Nine of Utah’s 10 highest state salaries, outside academia, are earned by psychiatrists at the Utah State Hospital for the mentally ill.
Those figures — between $273,000 and $480,000 in salary and benefits — surprise some mental health consumers, who would like to see more money routed to other public mental health services, particularly the hospital’s lower level staff who they believe works more frequently with residents.
Salary and benefits by the numbers
Some community members criticize the high pay of psychiatrists at Utah State Hospital, but many other state employees earn as much or more:
University of Utah football coach Kyle Whittingham » $1.5 million
University of Utah orthopedics professor John T. Smith » $1 million
University of Utah chief of the Division of Otolaryngology Clough Shelton » $1 million
Utah State Hospital clinical director and psychiatrist Richard Spencer » $480,869
Utah Transit Authority chief executive officer John Inglish » $351,891
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And Rep. John Dougall, R-American Fork has previously raised questions about compensation of medical staff at the hospital. “Whenever I see a number that large that’s being funded with taxpayer dollars it causes me concern,” he said. “It causes one to say ‘Is that really a necessary expense’?”
But experts and studies suggest the salaries are in line with those nationally. And with the spreading shortage of psychiatrists, the state could be forced to pay even more if the hospital lost doctors and had difficulty recruiting.
Whether Utah has an actual deficit of psychiatrists is a matter of debate, but experts agree mental health professionals are in high demand. Directors of publicly funded institutions such as the hospital and University Neuropsychiatric Institute (UNI) say they have lost psychiatrists to the U.S. Department of Veterans Affairs in Utah and Intermountain Healthcare because of higher salaries.
Utah’s growing population and the prevalence of such common disorders as depression is exacerbating the need for mental health experts.
The problem seems to be growing nationally: The National Resident Matching Program, which tracks medical school graduates’ residency acceptance, says fewer U.S. students graduating from medical school chose to specialize in psychiatry over the past several years. Though large metropolitan areas such as Chicago and New York have an adequate supply of psychiatrists, less populated areas are particularly in need, said Sidney Weissman, professor of clinical psychiatry at Northwestern University.
“The ability of our society to deliver mental health care to rural areas is significantly impaired,” he said.
In Montana, one wing of a new mental health facility for veterans was unable to take patients for about a year because it could not fill three psychiatrist positions. Though staff is now being hired, veterans had to travel all over the country — including Utah — to get help.
Time with patients » The American Psychiatric Association suggests that school loan debt may be playing a role in students’ decision to seek more lucrative careers. For the first time, UNI turned to a head hunter this year as it worked to fill several psychiatric jobs.
“It’s not uncommon to see people with $200,000 debt coming out of [medical] residency,” said Ross VanVranken, the institute’s executive director.
For those who do choose psychiatry as a career, some private sector jobs can pay significantly higher. A 2011 survey of psychiatrists nationally found that more than half made between $175,000 and $300,000 excluding benefits.
In fact, a 2011 Utah public employee salary survey found that state employees in the medical field make about 10 percent less than those in the private sector. Yet benefits are very good: state employees contribute about 10 percent of health care benefit costs where private industry employees typically pay between 15 and 29 percent, the analysis found.
Higher private sector pay isn’t the only factor. Working at a state hospital means caring for severely ill patients who may be unresponsive to treatment. Improvement can take years. And staff have a higher risk of being assaulted.
“If you hire people for low wages and get them to come and they only stay briefly then you have major turnover problems and that’s negative in terms of care,” said Michael Hoge, a professor at the Yale department of psychiatry.
Even so, salaries can seem inordinately high to those receiving service.
Tommy Tanzer of Park City, whose adult stepdaughter was treated successfully for schizophrenia at the state hospital several decades ago, believes paying too much for the people at the top is what tends to happen with government-run institutions. Yet he fears financial pruning could occur if the issue gets too much attention.