OBJECTIVE: To provide a better understanding of the complexities of
estimating psychiatric manpower requirements, the authors describe several
approaches to estimation and present a method based on patients' needs.
METHODS: A five-step method for psychiatric manpower estimation is used,
with estimates of data pertinent to each step, to calculate the total
psychiatric manpower requirements for the United States. The method is also
used to estimate the hours of psychiatric service per patient per year that
might be available under current psychiatric practice and under a managed
care scenario. RESULTS: Depending on assumptions about data at each step in
the method, the total psychiatric manpower requirements for the U.S.
population range from 2,989 to 358,696 full-time-equivalent psychiatrists.
The number of available hours of psychiatric service per patient per year
is 14.1 hours under current psychiatric practice and 2.8 hours under the
managed care scenario. CONCLUSIONS: The key to psychiatric manpower
estimation lies in clarifying the assumptions that underlie the specific
method used. Even small differences in assumptions mean large differences
in estimates. Any credible manpower estimation process must include
discussions and negotiations between psychiatrists, other clinicians,
administrators, and patients and families to clarify the treatment needs of
patients and the roles, responsibilities, and job description of