The picture around the mental health provider shortage has come into focus with the formation of a new national database.

Researchers with the George Washington University released a comprehensive national database of all primary care providers, behavioral health specialists and other physician specialists that prescribed more than 11 behavioral health medications in 2020.

The researchers claim the database — based on IQVIA Xponent retail prescription data, state licensure data, and the National Plan and Provider Enumeration System — is the first of its kind.

“It is difficult to know how many more providers are needed if we do not even know the current number of providers practicing or where they are located,” a Health Affairs article penned by the researchers states. “It is easy to call for more behavioral health providers. But without better data, public and private efforts to increase the supply may not be effectively targeted to the highest need communities.”

Anecdotal evidence of the mental health provider shortage abounds.

In some cases, major behavioral health operators such as Acadia Healthcare Inc. (Nasdaq: ACHC) are looking to M&A and joint ventures as a way to grow around the shortage.

In others, national acute and behavioral health hospital operators such as Universal Health Services (NYSE: UHS) have struggled to find the staff needed to operate behavioral health facilities, even while paying premium rates for temporary staff.

The database shows the U.S. in 2020 had about 1.2 million health care practitioners that could be considered mental health providers.

About half (600,000) are behavioral health specialists — psychiatrists, psychologists, licensed clinical social workers and the like. The remainder are advanced practitioners, primary care physicians and other physicians that exhibit some involvement in behavioral health based on their prescribing activity.

The database also plots, down to the county level, where these providers are domiciled. These data confirm many previous insights into the uneven geographic per-population distribution of these providers. 

Northeastern states have the highest concentrations of psychiatrists and addiction providers, while Southern and Western states have some of the lowest.

In Connecticut, there is one psychiatrist/addiction medicine specialist for every 3,113 residents. Oklahoma, a state of comparable population, has 9,570 residents per psychiatrist/addiction medicine specialist.

The researchers also found that about 50% of all U.S. counties do not have a psychiatrist or addiction medicine specialist while about 23% of all behavioral health prescribers didn’t see any Medicaid beneficiaries.

The researchers also highlighted the outsized role that primary care providers have in the behavioral health system compared to their relative share of the workforce. Nationwide, there are about 400,000 primary care providers who provide behavioral health care, including nurse practitioners and physician assistants.

There are 558 primary care providers in the database compared to 1,618 prescribing specialists. Primary care providers prescribed 224 million behavioral health medications, about 2.68 times more than prescribing behavioral health specialists.

“At a time of a national mental health crisis, having a reliable source of data on the active behavioral health workforce is more important than ever,” the Health Affairs article continues.

Previous federal research highlights mental health provider shortages and makes estimates about how many providers are needed for a state’s needs to be met. The researchers that created the database did not make comparable estimates.

The federal research shows that the United States would require about 6,600 new mental health practitioners to meet the demand in areas the federal government designates health professional shortage areas.