On December 2, the Rehabilitation and Community Providers Association (RCPA) in partnership with the Behavioral Health + Economics Network (BHECON) hosted a discussion on behavioral health workforce. Participants heard from experienced clinic executives and staff, trade associations, and hospital systems, who shared the challenges of maintaining and growing a quality workforce and offered potential solutions to address specific workforce shortages. Click here for the forum’s agenda and click here for a video message from the honorary event chair, Pennsylvania Lieutenant Governor Mike Stack.
Workforce Shortages Reflected in Data
RCPA President and CEO Richard Edley opened the day by presenting data showing the extent of behavioral health staff shortages nationwide. According to Edley, behavioral health providers struggle to find staff at all professional levels for a number of reasons including lack of qualified applicants, aging workforce, low salaries and benefits, and heavy caseload and paperwork requirements.
The forum’s first panel of community mental health treatment organization leaders supported Edley’s statements by sharing their own organization’s high turnover and vacancy rates. The trend holds true for providers across all parts of the state—in urban, suburban, and rural areas.
By 2020 12,624 child and adolescent psychologists needed. A supply of only 8,312 is anticipated.
Low Pay and Compliance Requirements Impact Care
The morning panelists agreed that the number one reason behavioral health providers struggle to recruit and retain staff is low wages. Providers are limited in how much they can offer potential employees because community behavioral health organizations are dependent upon Medicaid reimbursement rates set by the state legislature for revenue. Noreen Frederick of the Western Psychiatric Institute and Clinic noted the difficulty in raising staff salaries without any corresponding raises in state Medicaid rates. Cindy Mazza, Vice President and COO of Salisbury Behavioral Health, and Sara Mays, Clinical Administrator with Skills of Central PA, both discussed how providers often lose quality staff members to other organizations, like the Veteran’s Administration and area hospitals, that can offer higher salaries than community behavioral health providers.
In recent years, providers have had to adapt to a new business environment that prioritizes regulatory compliance. Connell O’Brien, Policy Consultant with RCPA, explained how this shift has left providers with less time to care for patients and mentor junior and mid-level staff.
“Mental health provider salaries are so low, we’re competing with grocery stores & fast food companies for our workforce.” Noreen Frederick, Western Psychiatric Institute and Clinic
Strengthening Public Psychiatry
In the afternoon, a second panel representing psychiatrists, provider organizations, social workers, and hospitals addressed the urgent need for more psychiatric services. In order to attract more psychiatrists to the public sector, Deb Shoemaker of the Pennsylvania Psychiatric Society proposed that more students be exposed to public psychiatry and addiction care during their residency. Multiple panelists noted that a greater promotion of federal loan forgiveness programs would also help get more students interested in behavioral health as a career.
Mike Quinn emphasized the importance of expanding access to telehealth as a way to help psychiatrists reach more patients, particularly those located in rural and underserved areas. Some panelists also suggested that changing certain state regulations would better maximize clinical time for psychiatrists. David Dinich talked about the Pennsylvania Psychiatric Leadership’s (PPLC) efforts to grow a pipeline for future psychiatrists. Specifically, the PPLC created three Centers of Excellence in Public Service Psychiatry, where students are trained and placed in in-state public psychiatry positions.
“There needs to be more recognition of telepsychiatry.” -Mike Quinn, Chestnut Ridge Counseling Services, on bolstering the psychiatric workforce.
At the close of the forum, providers walked away energized to work on public policy solutions to strengthen and expand the behavioral health workforce.