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Rutgers professor Theresa Miskimen tapped to lead national psychiatric association

Philadelphia Inquirer - 4/8/2024

Apr. 8—Embedding psychiatrists at primary care practices and expanding telemedicine could give more people access to mental health services, said Theresa Miskimen, a Rutgers clinical psychiatry professor who was recently named president-elect of the American Psychiatric Association.

These steps could help to offset a shortage of psychiatrists nationally. Such workforce challenges are a critical issue for Miskimen, whose appointment takes effect May 2025.

Some 59 million adults in the United States — about 23% of the population — had a mental illness in 2022, yet nearly half did not receive treatment, according to the Department of Health and Human Services.

Patients often struggle to find doctors who are accepting new patients, and may wait months for an appointment. Many live in counties without a single psychiatrist.

Psychiatrists are doctors with an MD or DO degree who are specialized in mental health, substance abuse, and other issues. Unlike psychologists, psychiatrists can prescribe medications.

The American Psychiatric Association, medical schools, and health systems must work together to find new ways to get patients the care they need, said Miskimen, who also works as medical director of the psychiatry department at Hunterdon Medical Center in Flemington, N.J.

Miskimen spoke with The Inquirer about the challenges facing the psychiatry field and how to improve access.

What is the challenge within the psychiatry workforce?

Demand for mental health services has been rising for years, while the Department of Health and Human Services projects a steady decline in psychiatrists.

"It is clear that we just don't have enough psychiatrists to provide for the necessary mental health needs of the nation," Miskimen said.

Health-care systems need to change the way they approach mental health, to make it easier for patients to access, she said.

What kind of changes should health systems make?

Embedding psychiatrists in other care settings such as primary care practices would make it easier for patients to access mental health services, Miskimen said.

Patients wouldn't have to wait to find an outside psychiatrist. And psychiatrists could manage more cases, because they could work with the patients' family doctor to quickly get up to speed on their medical background.

Can telemedicine help expand access?

Expanding telemedicine is "critical" to improving access, Miskimen said. Psychiatrists have found that many patients are more likely to make and keep appointments that can be done from home.

Routinely getting time off from work for a psychiatry appointment may be challenging for some.

People experiencing depression or other mental health problems may struggle to leave the house, which can also lead to missed in-person appointments.

What can medical schools and teaching hospitals do to increase the workforce?

Medical schools and organizations like the APA are working to raise awareness about career paths and the need for more psychiatrists. Veteran psychiatrists can help show students what a career in psychiatry could look like.

Residency slots enable students to explore the profession, and expanding the number of psychiatry slots could encourage more students to pursue the field.

"As a public health initiative, not only for psychiatry, we have to be able to train physicians," she said.

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