For generations, government leaders have used tuition reimbursement programs to attract new graduates to work in communities where their services are badly needed but often not widely available.
In New Jersey, public dollars have been set aside to help offset graduate education costs for social service workers, doctors, dentists, and teachers who agreed to work in underserved, often urban communities around the state.
In an effort to address a chronic shortage of behavioral health providers, state lawmakers are looking to create a new tuition reimbursement program to draw psychiatrists to areas in New Jersey where they currently are lacking. The Senate passed the measure,, Thursday with unanimous support; a version awaits a hearing in the Assembly.
Sponsored by former acting governor and Sen. Richard Codey (D-Essex), a longtime champion of mental health issues, and Sen. Joseph Vitale (D-Middlesex), the health committee chair, the bill would repay state residents who graduate with psychiatry degrees for up to one year of medical school if they work for one to four years in an underserved community.
The Department of Health would use health status, economic, and demographic information to decide where the program would operate; it would be administered by the state’s Higher Education Student Assistance Authority, which already runs similar programs. The proposal was lauded by psychiatrists and other mental health advocates when first introduced, earlier this month.
As many as one in four Americans suffered over the past year from the effects of mental illness, everything from minor depression to a major schizophrenic break, but most were not able to connect with effective care in a timely manner. A study by the American Medical Association found that, while the national pool of physicians expanded 45 percent between 1995 and 2013, the number of psychiatrists grew only 12 percent during that period. At the same time, the United States population increased by 37 percent.
“It’s the kind of carrot that has proved effective,” Vitale said after the vote. “If the model works like it has for nurses and teachers, it will be successful.”
Vitale said the measure builds on the successful program launched decades ago under Gov. Tom Kean, a Republican who championed education, to encourage new teachers to commit to inner-city and other needy schools. It also borrows from an effort instituted under Gov. Jon Corzine (D) to encourage more nurses to seek advanced degrees, he said.
The proposal also echoes a 25-year-old state program, now run by Rutgers University, that offers up to $120,000 to doctors, dentists and other practitioners -- but not mental health providers -- who establish key specialty practices in underserved communities.
In 2005, Codey, who was acting governor, established the Social Services Student Loan Redemption Program, which directed graduates to areas where they were needed most. Such programs tend to depend on annual budget appropriations to fuel their operations. The social services redemption program instituted by Codey received $3.5 million for five years, before it was cut from the budget entirely.
Mental health advocates note that, while any tuition reimbursement will help, the numbers are still stacked against young psychiatrists seeking to make their mark in regions that lack sufficient behavioral health services. Many of their patients are likely to be covered by Medicaid, which pays only a portion of the full cost of treatment; the new psychiatrists, meanwhile, have to deal with the significant debt most of them accumulate in school.
According to Doctorly.org, a website that compiles information on medical careers, the median tuition (in 2014-2015) for medical school ranged from nearly $34,500 for public schools to $53,700 for private colleges. Most graduate with between $170,000 and $200,000 in, just for medical school.
Psychiatrists must have a four-year bachelor’s degree, plus four or five years of medical school. They then must enter a four-year residency, where salaries rarely top $50,000. In total, it takes at least a dozen years for someone to become a licensed psychiatrist.
"Providing mental healthcare services to those who need it, when they need it and where they need it is paramount to effectively caring for our most vulnerable citizens," Codey said. "The tuition reimbursement program established under this bill will provide the necessary incentive for available psychiatrists to practice in New Jersey's most underserved communities."