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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


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


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


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


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


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


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


Psychologist Workforce Projections 2015-2030


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


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

http://www.apa.org/workforce/data-tools/interactive-state-level.aspx

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


• 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


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/

https://doi.org/10.1371/journal.pone.0170887

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!

http://www.apa.org/workforce

mailto:[email protected]

new what do we know about the current and future psychologist … · 2020. 9. 5. · • licensed...

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