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Melissa Larkin-Skinner, Roger Johnson: Solving Florida’s critical psychiatrist shortage

It’s no secret by now that our country is in the midst of an opioid crisis. Overdose deaths are at an all-time high, with no signs of slowing down. If the epidemic hasn’t already touched you or someone you know personally, the odds are that it will soon.

Tragically, our great state is not immune to this crisis. In fact, the statistics in south Florida are among the most alarming nationwide. Officials in this region estimate that someone overdoses every two hours, and overdose deaths in just three counties — Broward, Miami-Dade and Palm Beach — were on track to exceed 800 last year. Manatee County has had the highest per capita death rate for the past two years.

At the federal, state and local levels, there are several education, prevention and treatment-related initiatives aimed at combating this addiction crisis. For example, recent federal policy changes are allowing psychiatrists to treat more patients with Medication Assisted Treatment (MAT), one of the primary and most effective tools we have in fighting addiction.

A significant challenge we face, however, is a severe shortage of psychiatrists across our nation and here in Florida. If you’ve tried to make an appointment with a psychiatrist recently, you likely know how serious this shortage is. According to Florida’s 2015 Physician Work Force Annual Report, 14 counties in our state have no psychiatrists, and nine counties only have one. Professional physician recruiters estimate that there are about 250 vacant positions for psychiatrists in Florida. There are simply not enough doctors available to treat the number of Floridians who need critical, lifesaving help.

It is estimated that two-thirds of physicians remain within 50 miles of where they complete their residencies. Thus, filling the vacancies in our state means that we need to recruit more medical students to the field of psychiatry and train them locally.

Unfortunately, maintaining a psychiatric residency program is not easy. Behavioral health hospitals like Centerstone Hospital and Addiction Center cannot receive federal medical education funding to train up-and-coming psychiatrists like acute care hospitals receive for training physicians. This reality has contributed to the closure or scaling back of several Florida residency programs in psychiatry.

Luckily, our state legislature has stepped up to contribute funds to sustaining psychiatric residencies in our state, allowing us to train more psychiatrists to serve Floridians in need of treatment.

Centerstone is proud to have launched a psychiatric residency program three years ago, to help us further meet the needs of Florida families. This program allows us to expand our capacity to treat those in need today and shore up our state’s overall base of psychiatrists for the future.

It is estimated that a psychiatrist will serve approximately 40,000 Floridians over the course of his or her career, or roughly 800-1000 people, often in desperate need of help, each year. Through expanding our program to 16 residents, we will be able to contribute 4 new psychiatric residents and 2-3 new psychiatrists, plus support staff, to our workforce annually, who will collectively serve an additional 3,000 Floridians each year.

Given that research shows that untreated or undertreated mental health and addiction issues are the cause of significant declines in employee productivity and increases in absenteeism and unemployment, ensuring a strong psychiatric workforce is critical to the health and well-being of our residents and our economy.

We thank our legislature for their leadership and support on this issue and look forward to working with our public officials further on changing lives across our state.


Melissa Larkin-Skinner, MA, MBA, LMHC, is interim Chief Executive Officer and Chief Clinical Officer of Centerstone in Florida.  Roger Johnson is Senior Vice-President of Medical Services & Managed Care at Centerstone and leads the organization’s psychiatry residency program.

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