Opinion: Look abroad to solve Michigan's psychiatrist shortage

Laurence Dopkin
About 16 million people struggle with major depression, according to the National Alliance on Mental Illness, the author writes.

More than 40 million American adults suffer from mental illnesses like anxiety, depression, and schizophrenia. Nearly six in 10 aren't receiving treatment.  

That's often because they can't find a mental health professional. Michigan only has about seven psychiatrists per 100,000 state residents — roughly half the number that's needed to meet patient needs. Sixty percent of U.S. counties lack a single psychiatrist. And more than 110 million Americans live in mental health professional shortage areas.  

This shortfall will likely grow worse in the years to come — and Michiganians will be hit hard. More than six in 10 practicing psychiatrists are nearing retirement age. By 2024, the United States could be short between 14,000 and 31,000 psychiatrists, according to a study published in the medical journal Psychiatric Services.  

Graduates of international medical schools can help plug this gap. These doctors — many of whom are U.S. citizens who chose to pursue their medical degrees abroad — already account for a significant share of our nation's psychiatrists. Recruiting more of them to practice stateside would greatly improve Americans' mental health.

One in five adults in the United States lives with a mental health condition. About 16 million people struggle with major depression, according to the National Alliance on Mental Illness. Over 6 million struggle with bipolar disorder. And many patients cope with multiple conditions simultaneously. Here in Michigan, more than 330,000 adults suffer from a serious mental illness, according to the Substance Abuse and Mental Health Services Administration.

It's becoming harder for them to find mental health specialists. At the end of 2018, 4.1 million Michiganians lived in mental health care shortage areas, according to the Kaiser Family Foundation. And California, Florida and Texas — the three most populous states in the union — have less than half the number of psychiatrists they need to meet patient demand. In rural areas, 95% of mental health professionals say they can't handle their communities' needs.  

International medical graduates are well-equipped to fill these shortages. They already account for nearly one-third of our country's psychiatrists — and roughly one-quarter of all physicians nationwide.  

IMGs tend to minister to high-need populations. They account for more than 35% of the active psychiatry residents who specialize in adolescent and child treatment. Their work is crucial, given that 20% of kids ages 13-18 suffer from a mental health condition. Research shows that increased access to mental health care for our nation's youth could help reduce suicide rates, juvenile delinquency and school dropouts.

That's particularly important in Michigan. Sixty-five of the state's counties don't have a single child or adolescent psychiatrist. More than 100,000 kids in Michigan struggle with depression, anxiety or ADHD. And nearly four in 10 high school students report symptoms of depression, according to the U.S. Department of Health & Human Services.

This is a nationwide epidemic. Researchers at the University of Michigan recently found that roughly half of children who struggle with a mental health condition do not receive adequate treatment — and an increase in shortages would limit access to care even further.

International medical graduates also tend to practice in high-need areas. In places where three-quarters of the population is non-white, over one-third of practicing doctors graduated from international medical schools. Doctors trained abroad are "more willing than their U.S. medical graduate counterparts to practice in remote, rural areas," according to a report from the American College of Physicians.

Physicians trained abroad provide top-notch care — sometimes even better than their domestically trained counterparts.

Many international graduates already lend a hand in Michigan. Roughly 30% of the state's doctors trained overseas.  

Forty graduates of the school I work at, St. George's University in Grenada, West Indies, matched into psychiatry residencies in March. They started working at hospitals across the country this summer, from Michigan and New York to Kansas and California.  

America needs thousands of additional psychiatrists to meet patient demand for mental health services. The nation should look abroad, to international medical schools, to find them.

Dr. Laurence Dopkin is a practicing psychiatrist and serves as assistant dean of students at St. George's University.