More than 150 million Americans live in areas with a shortage of mental health specialists, according to the Kaiser Family Foundation. Experts say this gap will widen over the next few years due to a rising demand for mental health services and a dwindling number of mental health professionals.

“We have a chronic shortage of psychiatrists, and it’s going to keep growing,” Saul Levin, MD, CEO and medical director of the American Psychiatric Association is quoted as saying in an Association of American Medical Colleges article. In fact, the article states that one of the reasons why there’s a shortage of psychiatrist is retirement: more than 60% of psychiatrists are 55 or older.

At the same time, demand for mental health services doesn’t seem to be letting up. Due to the pandemic, the CDC reported an increase in the number of people indicating they had anxiety and/or depression symptoms.

“The frequency of anxiety and depression symptoms experienced among U.S. adults increased after August 2020 and peaked during December 2020–January 2021,” according to a CDC report. “The frequency of symptoms subsequently decreased but in June 2021 remained elevated compared with estimates from the 2019 NHIS.”

This shortage of mental health specialist puts primary care providers – including physicians and nurse practitioners – on the front lines.

Research has found that, “80% of people with a behavioral health disorder will visit a primary care provider at least once a year” and “50% of all behavioral health disorders are treated in primary care,” according to the Primary Care Collaborative. Yet, they also note that, “67% of people with a behavioral health disorder do not get behavioral health treatment.

“Of the top five conditions driving overall health care costs (work related productivity + medical + pharmacy cost), depression is ranked number one,” according to the Primary Care Collaborative.

So, these concurrent forces are putting a lot of pressure on primary care providers. That’s why, in the Fall 2022 GeneSight Mental Health Monitor, we asked around 600 clinicians, almost evenly split between primary care physicians and nurse practitioners, about what they are seeing in mental healthcare.

Sharing is key to providing good mental health care

A majority of primary care providers wish more patients would open up about their mental health (more than 83%). The survey found that PCPs want to provide quality mental healthcare so their patients can have a better chance at an improved quality of life (98%).

“When a patient comes into my practice, they may not even be aware that their symptoms could indicate depression, anxiety or another mental health condition,” said Michele Long, a nurse practitioner in Lancaster, Ohio. “It would be great if patients knew it was ok to bring up their concerns.”

Yet, at the same time, more than half of surveyed providers said they wait to discuss specific mental health disorders like depression and anxiety until a patient raises a concern, or when the results of a screening/evaluation indicate the need. Yet, the Spring 2022 GeneSight Mental Health Monitor showed 25% of patients are given a depression screening by their PCP.

“It’s also my responsibility to ask the right questions – either by having my patient complete a mental health screening or just asking them myself,” said Long.

Treating vs referring: the primary care challenge

More than six in 10 (63%) PCPs/NPs have increased referrals to mental health specialists over the past two years, despite the shortage in available care. Primary care providers are now fighting two battles at once: more and more patients are experiencing mental health challenges, but there are fewer specialists available to send them to.

How GeneSight may help PCPs

Many PCPs wish that patients knew they are fully trained to diagnose and treat mental health conditions, according to the GeneSight Mental Health Monitor. Yet, as patient demand increases, providers may have less availability for medication management and repeat office visits from the same patient.

Pharmacogenomic (PGx) testing, such as the GeneSight Psychotropic test, is an additional tool that may help PCPs better manage their patients’ mental health. The GeneSight test analyzes clinically important genetic variations which may impact how a patient metabolizes and responds to certain FDA-approved medications used in the treatment of depression, anxiety, ADHD and other mental health conditions. The test is intended to supplement other information considered by a clinician as part of a comprehensive medical evaluation.

Only 18% of responding prescribers in primary care use an available tool like pharmacogenomic testing to help inform their mental health medication treatment plan, according to the survey.

“Finding effective treatment can be a very frustrating process for patients and they often feel defeated when a medication fails,” Long said. “[GeneSight is] a valuable tool that helps me find solutions for those who have entrusted me with caring for their mental health.”

Read our press release and find more about the survey at: https://genesight.com/mental-health-monitor/

This is the personal experience of one patient, and the professional experience of one clinician.  Others may not have the same experience or outcome.