Paying off student loans. Providing bonuses. Talking up the schools. Pointing out home prices.
It may sound like a traditional Chamber of Commerce approach to recruiting workers, but in this case, it's how local mental health providers attract new talent to the Quad-Cities.
The number of mental health providers in the metropolitan area has been a front-and-center topic for weeks, ever since a Tennessee firm entered the local scene in August to propose a 72-bed psychiatric hospital in Scott County.
The owner of Memphis-based Strategic Behavioral Health LLC, or SBH, has applied to the state for permission to build the facility. Last week, the Scott County Board of Supervisors gave its blessing to the plan.
Currently, SBH has an application before the state, and it's to be heard next month by the five-person State Health Facilities Council.
A central argument to oppose the structure has been from established providers, including Genesis Health System and UnityPoint Health Trinity. The need for beds can be handled locally, they said. A lack of mental health specialists remains.
So, what is being done to attract psychiatrists and related mental health providers to the Quad-Cities? Why is there an ongoing shortage of such specialists?
The explanations range from how the profession itself is perceived to the Medicaid reimbursement rates, which are among the lowest in the nation in Iowa and Illinois.
According to the American Academy of Child and Adolescent Psychiatry, the demand for psychiatrists for youths, for example, will double between now and 2020. It is estimated that in 2020, 12,624 psychiatrists will be needed, but 8,312 will be practicing.
What a psychiatrist says
Dr. Jeff Weyeneth, a psychiatrist at Genesis Health System, is well aware his specialty has some sort of stigma, even within the medical profession.
The amount of training the Peoria native has is equal to that of an orthopedic surgeon or a cardiac specialist.
"There is a stigma, though," he said, even at times from medical colleagues, who don't realize the background his position requires.
Weyeneth tells medical residents who rotate through the Genesis system that the psychiatric specialty has many openings, but it's not something for those who seek a job with high recognition.
"You can't go into this to have people look up to you," he said. "You are really serving patients who no one else wants to serve."
That could change, Weyeneth said, as the psychiatric profession becomes better known as more of a biological science. He was drawn to the profession by its biological and neuro-physiological aspects and how behavior is related to the brain and the body's anatomy.
Weyeneth also cites ways to decrease the stigma, including more open discussions and a wider understanding of mental health.
Income is a top concern, according to Ann Armknecht, CEO at Vera French Community Mental Health Center, Davenport. The mean income for psychiatrists is 19th out of 25 medical specialties, she said.
Reimbursement rates for patients on Medicaid — the federal insurance program for low-income and disabled persons — is 47th out of 50 states in Iowa and 49th in Illinois.
What Armknecht and Dennis Duke, president of the Robert Young Center for Community Mental Health in Rock Island, actually need are employees they call "prescribers," or people who can legally write prescriptions for patients with mental health problems.
Prescribers are psychiatrists. They also are board-certified nurse practitioners, who are becoming more commonly used in the industry.
Currently, there are four full-time psychiatrists and seven nurse practitioners at Vera French. Robert Young has seven psychiatrists and three nurse practitioners, Duke said.
"I could hire three more prescribers today," Armknecht said.
To complicate matters, the psychiatrists who are in practice are getting older. About 44 percent in Iowa are 50 years old, and 57 percent of those in the U.S. are older than 55.
How to fix this?
Around 13 psychiatrists graduate from the University of Iowa's medical school every year. Weyeneth thinks there needs to be more economic incentives for some of the new psychiatrists to stay in eastern Iowa, and he suggests early recruiting at the medical schools.
"If the students are not from here, they are not likely to stay," Duke said.
But there are overtures to the job candidates, including talking up the local school districts and cost-of-living economics.
There could be increased collaboration among professions, including between psychiatrists, and, for example, pediatricians or primary health providers.
"That's a great idea," Weyeneth said. The psychiatrist also advocates increased use of technology, such as with tele-psychiatry and programs such as Skype.
Armknecht said the repayment program for student loans is not equal throughout the state, and that could be changed by legislation.
No one disputes how busy the mental health providers are. In August, Armknecht said, Vera French provided 1,622 psychiatric and 1,299 therapy appointments, and that number does not include the services provided to 20 school districts in the Quad-Cities.