The mental health system is increasingly relying on psychiatric mental health nurse practitioners (PMHNPs) to meet the psychiatric needs of Medicare patients, according to new research led by researchers at the Harvard TH Chan School of Public Health. .

In some parts of the country, I was surprised to find that PMHNPs are de facto mental health prescribers. In states where the PMHNP has no restrictions on drug prescribing, these providers make up 50% of his total rural mental health prescriber visits, which is higher than we expected. It was much more.”

Michael Barnett, corresponding author, Associate Professor of Health Policy and Management, Harvard Chan School

This research will be published in the September 2022 issue. health problems.

Access to mental health is a public health crisis exacerbated by the COVID-19 pandemic. While the demand for mental health treatment is soaring, the supply of insurance-accepting psychiatrists is declining, especially in rural areas.

To assess how the mental health workforce and patient populations have changed over time, Barnett and his colleagues analyzed Medicare claims for paid services from 2011 to 2019. The team analyzed the number of psychiatrists billing PMHNP and Medicare, the amount of outpatient and psychiatric services per provider his group, and how these numbers vary with rural and coverage regulations. I paid attention to PMHNPs may limit their ability to prescribe medications.

Findings showed that PMHNP provided mental health prescriber visits for nearly one-third of Medicare patients nationally by 2019. The number of PMHNPs also increased by 162% from 2011 to 2019, while psychiatrists billing for Medicare decreased by 6%. During this period, without an increase in the PMHNP workforce, mental health specialist visits at Medicare would have declined by nearly 30%. Instead the drop was 12%.

“This study puts PMHNP in the spotlight as an important part of the mental health workforce,” Barnett said. PMHNP workforce-targeted policies could be an important part of national efforts to expand access to mental health .”

Co-author Arno Kai is also from Harvard Chan School.

This work was supported by the National Institute on Aging (K23 AG058806-01) and the National Institute of Mental Health at the National Institutes of Health (R01 MH112829-01).