Psychiatrists’ Role in a Post-ACA World



 Sosunmolu Shoyinka, M.D., assistant professor of psychiatry at the University of Missouri and director of psychiatric outreach services discusses how the role of psychiatrists will change with the implementation of the Patient Protection and Affordable Care Act (ACA). As Dr. Shoyinka explains, the ACA emphasizes value-based care, prevention and health promotion, and specifically focuses on improving mental health and substance abuse treatment in medical care. Integrating mental health care into primary care is one service model that shows promise for accomplishing these goals. To foster integrated care, Title V of the ACA supports and expands the health care workforce especially through enhanced training of primary care and behavioral health providers. With the expanded implementation of integrated care and the likely increase in training programs for mental health care providers, Dr. Shoyinka makes a few predictions about the future of mental health services. First of all, he projects that there will be an initial shortage of psychiatrists to meet the needs of the new population of patients accessing mental health services in primary care. He says that psychiatrists will still play a critical role in providing direct clinical care and will also have the opportunity “to find expanded roles in planning and operationalizing mental health services, including prevention and wellness care, for entire clinic and insured populations.”

Dr. Shoyinka encouraged psychiatrists to maintain current clinical competencies while also embracing new ones such as monitoring and possibly treating non-psychiatric medical problems. He says “the ACA brings a sea change to all of medicine in this country. While we do not know how the details will play out, psychiatry as a profession will need to adapt and evolve to survive and thrive in this new world.”

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