Supply dynamics of the mental health workforce: implications for health policy

Milbank Q. 1998;76(1):25-58. doi: 10.1111/1468-0009.00078.


The U.S. mental health workforce is varied and flexible. The strong growth in supply of nonphysician mental health professionals, ranging from psychologists to "midlevel" professionals like social workers and nurse specialists, helps to offset the dwindling numbers of medical graduates entering the field of psychiatry. Primary care physicians often see patients who have some form of mental illness, which they are not always trained to recognize and treat. The data on the supply of several specialists--psychiatrists, clinical psychologists, and clinical social workers--indicate that the distribution of mental health professionals varies widely by state. The composition, supply, and distribution of workers in this field also affect the care of vulnerable populations. Broader policy questions, including the lack of parity between mental and physical health insurance coverage and barriers to entry by nonphysician professions, may limit the cost-effective expansion of this diverse and dynamic workforce.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adolescent
  • Aged
  • Allied Health Personnel / supply & distribution
  • Child
  • Health Policy*
  • Health Services Needs and Demand / statistics & numerical data
  • Health Services Needs and Demand / trends
  • Health Services for the Aged / supply & distribution
  • Humans
  • Incidence
  • Mental Disorders / epidemiology
  • Mental Health Services*
  • Physicians / supply & distribution
  • Policy Making
  • Psychiatric Nursing
  • Psychiatry*
  • Psychology
  • Rural Population
  • Social Work / statistics & numerical data
  • United States / epidemiology
  • Urban Population
  • Workforce