The Psychiatrist Gap

A fivefold gap in psychiatrist access

The national picture. Across the 30 largest U.S. metros, the supply of psychiatrists ranges from 52.7 per 100,000 residents in Boston down to just 10.1 in Las Vegas — a 5.2x difference. The Northeast and established academic-medical hubs (Boston, San Francisco, New York, Baltimore, Philadelphia) sit at the top; fast-growing Sun Belt metros dominate the bottom.

The fastest-growing metros have the fewest psychiatrists

The growth paradox. Among the lowest-supplied metros are some of the nation’s fastest-growing: Las Vegas, Orlando, Dallas–Fort Worth, Charlotte, Phoenix, Atlanta, Tampa and Houston. Populations are surging precisely where psychiatric capacity is thinnest — a widening mismatch between demand and the workforce able to meet it.

Where kids can’t find a psychiatrist

Children’s care. Child & adolescent psychiatrists make up only about 11% of the psychiatric workforce. Measured per million residents, the gap is even starker than for adults: Las Vegas has just 5.6 per million — 13 child psychiatrists for the entire metro — versus more than 55 per million in Baltimore. Miami, Charlotte and Orlando are also near-deserts for pediatric psychiatric care.

Half the psychiatrists in major metros are nearing the end of their careers

The retirement cliff. In several of the best-supplied metros, a large share of psychiatrists are decades into practice. In Detroit, 52% are 35+ years past medical school; Washington DC, Miami, New York and Boston are all near 45%. The places that look well-supplied today face a wave of retirements that could erode access quickly.

Plenty of therapists, far fewer who can prescribe

The prescriber bottleneck. Psychologists — who provide assessment and talk therapy but generally cannot prescribe medication — outnumber psychiatrists roughly two-to-three to one in most metros. The result is a structural bottleneck: patients can often find a therapist, but face a much thinner supply of clinicians able to prescribe and manage psychiatric medication.

Even where psychiatrists exist, they cluster

Access within metros. Supply is uneven inside metros, too. In several cities a single ZIP code — usually an academic medical center — holds a large share of all the metro’s psychiatrists, leaving outlying neighborhoods underserved even where the metro-wide number looks adequate.

All 30 metros

Full ranking.

#	Metro	Psychiatrists / 100k	Child psych / million	% 35+ yrs in practice
1	Boston	52.7	53.4	45%
2	San Francisco	41.6	33.9	39%
3	New York	37.3	41.5	45%
4	Baltimore	36.6	55.6	42%
5	Philadelphia	31.7	36.7	44%
6	San Diego	29.5	34.5	36%
7	Washington DC	26.5	35.6	47%
8	Denver	26.3	49.9	36%
9	Sacramento	24.9	33.1	29%
10	Los Angeles	24.6	22.8	38%
11	Seattle	23.9	21.6	39%
12	Portland	23.9	35.9	35%
13	Pittsburgh	23.7	38.0	39%
14	Chicago	22.2	23.8	40%
15	St. Louis	20.1	29.6	36%
16	Austin	19.4	25.9	30%
17	Minneapolis	18.8	18.4	28%
18	Miami	17.8	11.8	46%
19	Cincinnati	17.8	31.3	38%
20	Detroit	16.9	15.0	52%
21	Riverside	15.9	18.3	38%
22	San Antonio	15.9	26.5	36%
23	Houston	15.0	19.1	29%
24	Tampa	14.4	14.1	37%
25	Atlanta	14.3	16.7	37%
26	Phoenix	12.7	16.3	33%
27	Charlotte	12.1	12.1	31%
28	Dallas–Fort Worth	11.6	14.1	36%
29	Orlando	10.6	12.1	41%
30	Las Vegas	10.1	5.6	27%

Methodology & about

About Alpha Sophia. Alpha Sophia is a healthcare commercial-intelligence platform that maps the U.S. healthcare provider market — physicians and other clinicians nationwide, with profiles spanning specialties, Medicare and commercial procedure billing (CPT/HCPCS) and claims trends, financial relationships, publications and clinical-trial activity, credentials, and practice and contact details.

Methodology. Published June 2026. Source: NPI registry data and proprietary insights from the Alpha Sophia healthcare provider database. Psychiatrists are defined as physicians with a psychiatry taxonomy (general, child & adolescent, geriatric, addiction, forensic and related); psychologists are doctoral/master’s-level providers and are shown separately. Providers are assigned to metros by primary-practice CBSA. Per-capita rates use U.S. Census Bureau July 2024 metropolitan-area population estimates. Cross-metro comparisons are the most robust framing. Media contact: isabel@alphasophia.com.