A representative behavioral health workforce is critical to reversing worsening mental health and substance use trends in the U.S., according to a comment piece published Jan. 5 in Nature Mental Health.
The paper — written by researchers from Baltimore-based Johns Hopkins University and Fairfax, Va.-based George Mason University — emphasizes the importance of provider-patient concordance — alignment in identity, experience, language or community — as a driver of trust, treatment engagement and improved health outcomes. The authors argue that a lack of diversity among behavioral health providers is a structural barrier that continues to fuel inequities.
The authors highlight long-standing disparities in behavioral healthcare among minority racial and ethnic groups, individuals with limited English proficiency and those living in behavioral health shortage areas. It outlines evidence that concordant care improves adherence, symptom reduction and care continuity, and proposes policy changes to build a more representative workforce.
Their recommendations include strengthening workforce pipelines, expanding scope-of-practice laws, integrating culturally and linguistically appropriate standards into quality metrics, and requiring disaggregated provider data to ensure accountability.
The authors also warned that recent legal and political developments — including the Supreme Court’s decision in Students for Fair Admissions v. Harvard and efforts to roll back DEI standards — could hinder progress at a time when the crisis is escalating.
“Efforts to build a representative behavioral healthcare workforce are being undermined by flawed assumptions,” senior author Vincent Guilamo-Ramos, PhD, RN, executive director of the Institute for Policy Solutions at Johns Hopkins, said in a Jan. 5 news release from the university. “A representative workforce is not only diverse, inclusive and equitable, and does not only meet objective performance standards — it outperforms an underrepresented workforce. Efforts to undermine or reduce representation will deepen inequities and worsen the nation’s behavioral health crisis.”
Read the full paper here.
