Provider shortages in healthcare have been widely reported, and the problem appears particularly acute in behavioral health. Leaders should be engaging in four key dialogues related to the workforce, according to healthcare consulting firm The Advisory Board.
1. How are you investing in emotional support for your behavioral health workforce? How can you ease their administrative burden?
The field is a challenging one, and it takes a lot of emotional labor. It takes a lot of administrative labor, too: psychiatrists devote an average of 15.9 hours per week on paperwork and administrative tasks. That all translates to a high risk of burnout, and burnout begets turnover.
Even getting paid can be a chore in the best of scenarios. Reimbursement structures vary widely across states, professions and payers, and participating in multiple health plans involves, again, lots of paperwork.
In other words, an overwhelming administrative burden in exchange for often underwhelming reimbursement rates. It’s no wonder so many don’t accept insurance at all — an unfortunate fact for the tens of millions of people who are thus priced out of behavioral healthcare despite having the greatest need.
2. Which patients in our community have a harder time accessing behavioral healthcare? What could we do to make access more equitable?
It can take patients several months to find any provider, let alone one who meets their needs. Patients’ conditions often become more complex and severe when they are unable to access preventative or low acuity care. They may ultimately be treated in high-cost sites like emergency rooms.Comorbidities can worsen when patients can’t find sufficient behavioral health treatment, which increases the total cost of care.
Workforce shortages contribute to equity concerns as well: Therapists call back white middle-class women 20 percent of the time, but only 1 percent of the time for Black working class men. Geographic disparities exacerbate problems with access, too, with 45 percent of the U.S. population living in a designated mental health professional shortage area.
There is also an underrepresentation of professionals with marginalized identities entering the workforce, making it difficult for some patients who wish to see a provider of a similar background.
3. How can we partner with local stakeholders to build a diverse pipeline of behavioral health professionals for the roles with greatest demand?
The behavioral health workforce’s current growth rate isn’t enough to meet demand. With nearly 60 percent of all practicing psychiatrists at least 55 years old, the industry could soon see a disproportionately high retirement rate compared to the number of psychiatrists entering the field, according to Merritt Hawkins. The increased acuity and demand of behavioral health needs since the outset of the pandemic has made the sector unappealing for some.
4. Which state or federal policy changes would have the biggest impact on our ability to better meet behavioral health demand?
Federal and state policies can ultimately adjust the sliders on nearly every aspect of behavioral healthcare economics. Policy regulates, for example, who can be reimbursed for certain types of care — and for how much — along with where and how they may deliver that care.