Across the US, licensed behavioral health care specialists – psychiatrists, psychologists, and clinical social workers – are increasingly in short supply. And to make matters worse, this growing deficit arrives when substance use disorder (SUD) and mental illness rates are reaching new highs.
Approximately 122 million (37%) Americans live in places the Health Resources and Services Administration (HRSA) declares “mental health shortage areas.” And the HRSA projects the nationwide shortage could climb to as many as 35,000 full-time employees by 2030 for certain specialties, with most states left to confront deficits within their borders.
Further, a decades-long behavioral health technology gap exacerbates this worrying staff and skills disparity. Nearly a third of SUD and behavioral health providers manually track outcomes or use a homegrown solution, perpetuating blindspots in patient treatment outcomes and handicapping clinicians. And a lack of incentives and support for technology adoption has created analytic obstacles, with many providers not ready to answer basic operational and clinical questions.
What’s clear? There is a growing and concerning skills and data gap across behavioral health and SUD treatment providers in the US. And the consequence of this gap manifests as ongoing disparities in access and insights for some of our most vulnerable populations. But there are solutions.
Federal policymakers should take steps to foster a behavioral health workforce that extends beyond licensed professionals to help address these widening shortfalls. Concurrently, behavioral health providers must also invest strategically in technology to harness the data required to improve the current care baseline and “do more with less.”
The Current Care Equation
Addressing current deficits is particularly important as health equity gains much-needed national attention. The behavioral health skills and data gap has severely limited access to treatment. And this disparity hits underserved communities the most, including lower-income, Black, Indigenous, people of color (BIPOC), and the LGBTQ+ community.
These populations already suffer from complex trauma, co-occurring behavioral health issues, and substance abuse from a pre-existing lack of access due to stigma, underinsurance, steep costs, and shortages of licensed clinicians and therapists in their communities. And this access deficit leads to significantly worse outcomes. For example, rates of suicidal ideation are highest among LGBTQ+ youth, with over half of 11-17-year-olds reporting nearly daily thoughts of suicide. And solving these shortfalls is more critical than ever, as the most unprepared groups will likely fall through the cracks as access dries up.
Solving the Skills Gap
Workforce shortages among licensed clinicians will only worsen as the demand for services rises, so federal lawmakers need to cultivate a behavioral health workforce that is less reliant on licensed professionals. Through legislation, policymakers can build on previously reserved efforts to diversify the behavioral health workforce in two ways:
- Nurture a more significant role for behavioral health support specialists (BHSSs)
One of the most actionable methods for solving the talent gap is leveraging BHSSs (including peer specialists, community health workers, paraprofessionals, etc.). BHSSs can deliver vital non-clinical behavioral health services, so that facilities can free up the licensed behavioral health workforce for higher-level tasks.
Many states, communities, and insurers have already recognized the critical function BHSSs play in the care continuum. Policymakers can build on this momentum by fashioning a set of core competencies for BHSSs at the federal level that can serve as a guide for states to follow. Currently, no national standardized model exists.
Further, Congress should also create minimum federal exemptions for those convicted of nonviolent crimes to become BHHSs, to boost supply while reflecting many patient populations’ lived experiences.
- Leverage existing community support networks to augment the behavioral health care patients receive
Through policy, lawmakers should support the greater use of community-initiated care (CIC). Fostering CIC programs and initiatives can empower community members to adopt some behavioral health responsibilities when suitable while training those in other fields, like faith-based leaders and educators, to answer individual behavioral health needs at the community level.
Bridging the Data Gap
Social Determinants of Health (SDoH) drive up to 50 percent of the county-level variation in health outcomes. The problem? Many behavioral health facilities are ill-equipped to track these critical SDoH factors and link them to results. Many still use paper records, which are inefficient and make quantifying or objectively examining the data challenging. For example, less than 16% of behavioral health facilities have an integrated data platform. Therefore, providers can bridge the data gap in two ways:
- Integrate data and patient models for whole-patient health
Providers must rethink their program management and evaluation methods as facilities implement evidence-based treatment models and current regulatory movements to incentivize a “data-informed” approach. An integrated data platform will enable providers to track outcomes more effectively, ensuring clinical services and interventions are more successful and impactful with accountable care models.
- Implement data and technology to do “more with less”
Technology investment represents one of the fastest paths to protecting margins, driving higher reimbursements, and effectively identifying areas of loss and opportunity across behavioral health networks and facilities. By leveraging data and technology in this manner, providers can effectively care for a growing patient population, maximize staff hours and utilization, compensate for rising costs, and much more.
The One-Two Punch
Behavioral health’s problems and challenges in the coming years do not have singular solutions. It will take a coordinated effort at the national and provider level to solve skills shortages and bridge data deficits across behavioral health facilities and networks.
The future of SUD and behavioral health care hinges partly on a commitment to fresh policy ideas and innovative digital solutions. Behavioral health has long suffered under a skills and data gap that has only worsened our nation’s mental health crisis. But combining better data with progressive policy can go a long way in solving these systemic problems, transforming the behavioral healthcare continuum with actionable solutions and insights.