history at a glance
- The researchers looked at the shortage of psychiatrists in communities with beneficiaries of the US military health care system, TRICARE.
- Military personnel and their dependents who faced shortages between 2016 and 2020 tended to live in rural or economically disadvantaged communities.
- Those who lived in low-income communities with higher income inequality were more likely to live in areas with a shortage of providers.
Thirty-five percent of TRICARE beneficiaries lived in areas with a shortage of military and civilian psychiatrists between 2016 and 2020, the results of a new study showwhile six percent of all recipients did not have psychiatrists available within a 30-minute drive from their community.
TRICARE, the US military’s health care system, offers coverage to active duty military personnel, retirees, and their dependents. Many active duty service members and their families use military treatment centers (MTFs) for medical care, although fewer than 500 of these provide psychiatric care. Others choose to rely on civilian medical services, the authors wrote.
Previous research has shown that military service members and their families have greater mental health care needs than civilians, and may face unique barriers when it comes to seeking care, including frequent deployments and relocations, the researchers explained.
Researchers analyzed more than 39,000 ZIP code communities between 2016 and 2020 to better understand the availability of military and civilian psychiatrists within a 30-minute drive of recipients.
The data showed that beneficiaries living in low-income communities with high income inequality were more likely to experience provider shortages, along with those living in rural communities.
Compared with urban communities, rural areas were more than 6 times more likely to have a shortage of military and civilian psychiatrists. These areas were more than five times as likely to not have a psychiatrist within a 30-minute drive compared to urban communities.
The findings underscore the need for targeted strategies in these areas, as residents cannot rely on civilian psychiatrists to meet their needs, the authors wrote.
Psychiatrist shortage areas were based on the Health Resources and Services Administration definition, where the population to psychiatrist ratio was greater than 20,000 to 1.
Most of the scarcity areas were located in the southern, midwestern, and interior western regions of the United States. Only 13 percent of the TRICARE beneficiary population lived in a region with an adequate number of military and civilian psychiatrists.
Alaska and Hawaii were the states most likely not to have psychiatrists within a 30-minute drive of recipient communities.
The data also showed that communities with a higher presence of retirees were at greater risk of experiencing psychiatrist shortages or no access.
Although the access gap identified for military retirees may be partially filled by VA services, the researchers note that “only 60 [percent] of veterans are eligible for VA health care under current policy and only 50 [percent] of eligible veterans use VA health benefits.”
“As the military health system considers realigning its psychiatric capacity, it would be important to develop specific strategies for areas of shortage, as it cannot rely on civilian mental health care professionals to care for the military population in many communities”, they concluded.