A residency program launching at Northern Light Health’s Acadia Hospital in July aims to keep future psychiatrists in Maine as the state grapples with a chronic shortage of mental health care providers.
From 2020 to 2022, the number of licensed psychiatrists practicing in Maine dropped by nearly half, from 110 to 50, according to data from the U.S. Bureau of Labor Statistics.
Although Maine Medical Center has a psychiatry residency, there isn’t one in the Bangor region. Acadia’s new program will be the only one north of Portland. The hospital, which recently underwent a $49.2 million expansion, hopes it will help replenish the psychiatric workforce in a state with the oldest population in the country.
“There is a lot of the workforce that is moving toward retirement,” said Dr. John Campbell, senior physician executive at Acadia. “That is definitely a threat to the stability of the mental health system in the state.”
The program will cost Acadia $1 million in the first year and $2 million by the third year, Potts said. In the fourth year and beyond, when the program is fully running and staffed with 16 residents, it will cost about $2.5 million per year.
Acadia is one of two private psychiatric care hospitals in Maine.
The hospital has 770 employees and 12 psychiatrists, which Campbell said is too few considering the demand for mental health care. Acadia had 1,589 inpatient admissions and 174,737 outpatient encounters last year, according to figures provided by spokesperson Bob Potts.
When Acadia opened the program last year, nearly 500 people applied on the first day. Only four slots are available for the four-year residency. Eventually the program will reach 16 residents.
Hospital officials interviewed 100 applicants from medical schools across the country. The hospital sends its rankings, which are based on its impressions and an algorithm, to the National Resident Matching Program, and medical students do the same with their preferences. Then matches are released in March.
Some of the people who applied for Acadia’s program are from Maine or have connections to the state, which is positive and hopefully increases the likelihood of people staying beyond residency, Campbell said.
He said some of the reasons doctors are attracted to working in Bangor is because Acadia is a high-quality institution that cares for patients in areas beyond the city. Some of those who applied have an interest in helping patients from the poorest parts of the state, many of whom face barriers to mental health care.
Many medical students are saddled with debt, and Bangor is an affordable metropolitan area to live in, which is attractive to them, Campbell said. Wellness and access to nature are also important, and Maine certainly has that, he said.
More than half of people who completed residency training from 2013 through 2022, or roughly 57 percent, are practicing in the state where they did their residency, according to a 2023 report from the Association of American Medical Colleges.
While at Acadia, the four residents who begin July 1 will get a taste of different experiences, including working in inpatient and outpatient settings, addiction psychiatry and children’s psychiatry.
“We can’t just turn them loose to treat patients, so we support and work closely with them,” Campbell said, noting eventually they do see patients on their own but with immediate access to Acadia’s doctors.
Acadia’s expansion, which includes a new pediatric wing and rooms for adults, was designed to address the psychiatric care bottleneck. Hospital leaders spoke last year about how statewide demand for care continues to grow, leaving patients in emergency rooms for hours and sometimes days at a time as they wait for a psychiatric care bed.
Dr. Clifford Singer, chief of geriatric mental health and neuropsychiatry at Acadia, said that although the crisis in dementia care has been on a slow boil for about a decade, long wait times for an evaluation are concerning.
“The demand is infinite, and the supply is limited,” Campbell said. “We have to grow. One of the nice things about Acadia Hospital is we are capable of growth, and we’ve certainly demonstrated that over the past year with our campus expansion.”
The residency program goes a step further, he said. Acadia recently received a $1 million grant from the New York-based Manton Foundation to help fund the program.
Many hospitals, including Acadia, are unable to find people to hire, so they contract with agencies to bring in clinicians, Campbell said. It’s an expensive and unsustainable model.
“The best model would be when opportunities arise, we can see which of our residents are showing an interest and time people’s departures so there aren’t interruptions in our workforce and delivering care,” he said.