For about as long as anybody can remember, there haven't been nearly enough psychiatrists, psychologists, or any other mental health care workers. For Ryan Williams, CEO of mental health care company, PrairieCare, it means he spends a lot of his time on recruitment.
"That's an everyday conversation," he said in an interview. "Where are we going to keep recruiting more inpatient docs, different ways to kind of help cover some of the prescribing needs ... it's constantly a conversation going on."
PrairieCare promotional material indicates the company provides treatment services to "thousands of youth each year."
But it's hard to do that when there simply aren't enough workers. In just the last month, PrairieCare has posted jobs for two psychiatric technicians — one part time and one inpatient — a registered nurse, a family therapist for people who have mental illness and substance use issues, an art therapist, a group therapist, and the list goes on.
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"I think we try and stay ahead of it as much as possible so we're always hiring ahead, knowing there's just going to be a natural turnover," Williams said.
What the perpetual shortage means is that patients face long waits to get treatment, even if they're in a crisis. Williams said recently there were almost 40 kids in emergency rooms waiting for spots in residential facilities and more than 60 who needed intensive outpatient treatment.
And they would have taken spots almost anywhere. As with physical health problems, mental health issues often get worse when they're not treated, which can make them harder to treat.
PrairieCare isn't alone in the challenge of finding health care workers. According to one recent study the nationwide shortage of mental health practitioners will grow to more than a quarter of a million providers by 2025.
In Minnesota, all but two areas of the state have been officially recognized as not having enough. The only two not designated as shortage areas are the Twin Cities metro and the area around Rochester. But as William's experience shows, even the big cities struggle with a lack of providers.
Part of the problem is more demand for services across the country, said Angela Beck, who studies the mental health workforce at the University of Michigan.
"More people have insurance coverage for behavioral health services, so they're seeking care," she said. "We also have higher prevalence of some disorders, opioid use disorder in particular is one so there's more need for services overall."
Plus, as the population gets older, there's a greater need for more workers who can treat aging patients.
Still, more demand is only one factor. Part of the reason there are so few mental health care workers is that pay is relatively low, which makes it harder to attract workers, especially in rural areas.
In those parts of the state, there are also other, less obvious obstacles that make hiring harder, said Teri Fritsma Mogen, an economist at the Minnesota Department of Health.
"If there's not adequate housing," she said, "they're not going to be able to recruit a psychiatrist or a psychologist or you know another mental health professional. Child care is another big issue. Finding work for a spouse is another big barrier that we see."
Of course, none of this is news to the people in this business. Mental health executive Ryan Williams said the only thing to do is to try to keep the workers he has and always plan ahead for hiring new ones.
Have you had trouble hiring or retaining mental health care workers? Are you a mental health care worker who feels underpaid or overworked? Have you or a family member had to wait for treatment because of the worker shortage? If so, we want to hear from you. Please email firstname.lastname@example.org.