LANSING, Mich. — In 2017, an initiative called the Michigan Inpatient Psychiatric Admission Discussion Workgroup, or MIPAD was created to investigate the lack of mental health resources in Michigan. The group released a report in 2018 with what they believed the issues were and some recommendations for the state. One of the contributing factors was the shortage of psychiatrists.
FOX 47 News took an in-depth look into why there is a shortage.
Shuchi Khosla is the Chief Resident at Michigan State University Department of Psychiatry. She says in the greater Lansing area we're about 25 psychiatrists short.
"About 80 to 85% of all our patients are being treated by primary care. And they have on average about three to three and a half months to get into a psychiatrist office outpatient," Khosla said.
Dr. Zulfiqar Ahmed is a board-certified psychiatrist at Healthy Minds Psychiatric Services in Okemos. He says it can get overwhelming.
"We don't have enough beds available. We don't have enough facilities that can take those patients. And then for outpatient, we don't have enough psychiatry who can cater to the need," Ahmed said.
And over at Michigan State University Chairman of the Department of Psychiatry, Dr. Jed Magen says the shortage is nationwide but the federal government defines Michigan as a mental health shortage area.
"Which means we don't have nearly enough mental health practitioners in almost every county of the state. Even places we have them the demand is just huge," Magen said.
In 2018 the University of Michigan did a research analysis on this issue. Reporting on the data by MLIVE showed that the state had 1,180 active psychiatrists in 2018. That's about 11 Practitioners per 100,000 residents.
"I spend part of my time seeing children in the sparrow, the pediatric emergency department who are sitting there because I can't find psychiatric beds for them," Magen said.
And some practices are already full and causing psychiatrists to make arrangements for new patients and even work extra hours on the weekends.
Michigan's numbers are below the national average. But the pinch for psychiatrists is being felt across the country.
According to statistics last year from the Association of Medical Colleges we are about 2800 psychiatrists short in the country. It's projected to go up to 6800, short by 2025.
"Nationally, nobody is turning out enough. We have about 1000, maybe 1400 psychiatry residents in the country. So we turn out somewhere around that number each year, that's not nearly enough to take care of the huge burden of mental illness in the country," Magen said.
So, we know what the problem is. But why? And how can it be fixed?
"The average medical student comes out with debt somewhere in the range of $175,000. That's like a house payment. And students come out with more," Magen said.
And in many cases that dollar amount is much higher.
"Imagine coming out of medical school with a debt of $300,000 - $400,000, which might have some implications for the field you go into. And so psychiatry is one of the lower-earning specialties in medicine. And so there's some thought that some people really move toward the higher-earning specialties, because of loan repayment issues," Magen said.
But there are some relief programs in place like MIDOCS.
"We have a program called mi docs, which is supported by the state of Michigan, which, which provides loan repayment for psychiatrists who, in the last few years of training, go into the upper peninsula, so they train there," Magen said.
MSU has a total of 6 residents in MIDOCS, no one has graduated yet.
We reached out to the department of health and human services to find out what they're doing to address those costs.
In an email to fox 47, Bob Wheaton said.
"Based on the MIPAD report findings, MDHHS made pediatric inpatient psychiatrists the top priority for the Michigan state loan repayment program that repays up to $200,000 in medical education debt for providers who agree to practice in an underserved area."
They tell FOX 47 News that around 70 providers each year take advantage of this program.
Khosla was born and raised in India. She was once an engineering major but decided to be a psychiatrist after the death of her friend to suicide.
"It wasn't just the death of my friend to suicide, it was the societal response to it. How about the family, their parents, were essentially ostracized from the community, and nobody wanted to talk about it. As though it was something that the person had done, as opposed to something that had happened to a person," Khosla said.
She says more residency programs and recruitment initiatives will help.
"We just aren't training enough. Like if we're 2800 short, most of our psychiatrists are between the ages of 65 ish, and 70, which are all set to retire. And that's 1% of the psychiatrist's population," Khosla said. "So if we can get younger people in there wanting to come to medical school to be psychiatrists, kind of like I did, then it makes the rest of the journey a lot easier."
There's also a pipeline issue.
"So it takes a long time to educate people. So if you start now, you begin to turn out people, four or 567 years from now. So you got to start to address it now. But the payoff comes later," Magen said. "Therefore put more psychiatrists in the field, we keep about 80% of the residents, we graduate in the state of Michigan. So that's great for the state.
Michigan State is working hard to retain talent. An average calculation from the last four years shows the school has around six people graduating from the program each year.
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