County where ‘madman’ killed five has just two psychiatrists

Only two psychiatrists work in the rural county where Kevin Janson Neal shot and killed five people earlier this month, state records show.

Shortly after the shooting, Tehama County Assistant Sheriff Phil Johnston called Neal, 44, “a madman on the loose.” He said that Neal drove the streets of Rancho Tehama on Nov. 14 firing randomly at homes and structures.

Neal suffered from delusions and other mental health issues for years, according to his sister, Sheridan Orr.

Tehama County spreads across nearly 3,000 square miles and is home to 64,000 people.

It has less than one psychiatrist per 10,000 residents – 0.3 per 10,000, to be exact, according to records maintained by the California Medical Board. By comparison, there are almost two psychiatrists per 10,000 people statewide – six times the rate of psychiatrists in Tehama County.

Tehama County is not unusual.

Twenty-three California counties, mostly in rural Northern California, have fewer than one psychiatrist per 10,000 residents, state records show. Six Northern California counties have no psychiatrists at all.

Doctors of all types – including psychiatrists – tend to want to practice in urban areas.

A shortage of psychiatrists can lead to long wait times or long drives for appointments, discouraging some from seeking care. It can also cause access and cost problems for the general population as patients with a mental illness seek treatment in hospital emergency rooms or primary care clinics.

This story was originally published November 30, 2017 at 9:10 AM with the headline "County where ‘madman’ killed five has just two psychiatrists."