New data shows the stark imbalance between the markets with the highest and lowest concentrations of behavioral health providers.
The data, compiled and released by Trilliant Health, assessed the market concentration of primary care providers (PCPs) and behavioral health providers. The national median for behavioral health providers was 61 per 100,000 residents compared to 110 per 100,000 for PCPs.
While the U.S. is facing a behavioral health provider shortage across the country, several regions are disproportionately impacted. Previous analyses highlighted a need for additional providers across the U.S. Research has also shown that some regions have greater needs than others.
“Understanding what is required to ‘fix’ the provider shortage must begin with identifying which geographies have an oversupply or undersupply of providers by specialty,” Trillian Health researchers said in a blog post.
The markets with the highest concentrations of behavioral health providers were fairly well spread across several regions of the U.S. that tended to be more northern with the exception of Little Rock, Arkansas. However, the least concentrated states were limited to Texas; Southern, California; and Arizona.
The highest concentration, found in Ann Arbor, Michigan, stands at 218 per 100,000 while the lowest is in Laredo, Texas with 8 per 100,000; Ann Arbor sees a 27x greater concentration than Laredo.
The top 15 markets, per 100,000 residents
| Ann Arbor | MI | 218 |
| Eugene-Springfield | OR | 201 |
| Springfield | MA | 188 |
| Cleveland-Elyria | OH | 181 |
| Spokane-Spokane Valley | WA | 178 |
| Kalamazoo-Portage | MI | 178 |
| Akron | OH | 166 |
| Toledo | OH | 165 |
| Bellingham | WA | 162 |
| Madison | WI | 154 |
| Columbus | OH | 149 |
| Grand Rapids-Kentwood | MI | 148 |
| Cincinnati | OH-KY-IN | 144 |
| Huntington-Ashland | WV-KY-OH | 143 |
| Little Rock-North Little Rock-Conway | AR | 142 |
The report notes an increase in Americans reporting depression or anxiety symptoms compared to pre-pandemic levels as well as higher usage of behavioral health services during the pandemic. This demonstrates how the pandemic generated added demand for the limited supply of behavioral health providers to try to meet.
As many as 43% of Americans reported to the Household Pulse Survey feeling either anxious or depressed during the Winter 2020 COVID-19 case surge. The most recent survey data, presented by KFF.com, shows that the number is now near 33%.
Telehealth use for behavioral health increased by 4,000% in 2021 compared to 2019, according to Trilliant Health’s health claims database. Emergency room usage for serious mental illness was up 35% and all other mental health disorders were up 25% for the same period.
The imbalance of behavioral health providers and demand for behavioral health services has prompted several federal actions following the onset of the pandemic.
One recent action includes the Senate Finance Committee releasing draft legislation that would seek to make the most of the present behavioral health workforce and grow it.
| Corpus Christi | TX | 23 |
| El Paso | TX | 23 |
| Lubbock | TX | 23 |
| San Luis Obispo-Paso Robles | CA | 20 |
| Beaumont-Port Arthur | TX | 19 |
| Yuma | AZ | 19 |
| College Station-Bryan | TX | 18 |
| Amarillo | TX | 17 |
| Visalia | CA | 17 |
| Brownsville-Harlingen | TX | 16 |
| Merced | CA | 16 |
| McAllen-Edinburg-Mission | TX | 14 |
| Longview | TX | 12 |
| Lake Havasu City-Kingman | AZ | 12 |
| Laredo | TX | 8 |
The post also highlights the potential impacts of the possibility of all adults under 65 years old being screened for anxiety, depression and suicide risk following the US Preventive Services Task Force’s release of draft guidelines for more mental health screenings.
Trilliant Health’s workforce data comes from its provider directory in core-based statistical areas with more than 200,000 residents.
“Given the insufficient provider supply facing the health economy, stakeholders seeking to deliver primary care and behavioral health services must characterize consumer behaviors and preferences at a hyper-local level,” the post states.
It also limited PCPs in the analysis to board-certified physicians while more widely defining behavioral health providers to include board-certified psychiatrists, psychologists, behavioral therapists, social workers, psychiatric nurse practitioners, among unnamed others.
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