We didn’t see the COVID-19 crisis coming. But we’re well aware of the mental health emergency the pandemic has created. As cases continue to spike across the country, we are grappling with uncertainty, heightened anxiety, social isolation, financial stress and helplessness; in fact, nearly half of Americans say their mental health is suffering.
As a psychiatrist, I know how vital mental health care is. Loneliness, for example, can be more dangerous than smoking 15 cigarettes a day and deadlier than obesity, according to psychologists at Brigham Young University. Stress can trigger myriad disorders, even affecting the central nervous system.
Unfortunately, America doesn’t have enough qualified mental health professionals to meet rising demand. Even before the pandemic, 60 percent of U.S. counties lacked a single psychiatrist, according to the immigration nonprofit New American Economy. Nationally, there are only 11.5 psychiatrists for every 100,000 people. In Maine, we have a population of 1.3 million, but only 300 psychiatrists. I could be one of them, helping to fill this critical health care gap and easing the emotional trauma of my fellow Mainers. But barriers, including a licensing process that doesn’t recognize international credentials, stand in our way.
In 2015, I came to this country from Brazil with a well-established medical career. After receiving my psychiatry degree from a top-ranked Brazilian medical school, I completed my residency in psychiatry. Then I worked my way up to attending psychiatrist and clinical supervisor at one of the best hospitals in Latin America. I completed my doctorate in psychiatric emergency and crisis intervention the same year I immigrated.
Moving to the U.S. was the best decision for my family. Brazil can be dangerous. In Maine, my sons can ride their bikes down the street without a worry. But it came at a cost to my career. To work as a psychiatrist in the U.S., I’d have to pass a three-part medical exam, then redo my residency, a years-long process that would require me to begin my 25-year career from scratch. At this point in my life, I don’t have the time or resources to start over.
Instead, I decided to pursue academia. I took a job at a local university, teaching medical students. Three years later, however, my position was eliminated. Without a U.S. license, I haven’t been able to get another job since 2018.
When COVID hit, I felt called to help address the mental health crisis. Nearly a third of psychiatrists in the U.S. are foreign-born, according to New American Economy. And 93 percent of immigrant health care professionals not currently working in the field are willing to step up to fight COVID, according to a survey from Upwardly Global. But a substantial workforce gap still exists. In 2018, there were 27 open practitioner jobs – psychiatrists, doctors, surgeons – for every unemployed health care worker.
Several states – Michigan, New York, New Jersey, Massachusetts, Colorado and Nevada – have taken steps to close this gap with executive orders allowing some internationally trained health care professionals to temporarily fill front-line jobs. I’m working with IntWork, a diversity recruitment firm, to explore options locally. But short of having an executive order in Maine that opens similar opportunities for immigrant doctors here, my family and I may ultimately have to leave.
These inconsistent policies make little sense. Why should I be allowed to practice in New Jersey but not in Maine? And, for that matter, if professionals like me can help fill shortages in some states now, then why not next month, or next year? COVID or no, health care shortages are acute. If physicians are qualified and willing, they should be able to work no matter where they are from. If we can pass the U.S. medical exam and provide testimony of our credentials and work experience, why isn’t that sufficient?
It hurts me to see so many people struggling with their mental health and to be unable to help them. I’m determined to work in my profession, and my family is supportive. But it shouldn’t require a cross-country move. My kids grew up in Maine; this is our home. Yet, by staying here, I’m sacrificing my career. With these restrictive policies, we are also sacrificing Americans’ health. The thing is, we shouldn’t have to choose.
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