SAMHSA Takes Action to Address Our Workforce Crisis

Our current behavioral health workforce crisis remains the primary issue the field will confront in 2024. Specifically, we do not have sufficient workforce capacity to meet the needs of those seeking care for their mental health or substance use conditions. COVID-19 has contributed greatly to this problem by increasing the prevalence of these conditions among both adults and children. The effects of this problem can be seen in dramatically increased rates of suicide (up 32%) and opioid overdose deaths (up 376%) from 2001 to 2021.

Thus, it is very welcome news to report that the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a technical expert panel on the workforce January 18-19. This panel, Building the Behavioral Health Workforce with a Focus on Underserved Communities, was designed to re-envision our approach to the behavioral healthcare workforce, particularly in locales with fewer or no services. Through this effort, practical actions can be identified to mitigate the current crisis and plan both short- and long-term solutions.

The panel’s convener, Larke N. Huang, PhD, SAMHSA’s director of the Office of Behavioral Health Equity, challenged participants at the outset: “We want to hear solutions and build on them. ... There is a life-and-death urgency to the question, ‘Can you help me get treatment?’ ”

Participants included representatives from federal agencies (SAMHSA, the Health Resources and Services Administration, the Centers for Medicare and Medicaid Servioces, and the National Institutes of Health); national organizations interested in workforce policy; state and local behavioral health programs; private insurance and service programs; HRSA-funded Behavioral Health Workforce Research Centers at the University of North Carolina and HRSA, and other academic and consulting programs.

Barbara Bazron, PhD, director of the Department of Behavioral Health, Washington, DC, facilitated the meeting. She introduced the members of each panel and then led a focused discussion at the conclusion of panelists’ comments.

Panels included the following:

• Workforce Challenges and Innovative Solutions; Community Perspective;
• Behavioral Health Support Specialists (Peer specialists; community health workers, campus programs);
• Community Initiated Care—Examples from the Field;
• Policy, Data and Financing Issues; Expansion and Support for the Behavioral Health Workforce;
• Behavioral Health Workforce Centers;
• Career Pathways: Innovations in Recruitment, Retention, Incentives Focusing on Underserved Communities; and
• Workforce Challenges and Innovative Strategies: Perspectives from the States.

Participants expressed great enthusiasm for the dialogue, and they offered many recommendations over the 2-day meeting. Major workforce topics considered included:

• Expansion of the peer and community health worker workforce, and implementation of national certification standards for these groups;
• Improved interstate and inter-urban licensure compacts for all behavioral health providers;
• Sharing of professional roles with paraprofessionals; and
• Development of training pathways into behavioral health for minority students.

Consideration also was given to the financing of training and care. New federally operated training programs should be considered, and programs such as the Minority Fellowship Program should be expanded to include peers and community health workers. An urgent need also exists to improve reimbursement rates for behavioral health providers, and to fund social care at the personal level and preventive care at the community level.

Finally, none of these changes will go forward without dedicated federal funds and a federal staff with appropriate human resource technical skills specifically assigned to this work. Such developments will require broad commitment across the behavioral health field and concerted advocacy with Congress and White House.

Dr Huang and SAMHSA are to be commended for taking this essential step. I encourage you to join this effort now and to undertake the necessary advocacy to turn these recommendations into tomorrow’s reality.

Ron Manderscheid, PhD, is the former president and CEO of NACBHDD and NARMH, as well as an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.

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.