A shortage of psychiatrists in Arizona means people with mental illnesses are getting less in-person care than they sometimes need.

Arizona has long been a place where psychiatry services have been limited and undercompensated, said Dr. Francisco Moreno, interim head of the psychiatry department in the University of Arizona College of Medicine.

"This issue has eroded the satisfaction and profitability of private practice," Moreno wrote in an email. "Nationally, the payer trends have influenced a decrease in the use of talk therapy to favor medication management by psychiatrists."

The continuing cuts to mental-health services in the public sector stress existing resources, making it tougher to help the growing number of people who need it, he wrote.

He said the local community mental-health system is increasingly depending on alternative medical providers such as videoconferencing consultations and nurse practitioners rather than in-person care from a psychiatrist.

"I try not to see anyone long-term. I don't have time. I have more people than I know what to do with," said Dr. Kevin Goeta-Kreisler, a psychiatrist who has been in practice locally since 1994 and specializes in working with older patients. "When I first started in 1994, we were doing 15-minute medication checks. Now I like to have a minimum half hour, so I am trying to leave myself open, to be there for people if they are really having problems."

Goeta-Kreisler said someone with private insurance who wants to see a psychiatrist will typically need to make multiple calls to find one, and then it could take up to three months to get an appointment.

That's not good for patients, he said.

"People can even make themselves physically sick with psychiatric issues," he said.

Citing the psychiatrist shortage, psychologists in some states are seeking the authority to prescribe medications. Psychologists are already allowed to prescribe in the military and the Indian Health Service, and in New Mexico and Louisiana, the American Medical Association says. The latest measures have been opposed by the AMA and the American Psychiatric Association, among others.

Moreno said enhancing public education about mental illness and improving mental-health coverage in both public and private insurance plans would help attract more medical students to become psychiatrists.

Contact reporter Stephanie Innes at sinnes@azstarnet.com or 573-4134.