Shortage or Maldistribution?
Although the authors' data demonstrate a scarcity in rural areas compared with urban areas, their conclusion that this scarcity of PMH-APRNs equals a shortage is unsupported. On the basis of their data, an equally plausible (although empirically unlikely) conclusion is that affluent urban regions are oversupplied with PMH-APRNs.
The authors' proposal to increase the supply of PMH-APRNs would likely exacerbate their maldistribution and do little to improve access to mental health services in rural areas. In medically underserved areas where recruitment and retention of mental health practitioners is a challenge, provision of training to existing primary care practitioners, consultation via telemedicine, and introduction of incentives for mental health specialists of all backgrounds would be far more effective.
1 : Geospatial study of psychiatric mental health-advanced practice registered nurses (PMH-APRNs) in the United States. Psychiatric Services 62:1506–1509, 2011 Link, Google Scholar