The Wall Street Journal includes an article: "How the U.S. Can Solve a Shortage of Mental-Health Professionals—Some 130 million Americans live in areas that don’t have enough mental-health workers. We asked three experts for solutions."
Here are some excerpts:
Many sufferers of mental-health issues can’t find the help they need. Often there just aren’t enough providers.
More than a third of the U.S. population, about 130 million people, live in areas that have a dearth of mental-health workers. Residents of underserved areas have roughly a quarter of the providers they need, in aggregate, the Kaiser Family Foundation says. The shortage is even more acute in rural areas. About 80% of rural counties lack access to a single psychiatrist, according to a report by the U.S. Senate Committee on Finance, citing data from the Health Resources and Services Administration.
The pandemic brought the shortage of mental-health services into sharp focus as more adults sought help to deal with the stress and disruption of their daily lives. Children suffered immensely, too, as prolonged school closures weren’t only psychologically damaging, but also caused many children’s mental-health conditions to go unnoticed because teachers and school psychologists are a primary source of referrals.
How can more people be encouraged to pursue careers in mental health? And how can the existing system be improved to help more people?
To help answer those questions, The Wall Street Journal asked three experts to join in an online video roundtable discussion: Kyle Grazier, a Richard Carl Jelinek professor of health services management and policy and professor of psychiatry at the University of Michigan, Ann Arbor; Charles Ingoglia, president and chief executive, National Council for Mental Wellbeing; and Keris Jän Myrick, vice president for partnerships with the mental-health advocacy organization Inseparable, a board member for the National Association of Peer Supporters and host of the podcast Unapologetically Black Unicorns.
WSJ: Are there ways to quickly boost the mental-health system’s capacity?
MR. INGOGLIA: I represent about 3,200 clinics around the country, and as I talk to CEOs about why their staff members are leaving, one reason is they can earn more elsewhere. But paperwork is also right up at the top of the list—the amount of assessments, outcome measures and progress notes required. So anything we can do to reduce administrative burden and increase pay would be helpful.
DR. GRAZIER: There is evidence that if providing mental-health support to other people is viewed as a valuable and viable career path, more people are attracted to it. There are now several pilots in high schools and community colleges providing certification and licensing for students who want to pursue a career in the field. But state licensing laws make it really difficult for individuals, even with a bachelor’s degree in social work, to practice to the full extent of their ability.
****MS. MYRICK: People with serious mental conditions, like depression, anxiety, schizophrenia or bipolar disorder, can learn life skills that help them hold steady jobs, find secure housing and participate in community activities, like going to their local church or taking yoga classes at a YMCA. But too often, professionals who assisst these patients in the public system—practitioners paid by Medicaid, Medicare or the Department of Veterans Affairs—don’t focus enough on recovery. That is not only harmful to patients, who become increasingly isolated, but it also leads to shortages of service within the public health system. More people are now entering the public system than leaving it to live more independent lives. It’s like a balloon that just keeps getting bigger.
WSJ: Can drawing on people with different types of credentials and backgrounds help solve the shortage?
MS. MYRICK: The peer workforce—people who experienced mental-health or substance-use conditions and then are trained to support others—is one group. Peers have been through the process themselves, so they can help provide support. Peers help people cope and navigate the health system; they teach digital literacy and help find housing or employment. Having positive interactions with people who have experienced mental-health or substance-use conditions also helps reduce the stigma that is often associated with people who experience these ailments.
There are 49 states with peer certification through Medicaid, but peers are not widely used in the private sector. That is starting to change. Outcomes for peer initiatives include increased engagement with treatment and reduction in high-cost services, such as emergency-room treatment and hospitalizations.
DR. GRAZIER: There are effective programs in a growing number of high schools where mental-health clinicians train teachers and other staff members to screen and quickly assess students’ mental-health needs and then, if needed, connect them via telehealth with primary-care and mental-health providers for additional care. This training model expands the capacity of existing mental-health workers to reach vulnerable adolescents.
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