How Behavioral Health Staffing Challenges Are Impacting Children’s Mental Health

Throughout the pandemic, we have seen increases in families experiencing mental health challenges and substance use disorder. Parents have lost their sources of income, kids have been isolated from their peers and have faced challenges learning remotely, and friends and extended family have been cut off from one another. Too many families who were already struggling before the pandemic have been pushed to the brink, and we are seeing the impact of that stress on their and their children’s mental health. The situation is so critical that the surgeon general issued a warning in December stating that young people are facing a mental health crisis.

There was a shortage of affordable, accessible mental health services for children prior to the pandemic, and the need is only growing. At The Home for Little Wanderers, we have over 130 open positions for professionals who could help our kids, and our job openings top 200 if you factor in the need that would result from our waitlist for services. 

Families are facing months-long waits to access affordable mental healthcare for their children. Our program alone has 200 kids waiting for school-based clinical services and several schools who are desperate to embed our clinicians within their buildings as their behavioral health partners. Fifty-eight children are waiting for an opening across our 3 residential education schools in Massachusetts and New Hampshire, and 120 preschool children are waiting for services in our Center for Early Childhood. These numbers are historic and concerning.

Here in Massachusetts, our secretary of Health and Human Services is often quoted as saying there is not a shortage of clinicians in the Commonwealth. Rather, there is a shortage of clinicians who are not in private practice who allow to bill insurance. It’s a question of getting access, and it is a problem whether your family has Medicaid or private, commercial insurance. If you have a child who is having an issue with asthma or diabetes, you could get an appointment right away and have your child’s needs met. That isn’t true when it comes to mental health. 

This issue needs to remain front and center in the conversation until solutions are found and roadblocks removed. Among those challenges, reimbursement rates are driving highly credentialed and talented clinicians into private practice, where they can make a higher salary by charging out of pocket rather than taking insurance. As providers, we need help to be competitive with private practice so that we can retain the skilled clinicians who help the children and families we serve and attract new talent to provide the highest quality evidence-based treatment models. The deeper our bench of qualified practitioners, the more children and families we can serve.

The current climate is forcing the hiring teams in all industries to get creative, but particularly in the human services sector. Within our agency, recruitment efforts have been a top priority, and we are thinking innovatively about how to bring new practitioners, keep them here, and see to their professional growth and success. We partner with area colleges and universities to provide a pipeline for new employees, as well as continued education opportunities for staff, and have a wealth of internships at the graduate and undergraduate level that offer valuable training within The Home’s departments and programs, direct care with children and families, and certifications. Earlier this year, The Home implemented a new visa sponsorship program to facilitate the hire of international candidates.

As we build for the future, we are also laser-focused on all we can do in the here and now to mitigate this crisis. We have found that an integrated response is essential. Having a wide range of programs can strengthen families, allowing caregivers to feel less stressed and confident to meet children’s needs (which, research shows, impacts the mental health of kids). Some of the ways we can go about accomplishing this include:

• Going into the home to offer support for children and families within their own surroundings
• Embedding clinical social workers within schools to give students access to help and support groups they wouldn’t otherwise receive
• Offering in-person assessments in preschools through our Center for Early Childhood Program, which provides direct care services and therapeutic supports that build strong social-emotional foundations in children from birth to age 7 during a critical phase of development.

These proven methods and programs can help young people who are struggling during these exceptionally challenging and unrelenting times, but, again, access is the key. We can talk all day long about evidence-based models and practices that we know will improve mental health outcomes for children, but it’s all for naught if life-changing care remains out of reach.

Lesli Suggs, LICSW, is president and CEO of The Home for Little Wanderers.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.