Original Research

Improving behavioral health workforce supply and needs estimates using active surveillance data


Shinobu Watanabe-Galloway1 PhD, Associate Professor *

Li-Wu Chen2 PhD, Professor

Kate Trout3 PhD, PhD Student

David Palm4 PhD, Associate Professor

Marlene Deras5 BSc, Director

Zaeema Naveed6 MSPH, PhD Student


1, 6 Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska

2, 3, 4 Department of Health Services Research & Administration, University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska

5 Health Professions Tracking Service. University of Nebraska Medical Center, College of Public Health, Omaha, Nebraska

ACCEPTED: 16 March 2019

early abstract:

Background: Previous studies show that supply of behavioral health professionals in rural areas is inadequate to meet the need. Measuring shortage using licensure data on psychiatrists is a common approach. Although inexpensive, the licensure data have many limitations. An alternative is to implement an active surveillance system, which uses licensure data in addition to active data collection to obtain timely and detailed information.

Methods: Nebraska Health Professionals Tracking Service (HPTS) data were used to examine differences in workforce supply estimates between the passive (licensure data only) and active (HPTS data) surveillance systems. The impact of these differences on the designation of psychiatric professional shortage areas has been described. Information regarding the number of psychiatrists, advanced practice registered nurses (APRNs) and physician assistants (PAs) specializing in psychiatry was not available from the licensure database, unlike HPTS.

Results: Using licensure data vs.HPTS data to estimate workforce, the counts of professionals actively practicing in psychiatry and behavioral health were over estimated by 24.1% to 57.1%. Ignoring work status, the workforce was overestimated by 10.0% to 17.4%. Providers spent 54% - 78% of hours seeing patients. Based on primary practice location, 87% of counties did not have a psychiatrist and 9.6% were at or above the health professional shortage area (HPSA) designation ratio of psychiatrist-population. Conclusion: Enumeration methods such as ongoing surveillance in addition to licensure data, curtails the issues and improve identification of shortage areas and future behavioral workforce related planning and implementation strategies.