A recent survey, reported int his weeks Newsweek, confirms what those of us int he field have known for decades: our ranks are shrinking. There are 15% fewer psychiatrists in practice now than in 2000 and, of that group, there is a drop of 20% in those who accept insurance coverage in their offices. This due, in part, to a two decade cut in benefit payments to psychiatrists and decreased public support, including weakening of the commitment laws. As a result, fewer doctors are specializing in psychiatry and those who are trained are dropping off insurance panels. It is worse on impatient units where psychiatrist don’t want to take 24 hour responsibility for disturbed patients at such reduced pay. As a result, access to basic psychiatric care is at an all time low.
All the recent shooters in the nations mass killings have been persons with active psychiatric illness receiving inadequate treatment. “Penny wise, but dollar foolish”, as Ben Franklin said.
The psychiatric care system is now so damaged that it would take decades to rebuild, if we were so inclined. In the meantime, the top 5% of earners can afford adequate “out of pocket” private care, and the other 95% has only short term stabilization available. And, the mass shootings will continue unabated. Madness…