The author reviews a needs-based approach to estimating psychiatric workforce requirements that entails five determinations: (1) number of people with mental health problems, (2) number of people needing mental health treatment, (3) number of people needing psychiatric treatment, (4) amount of psychiatric time required to meet patient needs, and (5) amount of time psychiatrists have available to provide direct patient care. Questions, issues, and strategies raised by the needs-based approach are outlined. The author suggests that only a coordinated, carefully orchestrated effort among national psychiatric organizations will ensure that the future psychiatric workforce is adequate to meet the needs of the mentally ill.