Mass General Brigham's four-part strategy to address the behavioral health workforce shortage

Somerville, Mass.-based Mass General Brigham has a four-part strategy to build the behavioral health workforce. 

Joy Rosen, vice president of behavioral health at the system, told Becker's that for every 13 retiring clinicians in Massachusetts, only nine are entering the workforce to take their place. Facing a looming wave of retirement, Mass General Brigham is implementing several initiatives to increase the number of mental health professionals in the state.  

"All of these are long-term strategies. None of these are going to pay off tomorrow," Ms. Rosen said.  

The first part of the strategy was to increase compensation for providers across the workforce, including psychiatrists, psychologists, nurse practitioners and social workers. 

"It's not 100% there. We still have a ways to go, but we have made a pretty significant dent in improving salaries," Ms. Rosen said. 

The second part of the strategy was to expand both of the system's residency programs, which is the best way to retain psychiatrists after they graduate, Ms. Rosen said. The third part is  adding partnerships with 10 higher education institutions across Massachusetts, designed to educate more social workers, nurses, occupational therapists and other nonphysician mental health providers. The program is designed to graduate an additional 835 practitioners in the state.  

"I think we have a fourth area, which we are just beginning to tap," Ms. Rosen said. "And that's our career ladder. We haven't yet figured out what our plan is for that, but that is a critical piece of the work we need to do. In addition to compensation, it's also making sure that people who go into this field do not feel like they are going into a job that is a dead end but has opportunities for growth professionally." 

Getting creative about care 

Access challenges are created when the growing demand for mental healthcare meets the shrinking workforce, Susan Szulewski, MD, chief medical officer of McLean Hospital and vice president of medical affairs for behavioral and mental health at Mass General Brigham, told Becker's. 

Behavioral health has a "long-standing mismatch of demand to capacity," Dr. Szulewski said. To mitigate these challenges, Mass General Brigham created a centralized behavioral health access center, designed to match patients with available bed space at any hospital in the system when they need it. 

"We really came together as a coordinated system with shared accountability over our patients' care, and created a centralized point of access using data-driven, real-time tools, so that we could know who our patients are in our emergency rooms, and then match them to our beds in our system," Dr. Szulewski said. "Ultimately, the goal was to more efficiently use our assets and match the right patient to the right bed at the right time." 

Even given a number of efforts to increase workforce supply and use resources more efficiently, there will likely never be enough professionals to address the need for mental healthcare, Ms. Rosen said. 

"We have to get much more creative about how we deliver care, and I'm not just talking about telehealth, which I think is really important. … We need to be thinking about how we are training our next generation of clinicians, so they really can provide care in primary care offices and deal with patients who have a lot of comorbid medical, as well as psychiatric, needs," Ms. Rosen said. 

Another strategy in the playbook? Taking a preventive approach to mitigate the need for acute mental healthcare, Dr. Szulewski said. 

"Most people think that there are not ways to mitigate getting care or treatment, if it's inevitable," Dr. Szulewski said. "[We're] really focusing on the preventive aspects, early screening, decreasing stigma and doing all we can to really enhance access to care." 

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