Behavioral health is a serious issue across the U.S. According to a 2021 study, an incredible one in five Americans lives with a mental illness, while one in ten experiences a drug use disorder at some point. In the last few years, the Covid-19 pandemic and opioid health crisis worsened the situation. The World Health Organization (WHO) estimates that the pandemic alone triggered a 25% increase in the prevalence of anxiety and depression worldwide.
However, despite the profound need for mental and behavioral health services, there’s a chronic shortage in the behavioral health workforce. According to recent figures, nearly half of the U.S. population – 47% or 158 million people – live in a mental health workforce shortage area. This means that almost one in two Americans aren’t getting the care and support they need to get their lives back on track.
Why Is There a Shortage in the Behavioral Health Workforce?
Mental illness and substance use disorders are key factors in disability, mortality, and healthcare costs. So, it’s essential that Americans have good access to behavioral and mental health professionals. At the moment, however, things only appear to be getting worse. According to current projections, by 2030, there will be a 20% decrease in the supply of adult psychiatrists and a 3% increase in demand for their services. This makes psychiatry one of the leading mental health professional shortage areas.
There are several reasons behind the current behavioral health workforce shortage. One of the most important revolves around Medicaid. Figures show that demand for mental health services is highest among Medicaid enrollees. Around 39% of people on Medicaid suffer from behavioral or mental health issues.
However, only 36% of psychiatrists accept new Medicaid patients (compared to 71% of physicians). Moreover, even those who accept new Medicaid patients often take just a few, leaving millions without access to mental and behavioral health practitioners.
Many people are also put off from entering the profession because of poor security and high workplace violence rates. Up to 80% of mental health nurses and more than 40% of other mental health care clinicians experience violence at some point in their careers.
How Workplace Safety Is Contributing to the Shortage
High levels of violence in the mental health care sector directly contribute to the behavioral health workforce shortage. Not only does workplace violence put people off from entering the profession, but it can also negatively impact staff retention rates, further reducing the number of behavioral health providers available.
Repeated studies have shown that exposure to workplace violence is associated with poor mental health outcomes and unfavorable physical and emotional performance. Long-term exposure to workplace violence has been shown to lead to higher levels of PTSD, burnout, anxiety, depression, and insomnia in the mental health workforce.
Examples of Concerns Unique to the Behavioral Health Field
Many of the concerns held by behavioral health workers aren’t unique to the sector. However, they are amplified by regular exposure to patients with serious mental illness and substance abuse disorders. For example, many – even those outside the health system – are concerned about violence in the workplace. Many are also worried about a lack of funding and lack of provision.
However, these concerns are brought to the fore in the behavioral health field because mental health care professionals, especially those on the frontline, are far more likely to experience violence than other workers. In addition, people suffering from severe, acute mental illness and substance abuse issues are more prone to erratic behavior. This can lead to violent and aggressive outbursts.
Impact of Safety on Recruitment and Retention Efforts
If social workers, family therapists, and other mental health providers don’t feel safe in the workplace, they’re less likely to stay in the profession for an extended period. Studies have shown that exposure to workplace violence directly leads to poor mental health and high burnout, stress, and anxiety levels. These, in turn, result in high staff turnover.
As well as retention rates, safety concerns can make it difficult for healthcare providers to recruit staff in the first place. This can lead to fewer professionals joining the healthcare workforce.
Possible Solutions to the Workforce Shortage
There are several complex reasons behind the workforce shortage in the behavioral health sector. However, some solutions can help to address some of the most common issues impacting behavioral health workers.
Examples of Technological Solutions, Such as Wearable Devices and Alarm Systems
Technological solutions can help reduce workplace violence and make mental health professionals and primary care providers feel safer when treating their patients. For example, electronic entry systems can be used to control who enters and exits a building, and CCTV can be put in place to help security personnel better monitor the premises.
Alarm systems are another good option for mental health treatment centers. These systems can be installed in patient rooms and communal areas, or mental health workers can be issued with wearable devices (also known as panic buttons). One of the benefits of wearable devices is that they’re always on hand when workers need them. So if a clinician feels that their safety is at risk, they can trigger the wearable device and get help as quickly as possible.
Discussion of Best Practices for Implementing Safety Technology in the Workplace
Because all psychiatry and primary care settings are different, there’s no ‘one size fits all’ solution regarding safety technology in the workplace. Talking to staff about their concerns, and analyzing any prior incidence of workplace violence, is the best way to find the most effective solution.
Improved safety in the workplace benefits everyone, so it’s important to ensure all employees are involved in the implementation process. Instead, a collaborative approach will ensure all workers are comfortable with the safety solutions and that everyone is aware of the measures taken.
Advocate for Policy Change
Advocating for policy change is one of the most effective ways of improving the situation long term. For example, if the Department of Health, public health bodies, and policymakers legislate for better funding, prompt Medicare payments, higher reimbursement rates, and investment in safety technology, the real, permanent change could be achieved across the sector.
Organizations like the Substance Abuse and Mental Health Services Administration (SAMHSA) offer information on current funding opportunities.
Retaining Current Behavioral Health Professionals
Retaining current behavioral health professionals is a big piece of the puzzle when tackling the workforce shortage. Human services departments, government agencies, and state legislatures can employ many methods for improving retention rates in the behavioral health sector.
Better Compensation and Benefits
Increasing compensation and benefits for psychiatrists, mental health workers, and clinical social workers can help to stop professionals from leaving the sector. Studies have shown that raising pay helps to improve satisfaction levels and increase staff retention.
Offering professional development opportunities can also help to improve levels of staff satisfaction. For example, internships, placements, specialist courses, and initiatives incentivize existing team members and help overall workforce development.
The Substance Abuse and Mental Health Services Administration (SAMHSA) lists a number of professional development opportunities. In addition, the Health Resources and Services Administration (HRSA) also offers information on development programs. These are focused on high-need communities, such as pregnant people, children, low-income households and communities in rural areas.
Improve Working Conditions
Improving working conditions is key to boosting retention rates. Offering peer support, professional support specialists, and a safer workplace can help workers to feel happier and more appreciated.
More flexible working can also help to improve behavioral health conditions for workers. For example, giving professionals the chance to provide telehealth services instead of face-to-face consultations, can make it easier for people to work from home and achieve a better work-life balance.
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