Development of a New Methodology for Mental Health Professional Shortage Designation

Joseph P. Morrissey, Ph.D., Principal Investigator

Kathleen Thomas, Ph.D., Co-Investigator

Thomas R. Konrad, Ph.D., Co-Investigator

Alan R. Ellis, MSW, Project Analyst

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The Health Resources and Services Administration, Bureau of Health Professions has contracted with the Sheps Center to develop a new methodology for designating mental health professional shortage areas around the country. These shortage designations are used to target National Health Service Corps placements, J-1 visa placements, and the 10% Medicare incentive for psychiatrists. This two-year (September 2005-August 2007) project will compile small-area (i.e., county or county cluster) information on mental health workforce supply, estimate mental health service needs and utilization based upon available epidemiological data, and develop a formula for linking and weighting these data to identify under-served areas.

The Sheps Center has been instrumental in the development of shortage designation methodologies for both primary and dental care. However, these methodologies are inappropriate for mental health shortage area designations primarily for two reasons:

  1. The absence of national small-area data on the variety of mental health professionals; and
  2. The clear evidence that only 50 percent or fewer of those who need mental health services actually use them, so that utilization data per se, underestimates the actual need for mental health care.

Given these two constraints, the project will develop an alternative methodology for mental health professional shortage area designations. First, the supply of psychiatrists and other mental health providers will be estimated from available data and imputed to create national small-area counts. Second, need for these providers by the typical individual with and without serious mental illness will be estimated and used to impute national small-area demand. Small-area shortage scores will then be assigned based on the ratio of supply to need. An impact assessment will be undertaken by applying the new methodology to the existing mental health professional shortage areas; refinements will be made on the basis of feedback from interested parties.

The project team works under consultation with a 15-member Advisory Workgroup, which represents the range of technical and data expertise and professional interests necessary for creating a meaningful mental health professional shortage methodology. One meeting was held in 2005 to review the proposed methodology and a second will be held in 2006 to review the results of the designation and impact assessments.