend the cost curve" and better integrate care. One example of this is the patient-centered medical home (PCMH). The PCMH is a new model of delivering primary care that was mentioned explicitly in the Affordable Care Act, and is an innovative attempt to improve outcomes and control cost. The PCMH also is an excellent opportunity to discuss integrating behavioral health providers.
As deGruy and Etz have written:
"Any PCMH that neglects... the full psychosocial dimension of health and healthcare — mental healthcare, family and community contexts, substance abuse, and health behavior change... is incomplete and will be ineffective. It will fail. A solid edifice of empirical evidence supports this rather uncompromising assertion."
The PCMH evidence base continues to grow and more and more primary care practices are choosing to bring in and integrate behavioral health providers. However, is there a demand for behavioral health providers in these settings? What interest does primary care have in psychology? The answer, it turns out, is a lot.
Data to be published in an upcoming special edition of the American Psychologist on primary care shows the location of where the behavioral health providers are (including psychologists) across the country. Our team matched up the location of behavioral health providers with primary care colleagues to show where "colocation" of care was occurring. What is most exciting about these data is not just the hundreds of places where colocation is happening, but where there are opportunities for colocation.
So is there a demand for psychology? Well for now it is possible to say there is a demand for behavioral health. As more and more data emerge about the behavioral health workforce (like those mentioned above), it will become increasingly clear that there are simply not enough psychologists to meet the need primary care and the PCMH need. What will psychology do to stand out?
Make no mistake, the demand for behavioral health in primary care is not going to go away anytime soon. Primary care wants help with behavioral health. Primary care understands the importance of having behavioral health.
When the United States Preventative Services Task Force (USPSTF) recognizes that primary care practices should not screen for depression unless they have staff assisted supports in place, there will be a demand.
When we continue to find that avoiding addressing mental health conditions in primary care is costly, there will be a demand When we start to see health care better integrate to achieve the triple aim, there will be a demand.
The bigger question is — are we ready to meet the demand?