Physician’s Weekly co-hosted another installment of the #PWChat series on Wednesday, March 21, with Linda Girgis, MD, to discuss the current status of mental healthcare in the United States.

Topics include whether there truly is a  mental healthcare provider shortage in the US, and if so, whether the shortage has gotten worse in recent years and what its impact is on patients and other clinicians, why many psychiatrists are moving to all-cash practices, and what the impact of this is on both patients and other clinicians, with many pointing to mental health issues as a major factor behind some the recent mass school shootings in the US, and much more!

Please make sure to check back here for
updates on Part II of this #PWChat.

 

View our upcoming schedule, or read our other #PWChat recaps here.

Below are the highlights from the chat. You can read the full transcript here.

 

 

Question 1

Q1: Is there truly a #MentalHealthcare provider shortage in the US? Has the shortage gotten worse in recent years? What is the impact on patients and other clinicians of this shortage?#PWChat

— Physician’s Weekly (@physicianswkly) March 21, 2018

T1 Yes there is a shortage of well-prepared MH workers. No, there are many MH workers who want to “help,” taken a short course & set up an unsupervised MH practice. Also do not separate MN & drug related issues. #PWchat

— ElizabethKelly, Ph.D (@Elizabe85727641) March 21, 2018

Great point! So many people call themselves “therapists” and “counselors” that the designation becomes murky. #PWchat https://t.co/jV9ieluNed

— Linda Girgis, MD (@DrLindaMD) March 21, 2018

T1 IMHO there is a shortage and unlike some other areas of practice, this is not just shortage by displacement. Patients are suffering, w/ some waiting months for treatment #pwchat #patientchat

— ShereeseM, MS/MBA (@ShereesePubHlth) March 21, 2018

T1 Not sure about relative provider numbers, but the total number of MH beds has dropped steadily over time and many med/surg beds get blocked when physicians have nowhere to transfer MH pts. pic..com/zAldFKNvXX

— Matthew Loxton (@mloxton) March 21, 2018


Question 2

Q2: Why are many psychiatrists moving to all-cash practices, and what is the impact on both patients and other clinicians of this trend?#PWChat

— Physician’s Weekly (@physicianswkly) March 21, 2018

A2. They are not getting reimbursed enough by insurance companies to meet their overhead expenses.Again, patients and clinicians are left scrambling to find mental healthcare services. #PWchat https://t.co/LedVwXLoMH

— Linda Girgis, MD (@DrLindaMD) March 21, 2018

T2 Not sure perspective of psychiatrist. It will sever services for all who depend on health insurance payments. #PWchat

— ElizabethKelly, Ph.D (@Elizabe85727641) March 21, 2018

A2 The industry is over-regulated and public compensation can never meat the needs of https://t.co/UeoDOhSs6y practices allow greater “direct-patient” efficiencies, while alleviating waste #PWChat

— ShereeseM, MS/MBA (@ShereesePubHlth) March 21, 2018

 


Question 3

Q3: Many have pointed to mental health issues as a major factor behind some the recent mass school shootings in the US. How do we address these issues with a lack of mental healthcare providers?#PWChat

— Physician’s Weekly (@physicianswkly) March 21, 2018

A3. We have to wonder if any of these incidences could have been avoided if services were more readily available. I think the solution is to support more training and to reimburse providers sufficiently. #PWchat https://t.co/RbOy9oAj0K

— Linda Girgis, MD (@DrLindaMD) March 21, 2018

T3. MH is greatly abused term surrounded by superstition, myth, fear, & lacking Open discussion/research. Can be a false dx for MD who not want to exam further.
Has sexual overtone/ Hx for women. Ex: derivation of word from Greek for hysterectomy. #PWchat

— ElizabethKelly, Ph.D (@Elizabe85727641) March 21, 2018

A3 Seems that schools need to have qualified MH Drs on staff to help our young ones Not just counselors. Thinking out loud✨ #PWchat

— Lisa Davis Budzinski (@lisadbudzinski) March 21, 2018


Question 4

Q4: What role do stigmas play in access to appropriate care for patients with mental illnesses? How do we address these stigmas, both with patients and the general population?#PWChat

— Physician’s Weekly (@physicianswkly) March 21, 2018

A4. More education is needed. Many patients avoid treatment because of stigmas attached 2 mental health disorders. We need 2 educate the public that mental health disorders r just the same as physical disorders. Patients can’t just “get over” their mental health diseases #PWchat https://t.co/z7uZi6zhsh

— Linda Girgis, MD (@DrLindaMD) March 21, 2018

T4 MH Stigma is still a GIANT problem. I’ve said to patients many times, “Being treated for Mental illness is no different than needing insulin if you are diabetic”. It’s a disease that you didn’t cause! #PWChat https://t.co/4PTbEoTICt

— Becky Brandt RN (@bbhomebody) March 21, 2018

T4 2 crippling effects of stigma are –
1. feeble and wrong-headed health policies by government,
2. public sentiment that MH is a moral failing

Unless and until we fix those, MH care will always lag and suffer#PWchat

— Matthew Loxton (@mloxton) March 21, 2018