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What Do We Know about the Current and Future
Psychologist Workforce? Karen Stamm, PhD
Director, Center for Workforce StudiesVirginia Behavioral Health Summit
September 27, 2018
The opinions expressed in this presentation are those of the author and do not constitute official policy of the American Psychological Association.
Slides are available at the APA Center for Workforce Studies website under Presentations http://www.apa.org/workforce/presentations/index.aspx
Learning Objectives
• Describe trends in psychologist diversity in the training pipeline and workforce
• Identify patterns in the provision of psychologist services and the associated implications for cultural competency
• Discuss the implications of a psychologist supply that is projected to be insufficient to address unmet need for mental health services
APA Center for Workforce Studies
The mission of the Center for Workforce Studies is to collect, analyze, and disseminate information on the
psychology workforce and education pipeline.
• Psychologist vs. psychology• Psychologist - person with a doctorate in psychology• Psychology - discipline
Training Pipeline: 2018 Gender Diversity of Psychology Doctoral Students
Female 78%
Male 22%
Health Service Psychology
Female 65%
Male 35%
Research
Source: APA Graduate Study in Psychology, 2018. APA Office of Graduate and Postgraduate Education and Training
Training Pipeline: 2009 Race & Ethnicity of Psychology Graduate Students
Caucasian/White71%
Multiethnic3%
African-American/Black
10%
Hispanic/Latino9%
Asian6%
American Indian/Alaska Native
1%
Source: APA Graduate Study in Psychology, 2009. APA Center for Workforce Studies
Training Pipeline: 2018 Race & Ethnicity of Psychology Graduate Students
Caucasian/White62%
Multiethnic4%
African-American/Black12%
Hispanic/Latino14% Asian
7% American Indian/Alaska Native
1%
Source: APA Graduate Study in Psychology, 2018. APA Office of Graduate and Postgraduate Education and Training
Training Pipeline: Diversity of Doctoral Students in Health Service Psychology Programs
% Female
% White
% Racial/
Ethnic Minority (Black,
Hispanic, or Asian)
% Other race
2012 78.0 65.7 25.6 8.6
2013 77.8 65.5 25.8 8.7
2014 77.6 64.9 26.2 8.9
2015 77.3 64.5 26.5 9.1
Source: Page et al. (2017). Understanding the Diversity of Students and Faculty in Health Service Psychology Doctoral Programs.
Training Pipeline: Psychology Doctoral Degrees by Gender
Men27%
Women73%
2006Men25%
Women75%
2016
Source: National Center for Education Statistics, IPEDS Completions Survey.
Training Pipeline: Psychology Doctoral Degrees by Race/Ethnicity:
White69%
Hispanic13%
Black/AA10%
Asian6%
2+ races2%
2016
Source: National Center for Education Statistics, IPEDS Completions Survey.
White76%
Hispanic10%
Black/AA7%
Asian6%
American Indian
1%
2008
Psychologist Workforce Diversity
• Gender: 59% women• Racial/ethnic minorities: 14%• Sexual orientation: 7% gay, lesbian, or bisexual• Disability status: 6% reported at least one disability• Mean age: 55.7 years (SD = 12.7)
• Career stage, defined by years since doctorate• Early career (1-10 years)• Mid-career (11-20 years)• Senior career (21-30 years)• Late senior career (31+ years)
Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Diversity by Career Stage: Gender & Race/Ethnicity
76.7 72.258.7
38.1
23.3 27.841.3
61.9
0%
20%
40%
60%
80%
100%Percents by Gender
Female Male
78.2 84.1 89.4 91.0
21.8 15.9 10.6 9.0
0%
20%
40%
60%
80%
100%Percents by Race/Ethnicity
White Minority
12Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Diversity by Career Stage: Sexual Orientation & Disability Status
91.0 92.3 92.1 95.4
9.0 7.7 7.9 4.6
0%
20%
40%
60%
80%
100%Percents by Sexual Orientation
Heterosexual Gay/lesbian/ bisexual
94.0 95.2 94.6 93.1
6.0 4.8 5.4 6.9
0%
20%
40%
60%
80%
100%Percents by Disability Status
No Yes
13Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Diversity Implications
• The training pipeline and new doctorate recipients are predominantly White and female
• Slow change is occurring toward greater racial/ethnic diversity
• Comparison to overall psychology workforce demographics
• The workforce has higher percentages of women (69%), similar proportion of racial/ethnic minorities (14%), and lower age (mean = 48.9 years) (2015 American Community Survey)
• In 2013, psychology research doctorates were ~48% women, ~16% racial/ethnic minorities, and had a mean age of 54 years (Hur et al., 2017)
• Comparison to U.S. population• 51% women, 35% racial/ethnic minorities (U.S. Census, 2015)
Cultural Competency
• Overall preparedness by graduate training to work with diverse populations
• Mean = 3.44 (SD = 1) on 5-point scale• Higher ratings in earlier career stages
Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Knowledge Ratings about Working with Diverse Populations
0 1 2 3 4 5
ChildrenAdolescentOlder Adult
Black/African AmericanAsian
American Indian/Alaska NativePacific Islander/Native Hawaiian
Hispanic
Gay/Lesbian/BisexualTransgender
Clients living in povertyClients living with chronic IllnessClients with physical disabilities
Clients with intellectual disabilitiesClients with cognitive disabilities
MilitaryImmigrant
RuralReligious
Mean KnowledgeEarly Career Mid-Career Senior Career Late Senior Career
Race/Ethnicity
Sexual Orientation/Gender Identity
Chronic Conditions & Disabilities
Other Populations
Age Group
Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Knowledge Rating Highlights• Psychologists in earlier career stages reported
higher knowledge ratings for most population groups
• Exception – older adults had an opposite pattern where psychologists in later career stages reported higher knowledge ratings
Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Characteristics of Psychologists Providing Services to Diverse Populations• Are psychologists more likely to treat patients who
match their own characteristics? Generally yes.• A larger proportion of psychologists of color treated
racial/ethnic minority patients frequently/very frequently• Ex. 48% of psychologists of color vs 32% White psychologists
frequently/very frequently provided services to Hispanicpatients
• A larger proportion of older psychologists treated older adults frequently/very frequently
• 48% psychologists age 65 or older vs. 37% of psychologists overall frequently/very frequently provided services to older adults
Source: 2015 APA Survey of Psychology Health Service Providers Fact Sheets
Cultural Competency: Resources Utilized
0
2
4
6
8
10
Reso
urce
Util
izatio
n In
dex
Resource
Early Career
Mid-Career
Senior Career
Late SeniorCareer
19Source: 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Cultural Competency Implications
• A more culturally competent psychologist workforce is emerging
• Yet competency self-ratings may not improve patient outcomes (APA Handbook of Multicultural Psychology, 2014)
• Why is cultural competency higher in earlier career stages?
• Proximity to graduate training? • Knowledge fading over time? • Changing workforce demographics?
And now for something completely different …
…. and how it relates to weather forecasts
Psychologist Workforce Projections Overview• Projections address supply and demand for
licensed doctoral-level psychologists (practitioners) from 2015-2030
• Full-time equivalent (FTE) psychologist = works an average of 39 hours per week
• Starting point is ~95,000 licensed doctoral-level psychologists who are active in the workforce
• Assumption - Supply and demand are in balance nationwide in 2015
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
Psychologist Supply
• Supply Inputs• Licensed psychologists active in the workforce• New entrants • Workforce patterns• Migration across states
• Supply Scenarios• Baseline
• Assumes current patterns continue in the future• Increase/decrease # graduates by 10%• Retire 2 years earlier/later
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
Psychologist Demand• Demand Inputs
• Current service utilization patterns• Projected population demographic changes
• Demand Scenarios• Baseline
• Assumes current patterns continue in the future• Affordable Care Act
• Continued ACA expansion• Unmet need
• Address estimated 20% unmet need for mental health services• Geographic equivalence
• Uninsured people in rural areas had same utilization patterns as insured people in metropolitan areas
• Racial/ethnic equivalence• Entire U.S. population had same utilization patterns as non-Hispanic white
populations
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
Psychologist Workforce Projections 2015-2030
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
114,220
121,340
107,410
95,180
101,120
90,000
95,000
100,000
105,000
110,000
115,000
120,000
125,000
2015 2020 2025 2030
Full-
Tim
e-Eq
uiva
lent
Psy
chol
ogis
ts
Year
Demand (Address20% Unmet Need)
Supply (Baseline)
Demand (Baseline)
Psychologist Workforce Projections for Virginia
• State-level map tool: http://www.apa.org/workforce/ data-tools/interactive-state-level.aspx
Virginia
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
Year Supply DemandSupply-
Demand2015 2,930 2,360 5702020 3,360 2,430 9302025 3,680 2,490 1,1902030 4,050 2,550 1,500
Workforce Projections Key Points
• Increasing supply by increasing the number of graduates and delaying retirement narrows but does not eliminate this gap
• Psychologist supply is projected to be insufficient to address unmet need
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
• Demand (service utilization) is considerably lower than unmet need
• Addressing supply alone may not address unmet need• Complex financial, social, cultural, and geographic factors
represent barriers to care
Top Reasons for Unmet Need
1. Could not afford the cost of treatment (38%)2. Thought could handle the problem without treatment
(28%)3. Did not know where to go for services (21%)4. Did not have time (20%)
5. Health insurance does not pay enough for mental health services (13%)
6. Concerns about being committed or having to take medicine (12%)
7. Might cause neighbors or community to have negative opinion (11%)
Source: SAMHSA, 2016 National Survey of Drug Use and Health
Workforce Projections Limitations• Projections may underestimate demand
• Projections use traditional definitions of mental health services
• May not capture psychologists’ role in health services (obesity, smoking, pain management, chronic illnesses) or certain venues (primary care, integrated care)
• Lack of specialty data• Terms are not consistent with those used in psychology
• Ex. Employment settings • Offices of health practitioners vs. Psychologists in private practice
• Demand is based on utilization, not need• Projections ≠ predictions
Source: APA, 2018, Psychologist Workforce Projections 2015-30.
Workforce Projections Implications
• Do we have enough psychologists?• Better question: Do we have the right psychologist
workforce?• Age groups - Older adults• Race/ethnicity – Hispanic populations• Employment settings – Hospitals• Geographic location - South
Areas Where Demand is Projected to Grow• Older adults
• Council of Professional Geropsychology Training Programs• 16 doctoral programs• 20 internship programs• 17 postdoctoral programs
• Hispanic populations • 5.5% of psychologists can provide services in Spanish (2015 APA Survey of
Psychology Health Service Providers)
• 4.4% of psychologists are Hispanic (2015 APA Survey of Psychology Health Service Providers)
Areas Where Demand is Projected to Grow• Hospitals - 19% growth in demand by 2030
0
10
20
30
40
50
60
70
Perc
ent
Employment Setting
Early Career
Mid-Career
Senior Career
Late SeniorCareer
Sources: APA, 2018, Psychologist Workforce Projections 2015-30 & 2015 APA Survey of Psychology Health Service Providers: Career Stage Report
Areas Where Demand is Projected to Grow
• The South• Relatively fewer
psychologists in the South and middle of the country than in the Northeast and CA
• Relationships between the distribution of psychologists and health indicators
• More psychologists = healthier populations
• Fewer psychologists = less healthy populations
Source: APA, 2016, County-Level Analysis of U.S. Licensed Psychologists and Health Indicators
Conclusions
Diversity
Training Pipeline & Workforce
Demographics
Cultural Competency
Psychologist Workforce Projections
References: Center for Workforce Studies• American Psychological Association. (2016). 2015 APA Survey of
Psychology Health Service Providers. Washington, DC: Author. Retrieved from http://www.apa.org/workforce/publications/15-health-service-providers/index.aspx
• American Psychological Association. (2016). County-level analysis of U.S. licensed psychologists and health indicators. Washington, DC: Author. Retrieved from http://www.apa.org/workforce/publications/15-county-analysis/index.aspx
• American Psychological Association. (2017). Career stages of health service psychologists: Special analyses of the 2015 APA Survey of Psychology Health Service Providers. Washington, DC: Author. Retrieved from http://www.apa.org/workforce/publications/15-health-service-career/index.aspxAmerican Psychological Association. (2017). Degrees in psychology [interactive data tool]. Retrieved from http://www.apa.org/workforce/data-tools/degrees-psychology.aspx
• American Psychological Association. (2018). Psychologist workforce projections 2015-30. Retrieved from http://www.apa.org/workforce/ publications/supply-demand/default.aspx
References: Other Sources• American Psychological Association. (select years). Graduate Study in
Psychology [special analyses].• Hur, H., Andalid, M., A., Maurer, J. A., Hawley, J. D., & Ghaffarzadegan, N.
(2017).Recent trends in the U. S. behavioral and social sciences research (BSSR) workforce. PLoS ONE, 12(2), e0170887. https://doi.org/10.1371/journal.pone.0170887
• Page, C., Buche, J., Stamm, K., Lin, L., Christidis, P., & Beck, A. (2017). Understanding the Diversity of Students and Faculty in Health Service Psychology Doctoral Programs. Retrieved from http://www.behavioralhealthworkforce.org/project/recruitment-and-retention-of-a-diverse-health-service-psychology-workforce/
For more information, please visit the APA Center for Workforce Studies website:
www.apa.org/workforce
Questions? Contact [email protected]
Thank you!