The Answer To Our Psychiatrist Shortage Lies Abroad
Dr. Laurence Dopkin | 10/25/2019, 6 a.m.
More than 40 million American adults suffer from mental illnesses like anxiety, depression and schizophrenia. Nearly six in 10 aren't receiving treatment.
That's often because they can't find a mental health professional. Sixty percent of U.S. counties lack a single psychiatrist. More than 110 million Americans live in mental health professional shortage areas.
This shortfall will likely grow worse in the years to come. More than six in 10 practicing psychiatrists are nearing retirement age. By 2024, the United States could be short between 14,000 and 31,000 psychiatrists, according to a study published in the medical journal Psychiatric Services.
Graduates of international medical schools can help plug this gap. These doctors— many of whom are U.S. citizens who chose to pursue their medical degrees abroad— already account for a significant share of our nation's psychiatrists.
Recruiting more of them to practice stateside would greatly improve Americans' mental health.
One in five adults in the United States lives with a mental health condition. About 16 million people struggle with major depression, according to the National Alliance on Mental Illness. Over 6 million struggle with bipolar disorder. And many patients cope with multiple conditions simultaneously.
It's becoming harder for them to find mental health specialists. California, Florida, and Texas— the three most populous states in the union— have less than half the number of psychiatrists they need to meet patient demand. In rural areas, 95 percent of mental health professionals say they can't handle their communities' needs.
International medical graduates are well equipped to fill these shortages. They already account for nearly one-third of our country's psychiatrists— and roughly one-quarter of all physicians nationwide.
IMGs tend to minister to high-need populations. They account for more than 35 percent of the active psychiatry residents who specialize in adolescent and child treatment. Their work is crucial, given that 20 percent of kids between 13 and 18 suffer from a mental health condition. Research shows that increased access to mental health care for our nation's youth could help reduce suicide rates, juvenile delinquency, and school dropouts.
International medical graduates also tend to practice in high-need areas. In places where three-quarters of the population is non-white, over one-third of practicing doctors graduated from international medical schools. Doctors trained abroad are "more willing than their U.S. medical graduate counterparts to practice in remote, rural areas," according to a report from the American College of Physicians."
Physicians trained abroad provide top-notch care— sometimes even better than their domestically trained counterparts. A 2017 study in the BMJ, a medical journal, found that patients treated by international medical graduates had lower mortality rates than those treated by U.S. medical graduates.
This year, IMGs matched to U.S. residencies at the highest rate since 1991. Many of these new doctors are U.S. citizens returning home to practice. More than 60 percent of Caribbean medical school graduates, for example, are U.S. citizens.
Forty graduates of the school I work at, St. George's University in Grenada, matched into psychiatry residencies in March. They started working at hospitals across the country this summer, from Tennessee and New York to Kansas and California.
America needs thousands of additional psychiatrists to meet patient demand for mental health services. The nation should look abroad, to international medical schools, to find them.
Dr. Laurence Dopkin is a practicing psychiatrist and serves as Assistant Dean of Students at St. George's University (www.sgu.edu).