In the 2018 report on Behavioral health workforce shortageDr., Janet Kaufman of the University of California, San Francisco, also raised concerns that 45% of psychiatrists and 37% of psychologists could retire within a decade. She said the pandemic has accelerated that trend.
Many doctors say they are simply overworked. Not only are more people needing help, many are becoming sicker, with mental health issues that go untreated.
“Dealing with our patient population is much more difficult than it was a decade ago,” said Randall Hager, legislative advocate and policy advisor for the California Psychiatric Alliance.
With the slots not filled, the rest are left to carry more weight, he said.
Another problem mentioned by Hager et al: paperwork. He said that doctors spend about 40% of their time on paperwork.
Many doctors, especially colorists, say they simply do not receive enough emotional support from their employers. Dominguez, a Kaiser therapist, said she founded La Clinica, a nationally recognized pilot program for serving Spanish-speaking clients, in 2016. She said that when tragedies occur in the community, they affect clinicians, too. But, “it’s only expected to keep working and keep going,” she said.
Watching trauma constantly can be stressful, said Jeff Capps, a social worker at Pacific Clinics in Los Angeles. It emphasizes the need to make the work of physicians more sustainable. It includes better salaries.
“Sometimes in our field,” he said, “the assumption is that since you get value from your work, you don’t have to be compensated.”
A 2019 report by healthcare consulting firm Milliman found that California business plans, when setting prices, Pay 15% on average for primary care providers than they pay behavioral health care providers.
Luke Bergmann, director of behavioral health for San Diego County, said his county’s report on provider shortages showed that, in some cases, people chose to work at Panda Express rather than substance use disorder clinics “because they simply couldn’t make much.”
“People talk about love of work,” he said. “For people to leave this job is an incredible emotional sacrifice.”
Inflation is making the situation worse, said Candy Curiel, director of Pacific Clinics in the Inland Empire.
“Everything is so expensive at this point, people feel they need to look for more money,” she said.
Everyone competes with everyone else. Is this a zero-sum game?
Michelle Cabrera, executive director of the Association of Behavioral Health Directors of California County, said the state’s mental health care system is very overwhelmed, and everyone is fishing for each other.
“Let me be clear: It’s a zero-sum game,” she said. “There are only too many licensed or competent professionals in California to do these jobs.”
In August, the state’s Superintendent of Public Education Tony Thurmond announced that he had secured funding for Hiring an additional 10,000 psychiatrists To serve state students. This effort is key to pushing the Department of Education to increase mental health care provided in schools.
Adrian Shelton, a senior policy advocate for the California Alliance for Children and Family Services, called the $200 million to create a new scholarship program for masters-level physicians a “big win.”
But for Cabrera, the announcement “puts fear at the heart of the county’s behavioral health.”
She wonders how the provinces can compete.
“I don’t know that we actually have a computation yet on the degree to which demand has yet to outpace the supply of providers in our state,” she said.