Grow-Your-Own Psychiatry Fund
Cost of living for mid-level psychiatric prescribers to complete education and return to the high-need areas of the community
All of Southeastern Wisconsin is in a drought, to put it very mildly, with access to psychiatric services.This is already a dire issue with the U.S. as a whole.However, our region is particularly desperate for prescriptive care.When we consider the population that needs the care the most…being those who are uninsured, on Medicaid, or on Medicare and thus under a low federal poverty level…the services become even more scarce.The aim of this campaign is to gather much-needed donation dollars for individuals specializing in psychiatric nursing or physician assistant studies, to return to the community and provide much needed care to those who are at risk from deteriorating mental health care.
My name is Jason Free.I am seeking to guide funding efforts to myself, as a student pursuing adult psychiatric education, and one other candidate who would preferably be pursuing pediatric & adolescent psychiatric education (yet to be identified).
Why does the problem exist?
Due to multiple angles having taken place over a large amount of time, the nation as a whole has seen drastic change in mental healthcare.Starting with the invention of antipsychotics and being fueled by the national push for deinstitutionalization, the United States has placed more emphasis and responsibility on outpatient care.There are cost-savings when it comes to those who are suffering from major mental illness.However, the need to obtain outpatient care still remains high.
In Wisconsin, many of the privatized facilities, such as St. Luke’s in Racine and Rogers in Milwaukee County, have lowered the number of beds for inpatient stays.The state, and Kenosha, Racine, and Walworth counties especially, has not generated the amount of providers to keep up with the need.Even more specifically, the needs of those on public insurances or without insurance have been lacking services at a more alarming rate.With what providers exist (and we’re talking about Psychiatrists, Psychiatric Nurse Practitioners, and Psychiatric Physician Assistants who have the ability and education to prescribe psychotropic medications), there are often long waits or no new patients seen at all.Children’s Hospital of Wisconsin has a waiting list of over 200+ children, alone.
There are other, more regionalized, factors that present themselves.Our area hospital systems have a part in that the major players either do not offer behavioral health services or have their services “capped” at a percentage of public insurance patients.Sometimes the hospital systems require an internal, general practitioner referral.When providers do come to the area, which is not often as local industry has been in decline and our region is not a hotbed of psychiatric residency, they often don’t have the heart or financial capabilities to serve the needy with their entire focus.For more information, including details and proof of the area situation, google “Wisconsin”, “Kenosha”, “mental health” and “psychiatry”.Endless stories begin to present a picture of the need.
Why don’t traditional methods of recruiting work to fill needed jobs?
If one were to look at any job search engine or with any staffing firm, they would see no less than a dozen search firms, medical, and mental health entities searching for psychiatric providers in the form of MD / DO psychiatrists and psychiatric Nurse Practitioners (FNPs, PMHNPs or APNPs).Many of these jobs go unfilled.The highest density of need is in the areas of Medicaid and Medicare-funded service.The reality is that traditional methods of recruiting will not solve the problem.
Medicaid, and to a much worse extent Medicare, do not reimburse at the level of commercial insurance which is already paying less than traditional hourly “cash payer” rates.Yet, despite the lower-paying clientele, the educational requirements to practice in psychiatry are as high, or higher, than other fields of medicine which pay better and offer subjectively less difficult clientele.Other fields also offer the ability for treatment to result in diseases to be cured rather than managed.When the field of medicine is already stretched and requiring more creative ways to draw specialists, a trying and less financially rewarding subfield will have a hard time giving incentives to providers to work in that field.
Another reality is that this is not a lucrative area in terms of industry growth, and has not attracted a new crop of psychiatric prescribers at a level that matches the need or pace of other fields of medicine.Many psychiatric residencies, and all of the psychiatric educational certifications for nurse practitioners, exist in predominately urban areas far away from here.Thus, the students who are graduating would not find themselves here and having put roots down.Outside the field, the area does not exactly have a flourishing industry aside from the manufacturing hub (5th largest in the US in Pleasant Prairie and 20th in the country in Kenosha).Thus, this is not a magnet for this type of employment seeker.Finally, psychiatry has traditionally been more accepted in urban areas, rather than rural and suburban.Yet, the issues of homelessness, drug addiction, and job loss plague the area at a higher-than-average rate combined with the already existing mental health needs in the community.
Because of the nature of mental illness to become a “community problem”, there is often a gap that comes to exist where the entities involved, being private hospitals & clinics, 3rd party contracted agencies, county government, state government, mental health advocacy groups, and communities as a whole, are not capable of coming up with a shared solution.Those parties have difficulties with reactive responses to mental illness, let alone proactive steps towards resolving the issues.Thus, funding and plans to ensure the future of community mental health tends to stall and fall apart.
Why don’t you use typical means to fund education like savings and loans or existing loan repayers?
The reality is, if no funding is garnered, that will have to be the means for myself and other candidates to fund their psychiatric education.However, with more loans come the need to go back to higher-income positions.This deteriorates the ability to work in a position that serves the indigent, major mentally ill, and underinsured.To put it simply, if the entire burden goes back on the individual to pay this education off, we- the community that is - are back in the same position and not likely gaining the provider in the area it is needed.The difference in salary can be tens of thousands of dollars per year in the non-for-profit sector versus for-profit sector.
The other reality is there are certain entities who exist, going back to a “reactive” stance, to repay loans in exchange for service.Those entities, who fall under various programs but nearly always require being deemed a HPSA (or Health Professions Shortage Area).We have one such entity in the area.Yet, that one such entity does not provide psychiatric care nor comprehensive mental health services at a rate that cares for the need and shows no such likelihood of going into psychiatry.There are no existing Community Health Centers, county behavioral health centers, or other service points outside of the correctional system that both give psychiatric care and have a HPSA.The local entity which services mental health care is a 3rd party vendor, operating off of a county budget, and is unlikely to be able to attain a HPSA score.This makes it so that the area will likely not have a loan repayer to entice professionals into area service in the near future.
What, and specifically who, will this money be used for, and when shall it be used?
In an ideal world, the breakdown would be as follows:
-Direct Entry MSN Tuition: $50,000
-Advanced Practice Nurse Practitioner Capstone / Certification Program: $18,360
-Cost of living allowance: $2,000 per month for 18 months / $36,000
= $104,360 (and at this point, that is going to be funded by Graduate Plus loans and hope for private scholarships)
In all probability, unless donors were to fund that much, the reality is funding will go in the following order:
- Cost of living expenses to offset the cost of living loans for one individual (if this garners enough donations, then two individuals - with preference being given to one being a future pediatric & adolescent practitioner and one being an adult practitioner - split equally among donations)
- Cost of Certification or Capstone Program (again - if this nets enough, one being pediatric & adolescent and one being adult - split equally among donations
- Cost of Tuition (again - one being pediatric & adolescent and one being adult - being split equally among donations)
As each stage of funding progresses, there will be less-and-less reliance on graduate loans and more of an expected time contribution of service from the individuals accepting funding.
Why not fund Medical School?Don’t you want psychiatrists?Don’t you also want counselors, therapists and psychologists?
Of course the community would love to have psychiatrists.However, the history of such professionals coming to the area combines with the financial aspect to show that it is more expensive and time-consuming to fund medical school than a nurse practitioner (or physician assistant).If such funding were located, the donations would be used to expand into medical school and psychiatrists.With regards to mental health therapists, in an ideal world there would be similar funding for them as well.But if it were an ideal world, I would not be asking people for donations.There is simply not the community shortage with psychologists who bring testing and assessment to the table or psychotherapists & counselors that exists with prescribers.If such a need were to escalate, funding goals may be shifted accordingly.
What is the “return investment” to society for donations, and how do investors have a guarantee it’ll be used as stated?
The biggest goal is to alleviate the suffering individuals are experiencing and provide the same, top-notch psychiatric resources that people in different areas of the country and those with commercial insurances are able to attain.However, in addition to your own betterment of our society and karma points, the receiving individuals (including myself) will be expected to return the investment by serving, within their psychiatric capacity, a select pool of agencies and medical organizations in the counties of Kenosha, Racine, or Walworth, WI where the client-load is heavily focused with Medicaid, Medicare, and uninsured populations.The expectation would be to mirror funding-for-service agreements within the National Health Service Corps (in two-year increments).
I will begin Marquette’s DE MSN program in the Fall of 2017, pending completion of several natural science pre-requisites within the next 12 months.The timeline, and goal, is to have myself and one other candidate licensed, matched to local agencies, and prepared to practice in 2020.In addition to generalized, adult / geriatric psychiatry, there will be additional training in the use of Vivitrol to combat the opiate epidemic plaguing us.All awarded funds will be published in the local news outlets in addition to this page’s updates.All accountability measures are welcome should any donor like open access and receipt of use for any funding to ensure it will be used precisely how it is stated.For any questions / input requests, feel free to reach me at my contact.
I grew up in Kenosha, and aside from a brief stay in Texas and holidays / summers in Arkansas & Tennessee, have lived here for over three decades.I believe in this community and am invested in this community as it is where I am raising my own son and stepdaughter.Past this or any commitment for work, I am committed to residing in southeastern WI for as far as I can see.A graduate of Tremper High School, I have a Master’s in Human Services & Counseling Psychology with a broad background in clinical-counseling psychology.My BS was completed, Cum Laude, at Carthage College in Kenosha, and my Masters at the University of Wisconsin-Platteville with much of my coursework coming from the Wisconsin School of Professional Psychology.I’ve received honors including The Hawkinson Foundation Scholarship (2016), Who’s Who Among Universities (2010), and repeat Deans List placements.
Within my eclectic career, I have worked for over four-and-a-half years as a 911 dispatcher and trainer where I served as the Union President for two years (no stance on unions), and been a case manager with the Kenosha Community Health Center and Kenosha Human Development Services for over four years now.My specialization has been in major mental illness and chronic physical illness, where I’ve worked integrated healthcare for a large portion of my years as a case manager.I have also had the honor of advising on multiple projects including corrections-to-community exit planning, psychiatric provider recruitment and case management program design.In all of my years as a case manager, I’ve been nearly exclusive to the Medicaid and Medicare population and people who fall below 150% Federal Poverty Level.That means I am overeducated, underpaid, and have seen some stuff.
In my very rare down time, my interests are in reading about criminology, public policy with a huge interest in game theory, and film.I play chess, study home library architecture, am a huge horror movie nerd and attend a convention each year where I have developed a list of films every avid horror fan must see during their life, and enjoy Multiplayer Team gaming with the Call of Duty series. Aside from this, I prefer to type on manual typewriters (1939 Royal KMM, 1950 Olivetti Lettera 22, and 1944 Underwood Noiseless Portable if you must know).I have a deep history with mental illness and suicide, myself, and am both partially blind in my right eye and affected by migraines and degenerative disease, giving me what I believe is a strong sense of empathy and interest in the overlap between physical conditions and mental health.
At the age of 8, I saw an episode of MASH (which my father still watches in his recliner), where a character named Dr. Sydney Friedman appeared and counseled a man with Dissociative Identity Disorder.When my father told me that man was a “shrink”, I knew that was a career I would want.One day, when I grow up, I still want to be a shrink, riding my Vespa through town to the sites where folks who need it the most…making house calls to shelters and addiction stops as well as the office, going home to a dog, a fireplace, and my children.
A very special thanks to Douglas Moss for pushing me into “crowdfunding”…even if I still think it’s electronic begging for change.Thank you…be kind, learn lots, and have fun.