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Mental health workforce : general analysis Rahim-Jamal, Sherin, 1963- Jan 31, 2001

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Centre for Health Servicesand Policy ResearchMENTAL HEALTH WORKFORCEGeneral AnalysisSherin Rahim-JamalHHRU 01:2W January 2001Health Human Resources UnitResearch ReportsTHE  UNIVERSITY  OF  BRITISH  COLUMBIAMENTAL HEALTH WORKFORCEGeneral AnalysisHHRU 01:2WHealth Human Resources Unit Sherin Rahim-JamalCentre for Health Services and Policy ResearchThe University of British ColumbiaVancouver, British Columbia  V6T 1Z3January 2001Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia1Mental Health Workforce - General AnalysisMethodologyI. Identification of Professions Working in Mental HealthDefinition: We assumed several professional sub-groups would be working in the mentalhealth field including LPNs, RNs, RPNs, Psychologists, OTs, Social Workers (SWs), andPhysicians.  An operationalized definition of mental health was developed pertaining to thoseemployed in:· Psychiatric Hospital· General Hospital Psychiatry· Adolescent/Child Psychiatry· Mentally Handicapped Hospital/School (includes centre for mentally handicapped, andinstitutions for developmentally/mentally challenged)· Boarding Home/Group Home/Specialized Residential Care· Mental Health (includes mental health centre, mental health clinic, community mentalhealth team)· Corrections· Forensics· Substance Abuse/Detox· Sexual Abuse Recovery· Crisis Intervention/Suicide PreventionFor each of the professions identified above (with the exception of SWs where we examinedindividual level data gathered by survey for ROLLCALL 95), we examined the ROLLCALL 99data and identified the number of individuals in each profession who had indicated that theyworked in the employment areas outlined above.Limitation: The above information is limited as only published aggregate data (i.e.ROLLCALL 99) are used; we did not examine individual records except for SWs.  Thus, we mayhave missed some people (e.g. some professionals who provide mental health services in longterm care facilities or in community health agencies or in private practices will not have beenpicked up using the above definition).  Further verification of area of service requires access todisaggregated unpublished data.It is also important to note that with regard to physicians, we included both general practitioners(GPs) and those who indicated Psychiatry as their specialty.  However, we cannot determine fromthe published data alone the number of GPs who actually work in mental health and/or who havemental health patients.  In order to determine this, we would have to examine MSP payment data.The number of GPs and Psychiatrists was determined using both the Medical ServicesCommission of British Columbia (MSC) specialty codes and the Royal College of Physicians andSurgeons of Canada (RCPSC) specialty codes.  However, there was no significant difference inthe number of physicians identified using the MSC codes and the number identified using theRCPSC specialty codes.  As a result, we decided to use the Royal College data for furtherPrepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia2analyses since the RCPSC specialty codes reflect the actual training of physicians rather thancurrent practice patterns.II.  Age DistributionAs we did not use individual level data, (except for SWs), to determine the age distribution of theprofessions identified in (I) above as working in mental health, we assumed that the agedistribution for the subset of mental health staff was the same as the whole membership of aparticular profession.  The age distribution of the membership was then applied to the subsetworking in mental health.  For example, the subset of RNs working in mental health in 1999equalled 350 individuals.  Using the proportionate age distribution of the total RN membership,we estimated the age distribution of the subset of RNs working in mental health: 6 of the 350 RNsworking in mental health were aged < 25 years, 59 were 25-34 years, 106 were 35-44 years, etc.The limitation here is that the assumption made above about the age profile of the membershipbeing the same as the age profile of those individuals working in mental health may not becorrect.III.  Ageing of the Mental Health WorkforceOnce the age profile of each profession working in mental health was determined, eachprofession was aged 10 years in order to determine the profile 10 years later.  Note that the ageingof each profession was based on the date of record of information provided for ROLLCALL 99.OTs had a date of record of April 2000.  As a result, they were aged 10 years from 2000 to 2010,while the LPNs, RNs, and RPNs, had a date of record of 1999 and they were aged from 1999 to2009.  The date of record for SWs is 1996, therefore, the SWs were first aged 3 years to 1999 andthen were aged 10 years from 1999 to 2009.The limitation here is that since published data are in 10-year age groups, we could only age theindividuals in 10-year segment intervals.IV. RemarksGiven the methodological constraints due to the limitation of published data, it is likely that wehave underestimated the total number of health professionals employed in mental health.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia3Mental Health Workforce - General Analysis - ROLLCALL 99Table 1:  Regulated Professions in British Columbia by Place of EmploymentPlace of EmploymentPractisingProfessionals Boarding Home/ CrisisEmployed in their General Adolescent/ Mentally Group Home/ Sexual Intervention/Respective Psychiatric Hospital Child Handicapped Specialized Mental Substance Abuse Suicide Total by Place ofProfession Areas of Work Hospital Psychiatry Psychiatry Hospital/School1 Residential Care Health2 CorrectionsForensics Abuse/Detox3 Recovery Prevention EmploymentLPNs 4,216 8 8RNs 27,992 350 350RPNs 2,179 448 318 58 28 210 294 45 164 48 1,613OTs 854 17 1 18SWs4 982 151 270 90 3 29 543Psychologists 828 28 62 27 6 123TOTAL 37,051 501 318 58 180 210 976 72 164 144 3 29 2,6551 Includes Centre for Mentally Handicapped and institutions for Developmentally/Mentally Challenged.2 Includes Mental Health Centre, Mental Health Clinic, and Community Mental Health Team.3 Includes Alcohol and Drug and Addiction Treatment Centre.4 Social Work data obtained from ROLLCALL 95. Date of record April 1996.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia4Mental Health Workforce - General Analysis - ROLLCALL 99Table 2:  Directory Active Physicians in British Columbia by MSC and RCPSC SpecialtyDirectory Active MSC Specialty Group RCPSC Specialty GroupNon-PostgraduateProfession Physicians GP1 Psychiatry GP1 PsychiatryPhysicians 8,106 4,483 524 4,481 5251 Includes General Practice and Family Practice - not able to determine the proportion of GPs that  work with the mentally ill population.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia5Mental Health Workforce - General Analysis - ROLLCALL 99Table 3:  Age Distribution1 of Regulated Health Professionals Working in Mental Health in B.C.Profession < 25 25 - 34 35 - 44 45 - 54 55 - 64 65 + Age Unknown Total2LPNs3 1 2 3 1 7RNs 6 59 106 117 56 5 349RPNs 17 250 411 582 298 19 36 1,613OTs4,5 3 5 4 1 5 18Social Workers6,7 48 132 204 92 4 63 543Psychologists8 4 25 54 34 7 124Physicians (RCPSC)9 5 812 1,561 1,447 786 386 10 5,0071 The age distribution of respective professions working in Mental Health has been extrapolated using the  age distribution of those professions in British Columbia as per ROLLCALL 99.2 The total number of individuals in each profession may vary slightly from Table 1 due to extrapolation  and rounding.3 The age distribution of LPNs working in Mental Health is very crude due to the small number of LPNs   identified as working in Mental Health (total of 8). There are no LPNs working in Mental Health under the age   of 25 or over the age of 65.4 There are no OTs working in Mental Health under the age of 25 or over the age of 65.5 The number of OTs whose age is unknown has increased substantially since 1995, as the British Columbia   Society of Occupational Therapists (BCSOT) no longer collects birthdate information from its members. 6 Social Work data were obtained from survey data collected for ROLLCALL 95. Date of record, April 1996. The    age distribution of SWs has been extrapolated to 1999 using the age distribution for SWs identified as    working in Mental Health and aging each individual by 3 years from 1996 to 1999. New registrants    since 1996 are not incorporated in these data.7 There are no SWs working in Mental Health under the age of 25. New registrants since 1996 are not   incorporated in these data.8 There are no psychologists working in Mental Health under the age of 25.9 Includes both GP and Psychiatry specialties as per the RCPSC specialty codes.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia6Mental Health Workforce - General Analysis - ROLLCALL 99Table 4:  Regulated Health Professions Working in Mental Health in British Columbia, 1999Age at 20091(Aged 10 years from 1999 - 2009)Profession < 25 25 - 34 35 - 44 45 - 54 55 - 64 65 + TotalLPNs 1 2 3 1 7RNs 6 59 106 117 61 349RPNs 17 250 411 582 317 1577OTs2,3 3 5 4 1 13Social Workers4 48 132 204 96 480Psychologists 4 25 54 41 124Physicians (RCPSC)5 5 812 1561 1447 1172 49971 Only the cohort working in Mental Health in 1999 was aged. The numbers provided above do not  take into account new registrants, attritions or reactivations.2 OT information in ROLLCALL 99 had a date of record of April 2000.3 Note the high number of OTs working in Mental Health whose age is unknown (28%).4 The date of record for Social Workers is 1996.5 Includes both GPs and Psychiatry specialties as per the RCPSC specialty codes.Prepared by:Health Human Resources UnitCentre for Health Services and Policy ResearchThe University of British Columbia7Figure 1: Regulated Professionals Working in Mental Health in British Columbia by Age Group, 1999 (%)05101520253035404550< 25 25 - 34 35 - 44 45 - 54 55 - 64 65 + AgeUnknownAge GroupPercentLPNsRNsRPNsOTsSocial Workers PsychologistsPhysicians (RCPSC)Figure 2: Regulated Health Professions Working in Mental Health in British Columbia in 1999 Aged 10 Years (%)05101520253035404550< 25 25 - 34 35 - 44 45 - 54 55 - 64 65 +Age GroupPercentLPNsRNsRPNsOTsSocial WorkersPsychologistsPhysicians (RCPSC)

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