Does Hawai'i Have Enough Psychiatrists? Assessing Mental Health Workforce Versus Demand in the Aloha State.

National data reports the number of adults with any diagnosable mental disorder within a given year is nearly 1 in 5. Hawai'i, along with the rest of the nation, faces a serious shortage of mental health providers. This article describes the research undertaken to create a more accurate assessment of the current mental health provider workforce in Hawai'i through developing an estimation strategy to appraise local mental health workforce needs. The results indicate the supply of psychiatrists for Hawai'i's 2010 census population was found to be 161.4 Full Time Equivalents (FTEs) psychiatrists, or 11.86 psychiatrists/100,000 population, with the greatest number of psychiatrists per capita on the island of O'ahu. Of the 161.4 FTEs, 50.4 FTEs or 31.2% were accepting new Medicaid patients. The state's results show that Hawai'i is short of meeting current patient need by more than 100 psychiatrists though the state was only short by 6 FTE psychiatrists with regard to estimates of Medicaid patients' need. While the first number is likely accurate, the second number is likely to be significantly underestimated for a number of reasons. One reason is that practitioners who reported accepting new Medicaid patients likely see comparatively few. Another reason is that it is likely that Medicaid patients make up more than the approximate 20% of the psychiatric patient population. It is reported nationally that a greater percentage of the mentally ill receive Medicaid than the population at large. Thus, there are probably many more patients on Medicaid than our estimations accounted for. It is clear more research and more changes need to be made in Hawai'i's publicly funded healthcare system to incentivize physician acceptance and make mental healthcare more accessible to this growing population.