California’s Psychiatry Workforce Challenges

March 2, 2020

In his 2020 State of the State address, California Governor Gavin Newsom called for the state’s counties to spend Mental Health Services Act funds more quickly to assist the 1 in 6 California adults who suffer from mental illness and the 1 in 13 California children who suffer from a serious emotional disturbance. The impact of these expenditures will depend on the adequacy of the supply and distribution of the mental health workforce. This issue brief profiles California’s psychiatrists and the pipeline of trainees in the state’s psychiatry residency programs. Psychiatrists are a key part of the mental health workforce because they are among the few professionals authorized to prescribe medications that are integral to the treatment of many mental health conditions. The issue brief finds that:

  • California has 22 general psychiatry residency programs, most of which are located in the Greater Bay Area or in metropolitan areas of Southern California.
  • In 2015, California had 5,809 active licensed psychiatrists, which is five percent fewer than the number needed to meet demand. 
  • The Inland Empire and San Joaquin Valley regions of California have half as many psychiatrists per capita as California overall.
  • 45 percent of psychiatrists in California were over 60 years old in 2015.
  • Forecasts of supply and demand for psychiatrists suggest that California will have a severe shortage of psychiatrists by 2028 unless policymakers take action, because the number of people training to become psychiatrists is not sufficient to replace older psychiatrists who are expected to reduce their work hours or retire.

The issue brief notes that the California Future Health Workforce Commission recommends that California invest $741.7 million to train 527 first-year psychiatry residents per year from 2025 to 2029. The CalMedForce program, which is funded through Proposition 56, is a potential source of funding for expansion of psychiatry residency training because Proposition 56 permits the program to fund training in other medical specialties that are facing (or that are projected to face) shortages. The issue brief recommends that CalMedForce assess the feasibility of securing new resources to support the expansion of existing psychiatry residency programs and the development of new residency programs, especially at institutions that have not previously received Medicare funding for residency training.