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State workforce report: psychologists and dentists in short supply; growth in nonprescribing behavioral-health roles
Summary
The state's health-professions data center presented part two of the 2024 workforce report, finding continued decline or constrained supply among psychologists and dentists, growth in master's-level mental health practitioners and substance-use counselors, and geographic disparities that leave rural areas with fewer providers per capita.
Danielle Hernandez, administrator of the Health Professions Data Center at DHHS, presented Part 2 of the 2024 New Hampshire Health Care Workforce report to the oversight committee on Sept. 26, focusing on nonprescribing behavioral-health professions and dentists.
Hernandez summarized the report's principal findings: psychologists are in limited supply and the psychologist workforce is aging with relatively few entrants; dentists showed a net supply loss (about an 8% decline in the reported licensing year); and nonprescribing behavioral-health roles (licensed clinical social workers, licensed clinical mental health counselors and alcohol and drug counselors) have shown net increases and more favorable demographic indicators.
Hernandez said the state rate for dentists is 37 per 100,000 population, compared with a national American Dental Association rate of 60.4 per 100,000, and noted that dental availability and Medicaid participation gaps produce substantial access challenges. "The national rate... is 60.4 per 100,000 population. That's 60% higher than the state rate of 37 dentists per 100,000 population," Hernandez said.
The report found that psychologists skew older: about 40% of licensed psychologists are 60 or older, with few new entrants in New Hampshire and roughly a third anticipating a reduction in practice in the next five years. By contrast, Hernandez said alcohol and drug counselors (ADACs) show more favorable demographics, shorter wait times and quicker new‑patient availability in some areas.
Access indicators showed lower new-patient acceptance and longer median waits for new patients among outpatient psychologists and mental health practitioners, particularly in rural areas; median wait times cited were about two weeks for new behavioral health patients compared with one week for established patients. The department noted that telehealth and licensure compacts may help alleviate access problems but that broadband gaps and uneven distribution of providers will limit gains in rural communities.
Committee members asked about psychiatrists and psychiatric residencies; Hernandez said there are two psychiatry residency programs she was aware of (Dartmouth and Portsmouth Regional) and noted growth in psychiatric nurse practitioner FTE relative to psychiatrists. Committee members also asked for regionally normalized rates and confirmation of maps and HPSA (Health Professional Shortage Area) designations included in the packet.
Hernandez concluded with policy recommendations echoed nationally: invest in pipeline programs, loan repayment and scholarships, support interdisciplinary team-based care, expand preceptor and faculty capacity, and target rural recruitment and retention strategies. She said the workforce material will be used to inform planning for the federal rural health transformation application.
