Dealing with a Shortage of Psychiatrists

Question

In the city I am living in, we are in a psychiatric crisis. We cannot recruit and keep enough psychiatrists to meet the needs of the community. As a therapist I am faced with trying to find suitable help for someone while they are put on a waiting list for a psychiatrist. I have some nurse practitioners who are willing to help as long as the needs are not severe (psychosis, etc). What is your opinion on referring to medical professionals that are not psychiatrists just as a bridge to recovery and wellness while awaiting appropriate psychiatric care?

Dr. David Sack · Accepted Answer

There is a shortage of psychiatrists in many places as the specialty has not kept pace with demand. Over the last twenty years, primary care physicians (GPs, internal medicine, ob-gyn) have stepped in to provide treatment for patients with a range of problems. As a first line of treatment, this approach makes sense and is consistent with other medicine specialties. Primary care physicians currently prescribe 70% of antidepressants. If the first treatment fails, referral to a psychiatrist is the logical next step.

Psychiatric nurse practitioners have proven invaluable in filling the service gap. Many NPs have extensive experience in both inpatient and outpatient psychiatric settings.

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