BehavioralHealthWorkforce:Challenges,Opportunities&

Initiatives

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A.KathrynPower,M.Ed.SAMHSARegionalAdministratorRegionISeniorFocusLead– MilitaryServiceMembers,Veterans&theirFamilies

Governor’sSummitonVermontSubstanceUseDisorderWorkforceVermontTechnicalCollege,Randolph,VT05061April17,2017

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BehavioralHealthWorkforceProjectedGrowth

GoodNews:ProjectedGrowth

• Thebehavioralhealthworkforceisoneofthefastestgrowingworkforce groupsinthecountry.

• Employmentprojectionsfor2024basedontheU.S.BureauofLaborStatisticsshowariseinemploymentforsubstanceabuseandmentalhealthcounselorswitha22%increasefrom2014to2024,greaterthanthe6.5%projectedaverageforalloccupations.

• Thisprojectionisbasedonincreasesininsurancecoverage formentalandsubstanceusedisorderservicesbroughtaboutbypassageofhealthreformandparitylegislationandtherisingrateofservicemembersseekingbehavioralhealthservices.

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BehavioralHealthWorkforceShortages

TheChallenge:WorkforceShortages• 62millionpeople(20-23%)oftheU.S.populationlivein

ruralorfrontiercounties;13%ofthesecountieshavenoadvancedbehavioralhealthpractitioners.

• 9percentofallUScountieshaveNOmentalhealthprofessionalsandsohavenoaccesswhatsoever.

• In2012,theturnoverratesintheaddictionservicesworkforcerangedfrom28.5%tomorethan50%.

• StateswithhighestratesofM/SUDandlowestratesofaccessareinSouthandWest.

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ScopeoftheProblem5

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ScopeoftheProblem6

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ScopeoftheProblemBehavioralHealthWorkforceShortages

ProjectedGrowthofSpecificBehavioralHealthOccupations

Profession 2024Projection Increaseover2014

MentalHealth&SubstanceAbuseSocialWorkers

140,000 22,300(19%)

SubstanceAbuse&BehavioralDisordersCounselors

116,200 21,200(22%)

MentalHealthCounselors 160,900 26,400(20%)

Psychologists 206,400 32,500(19%)

MarriageandFamilyTherapists 38,700 5,000(15%)

Psychiatrists 32,400 4,200(15%)

SOURCE:Bureau ofLaborStatistics:OccupationalOutlookHandbook,2015

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ScopeoftheProblem

• Lowsalariescomparedtootherhealthprofessionals

• Agingworkforce

• Mal-distribution

• Lackofaccess

• Lackofintegration

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NationalProjectionsofSupplyandDemandforSelectedBehavioralHealthPractitioners,2013-2025

1. Psychiatrists2. Behavioralhealth

nursepractitioners3. Behavioralhealth

physicianassistants4. Clinical,counseling,

andschoolpsychologists

5. Substanceabuseandbehavioraldisordercounselors

6. Mentalhealthandsubstanceabusesocialworkers

7. Mentalhealthcounselors

8. Schoolcounselors9. Marriageandfamily

therapists

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FactorsDrivingDemandforBHCareProviders

1. EmphasisonintegratingBHserviceswithprimaryhealthcare

2. Increasedutilizationofhealthcareservices3. Advancesinmedicineandtechnology4. GrowingemphasisonBHwellness,

preventionofmentalandsubstanceusedisorders,BHcarecoordination,andBHcaremanagement

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Goals:1. Developanddisseminateworkforce

trainingandeducationtoolsandcorecompetenciestoaddressbehavioralhealthissues.

2. Developandsupportdeploymentofpeerprovidersinallpublichealthandhealthcaredeliverysettings.

3. Developconsistentdatacollectionmethodstoidentifyandtrackbehavioralhealthworkforceneeds.

4. Influenceandsupportfundingforthebehavioralhealthworkforce.

SAMHSAStrategicInitiative#5:WorkforceDevelopment

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Partners in Building Solutions

NationalPartnersPre-ServicePartnersHigherEducationProfessionalOrganizations

Federal GovernmentAssistantSecretaryforPlanningandEvaluation(ASPE)HealthResourcesandServicesAdministration(HRSA)CenterforDiseaseControl(CDC)DepartmentofDefenseandVeteransAdministration(DOD,VA)

State&LocalGovernmentStateAgenciesEducationPartnersLocalHealthAuthoritiesHealthCareProviders

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Partnershipsw/HHSDepartments

HealthResourcesandServicesAdministration(HRSA)• WorkingwithHRSAtoexpandtheNationalHealthServiceCorpstobehavioral

healthprovidersites.ExploringexpansionofNurseServiceCorps toM/SUDsitesaswell.

• CollaboratingwiththeRegionalPublicHealthTrainingCenters(RPHTC)toestablishstronglinkagew/SAMHSAintheprofessionaldevelopmentandtechnicalassistanceoutreachtothepublichealthservicedeliverysystem(<1M)

HealthResourcesandServicesAdministration(HRSA)• CoordinatingwithTele-HealthEducationCentersandtheAddictionTechnology

TransferCenters (ATTC)toenhancetheavailabilityofresourcestothebehavioralhealthprovidersystems.

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SAMHSA’sWorkw/BehavioralHealthWorkforceResearchCenteratUniversityofMichigan

v Initialprojects:

– DevelopmentofaMinimumDataSet– ExamineWorkforceCharacteristicsandPracticeSettings

– ExploreScopesofPracticefordifferentprofessions

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SAMHSA’s23TAcentersprovideBHskillstraining.Someofthese:• AddictionTechnologyTransferCenters(ATTCs)

• CenterforIntegratedHealthSolutions(CIHS)

• CenterfortheApplicationofPreventionTechnology(CAPT)

• BringingRecoverySupportstoScaleTACenter(BRSS-TACs)

• GAINSCenter

• ServiceMembers,Veterans&FamiliesTACenter

• SuicidePreventionResourceCenter

SAMHSAWorkforceDevelopmentTechnicalAssistance

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States:WorkforceDiscussionFindings

BehavioralHealthWorkforceIssues-LeadershipintheStatesin:

– StateDepartmentsofHealthCareServices

– StateDepartmentsofAdministrativeServices

– StateDepartmentsofHealth

– Governor’sOffice

– DepartmentsofEconomicDevelopment

– DepartmentsofEmployment&HigherEducation&Labor

– Multi-partneredBehavioralHealthWorkgroups

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PartnersinBuildingSolutions

• ABehavioralHealthWorkforcePlan

• TheNeedforBetterData&ImprovedTechnology

• PeerRecoverySpecialists

• Credentialing/Licensing&ReciprocityIssues

• ConcernsAboutParity

• IntegrationofCare&theContinuumofCare

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States:WorkforceBestPractices

PeersintheWorkforce

– Statesrecognizethevalueaddedwhenpeersareintegratedintotheworkforceandareusingtheminasmanydomainsaspossible;correctional,primarycare,emergencymedicine,pre-release,crisis,andhousing.

– Peersareusedasnavigatorsandbridgestofacilitatecaretransitions.

– Trainingandcertificationisincreasinginmoststatesforpeerspecialties.

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States:WorkforceBestPractices

Tele-healthInvestmentsforimprovedproviderandqualityaccess

• Improvedaccesstospecialtyservices

• Traditionalface-to-facevisitsusingvideo• Mobileapplicationsusingsmartphonesandprovidingeducation,interventions,GPSalerts,on-demandadvice

• Statesidentifiedparticulareffectivenesswithyouth,including:outreach,serviceson-demand,textingsupports.

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States:WorkforceBestPractices

CEUs/TrainingDistanceLearning:

– Rangefromself-directedcoursesandcurriculatointeractiveWebinarstomental/substanceusedisorderspecificECHO sites.

– OfferedbyarangeofTAproviders,professionalorganizations,communitycollegesanduniversities.

– Mostprovidersarefamiliarwithandacceptuseoftechnologyforeducation/training.

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EngagingKeyInfluencers

SuccessfulCollaborationsinoperationwith:– Preserviceorganizations(i.e.HOSA,ARS)

– HigherEducation

– FederalAgencies(HRSA,CMS,DOD,VA)

– ProfessionalOrganizations

– InclusionofM/SUDinNHSC,NurseCorps,loanrepayment

– PhilanthropicOrganizations

– Privatesectorservicedelivery,insurers

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SAMHSA’s:CurrentInitiatives

• BehavioralHealthWorkforceEducation&Training;MinorityFellowshipProgram

• NationalTechnicalAssistanceCenters;BehavioralHealthWorkforceResearchCenter

• Screening,BriefIntervention,andReferraltoTreatmentTrainingPrograms;MentalHealthFirstAid;CenterforIntegratedHealthSolutions

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Strategies

• Scholarship/stipendprograms;BHCurricula/programsinuniversities;loanrepayment;residencyslotnumberandtypeexpansion

• Hubandspokemodels;collaborativecare;Medicaidrateincreaseforbehavioralhealthinterventions

• Integratedcareexpansion;licensemobility;peerprogramexpansion

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Thankyou!Questions?

A. KATHRYN POWER M.Ed.Regional Administrator-Region 1

Substance Abuse and Mental Health Services AdministrationU.S. Department of Health and Human ServicesJFK Federal Building15 New Sudbury Street, Room 1826Boston, MA 02203kathryn.power@samhsa.hhs.gov617-565-1482617-565-3044 (fax)

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