The Current Access to Psychiatric Care Problem in Hawaii

The mental health needs of individuals across our state continue to outweigh the capacity of our mental health system. According to a Report on Findings from the Hawai’i Physician Workforce Assessment Project (Withy, 2014), physician shortages, including psychiatry, are highest in Hawai’i’s rural areas. Across the different counties, in ranking order, the greatest shortage of psychiatrists is found on Maui at 41.2%, followed by Hawai’i island 39.2%, and, Kaua’i at 29.5%. According to this report, there is a 0% shortage for psychiatry O’ahu, however, this does not capture other aspects of accessibility including, availability and acceptability. Many psychiatrists on Oahu are not available to new patients and/or patients with certain types of insurance (i.e., Medicaid) or no insurance. Additionally, psychiatrists practice in various types of health care settings, to include hospitals and residential treatment programs (O’ahu having the highest numbers of these types of settings, thus, more psychiatrists who staff these programs) where the larger portion of our population does not require care. Many individuals in need of outpatient psychiatric care, however, face multiple barriers when it comes to receiving medication management in order to maintain functioning and prevent worsening of their mental health related symptoms.

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