Community leaders warn of psychiatry shortage amid mental health crisis, advocate for support in schools

By Gaby Vinick | Wisconsin Public Radio

Mental health advocates in Wisconsin are calling for more funding and investment in access to care amid rapidly growing demand for services.

Leaders spoke at a Wisconsin Health News virtual event last week to address community needs as the state sees what Gov. Tony Evers described as a “quiet, burgeoning” mental health crisis.

“We are very concerned about the crisis services system right now. I like to say we can either pay for it now or we can pay for it later,” said Mary Kay Battaglia, executive director of NAMI Wisconsin, an affiliate of the National Alliance on Mental Illness.

She said a shortage of providers means people have a hard time finding care when they need it.

“The number one thing is the workforce. We have mothers calling our office to say they have an appointment in nine months for their son who just had a suicide attempt in hospital,” she said.

Call volume to Wisconsin’s suicide and crisis hotline jumped after the shorter 988 number was implemented. The line received 6,030 calls in January, up from 4,074 in January 2022.

The state Department of Health reported that Wisconsin’s suicide rate is ahead of the average for neighboring states. The suicide rate has been higher every year since 2005 except 2012, according to a recent mental health and substance abuse needs assessment.

The Wisconsin Office of Children’s Mental Health reported earlier this year that more than half of the state’s high school students experience anxiety. The number of students who report feeling sad or hopeless almost every day has increased by 10 percent over the past decade.

Linda Hall, director of the state Office of Children’s Mental Health, said educators are sounding the alarm as they strive to help children overcome difficult mental health challenges.

“We’re hearing school staff and teachers say that kids are coming to school with so much trauma and issues that they’re dealing with that we need help, we need a space to address mental health and work with them,” Hall said. “And we need training to be able to do that.”

Hall said one solution he hopes to see is health plans paying for qualified medical interns — people with master’s degrees and some experience but not yet licensed.

Battaglia also would like the state to focus on “earn while you learn” career ladders to increase the number of providers and speed up the licensing process for social workers.

In Wisconsin, 440 people are served by one mental health provider, according to a report by County Health Rankings & Roadmaps in 2022. Nationally, that ratio shrinks to 350 people per mental health provider.

Amy Herbst, vice president of mental and behavioral health at Children’s Wisconsin, agreed that licensure can be a barrier.

“There are various reasons why there are licensing issues. But the bottom line is that we have lost candidates and we cannot afford that to happen,” she said.

Herbst said the Wisconsin Hospital Association worked with the Legislature and Gov. Evers to pass legislation two years ago allowing out-of-state health care providers to apply for temporary licensure and begin practicing in Wisconsin.

“This allowed providers to be able to practice, which then provided access to mental health for our children. So it was a solution to the licensing problem,” she said.

In an interview with Wisconsin Public Radio, Tony Thrasher, president of the Wisconsin Psychiatric Association, said the state needs to go one step further by making these licenses permanent.

Thrasher said there is a shortage of doctors in the country, but it is worse in psychiatry.

“It mostly affects every state. So I don’t think Wisconsin is any different in that regard. But I really think Wisconsin is in the wrong half of that equation,” he said. “We have more vacancies in psychiatry than most other states.”

Even before the pandemic, 55 of Wisconsin’s 72 counties had a “significant shortage” of psychiatrists, according to a 2019 report by the UW Institute for Population Health.

Thrasher said psychiatry is the oldest medical specialty, with an average provider age of 55 to 56. He said early retirement trends, physician burnout and physician dissatisfaction with health care and health care systems are causing more psychiatrists to leave the profession.

“Unfortunately, what we’re seeing now is probably just the tip of the iceberg.” There will likely be more shortages before it improves,” he said.

Rep. Paul Tittle, R-Manitowoc, is chairman of the Assembly Committee on Mental Health and Substance Abuse Prevention. He said he supports a bill that would provide up to a $200,000 income tax deduction for psychiatrists who work in medically underserved areas.

“We always run into some resistance because people don’t want to spend the money to do it,” Tittle said.

Hall, of the Office of Children’s Mental Health, said some possible solutions are to focus on collaboration between schools and community mental health providers and to help children become more mental health literate.

She said the money previously invested in school mental health had made a difference, “but we need to ensure sustainable, ongoing funding”.

The governor has proposed spending $500 million over the next two fiscal years on mental health services, with more than $270 million making the Get Kids Ahead mental health initiative a permanent program. That would include $18 million a year to reimburse schools for the cost of hiring school counselors, psychologists and nurses, along with $580,000 a year for training.

Herbst of Children’s Wisconsin called that funding critical.

“We need to treat mental health like health,” she said.

If you or someone you know is considering suicide, call the suicide prevention helpline on 988 or text ‘Hopeline’ to 741741.

This story was created by Wisconsin Public Radio and is being republished with permission. See the original story here.

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