Supply and co-location of mental health providers across the U.S

Current efforts to plan and implement mental health services require a geographically well-distributed workforce as well as accurate information about practice locations. However, supply data currently available at the small area level are limited. Drawing from professional associations, state licensure boards, and national certification boards, this project compiled county-level supply data on clinical psychiatrists (n=34,462), psychologists (n=31,746), social workers (n=99,559), psychiatric nurses (n=8,741), marriage and family therapists (n=43,349), and professional counselors (n=69,211). This analysis describes the distribution of each profession and the extent of co-location among the six types of professionals. Hierarchical linear modeling is used to model provider counts as a function of provider type and county characteristics, controlling for clustering within state. Findings indicate that there are approximately 5 prescribers (counted as psychiatrists) per 100,000 population and 69 nonprescribers (all others) per 100,000 population. Regression results indicate that (1) consistent with economic incentives, all providers tend to ‘go where the money is'—to urban areas, with higher per capita income and lower poverty rates; and (2) however, marriage and family therapists are more likely than others to practice away from psychiatrists and in rural or low income areas. Implications for mental health service planning are discussed.