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'Silent shortage'

Amidst a nationwide shortage of mental health workers, Jackson County will spend up to $200,000 for a recruitment firm to find as many as 15 mental health professionals.

The Jackson County Board of Commissioners approved the spending Wednesday.

"There's a real shortage of them out there and a huge demand," said Commissioner Rick Dyer.

He said Jackson County has been working diligently to hire more mental health workers but needs help from recruitment firm Merritt Hawkins.

The county has hired more than 100 mental health workers over the past few years and also contracts with outside providers and agencies. But residents who need care are still facing wait times due to limited staff availability, said County Administrator Danny Jordan.

A nationwide rush to hire mental health professionals was triggered by the 2010 passage of the federal Affordable Care Act, which put mental health care coverage on par with physical health care coverage. The nation does not have enough mental health workers to meet the demand for care.

Coordinated care organizations are paying Jackson County to provide mental health care to the 65,000 county residents now on the Oregon Health Plan. The number of residents on the plan skyrocketed from 30,000 four years ago.

The national firm Merritt Hawkins specializes in recruiting health care professionals.

During the past fiscal year, the firm was successful in recruiting for several hard-to-fill positions for Jackson County, county officials said.

In 2015, Merritt Hawkins issued a report showing national demand for psychiatrists is at an all-time high. Psychiatrists trailed only primary care doctors on the firm's list of the 20 most in-demand medical specialties.

The firm has called the shortfall of psychiatrists a "silent shortage" because of the lack of attention paid to the problem.

In addition to passage of the Affordable Care Act, recessions, slow economic recoveries, unemployment and wars during the past 15 years have exacerbated the demand for mental health care, said Merritt Hawkins Regional Vice President of Sales Corey Johnson, who covers the western United States.

At the same time, entering the psychiatric field is often not attractive because of low reimbursement rates and the emotional toll the work inflicts, Johnson said in a phone interview.

"Mental health issues are often ongoing and chronic," he said. "That can lead to lower morale among psychiatrists."

He said professionals who serve in jails, prisons and state mental hospitals have especially difficult work environments.

Across America, there aren't enough residency spots for doctors, including psychiatrists, who finish medical school. The number of slots hasn't expanded since the 1990s — and that can derail medical school graduates' careers, Johnson said.

During a residency, a graduate works under supervision in a clinic, hospital or similar setting to gain additional experience.

With 70 percent of psychiatrists over age 50, the shortage could get worse as people move into different roles or retire, he said.

A positive development is the increasing integration of physical and mental health care, Johnson said.

"We're now starting to treat the whole patient. The primary care team is supported by mental health," he said. "Cultivating those kinds of models will help."

A cancer patient, for example, is at increased risk of developing depression. A mental health professional could feel additional fulfillment from helping the patient, Johnson said.

Rogue Valley efforts to integrate physical and mental health care received a boost when Jackson Care Connect, a coordinated care organization, announced this summer it is investing $487,500 over the next year to help medical clinics add mental health workers. The money also will help support clinics that already offer mental health services.

Organizations trying to hire mental health workers can better their odds with incentives such as sign-on bonuses, help with moving expenses and competitive compensation, Johnson said.

Mental health job openings currently posted on Jackson County's website include psychiatrist, psychiatric nurse practitioners, mental health nurse, mental health utilization coordinator, mental health associate, mental health case manager, skills trainer, health assistant, law enforcement crisis team liaison, clinical therapist, children's mental health worker, clinical supervisor and pre-commitment investigator.

— Reach staff reporter Vickie Aldous at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.

Positions at Jackson County mental health have gone unfilled because of a national shortage of workers. Mail Tribune / Jamie Lusch