Since the onset of COVID-19, the term “mental health” has become a buzzword in the public consciousness. Going to a mental health provider — and publicly acknowledging it — is being destigmatized, person by person, story by story. However, the United States has begun to run into an issue: a shortage of behavioral health professionals.
To understand the heart of the issue, it is important to first know how we got here. Mental disorders (as specified by the Diagnostic and Statistical Manual of Mental Disorders, the holy grail of psychologists) are conditions that vary in impact and scope, with the ability to impair emotional, mental, or behavioral cognition. The National Institute of Health estimated the number of people in the United States struggling with these mental disorders as 59.3 million in 2022, totalling 23.1% of the population.
Of those numbers, only 30 million (50.6%) have been able to get treatment. Some of this is accounted for by external factors, such as there simply being too many patients for one provider to see. A lack of accessibility to certain populations provides another barrier, with the Health Resources and Services Administration estimating more than half of the United States population lives in a Mental Health Professional Shortage Area. Particularly prevalent in the more rural areas of the country, low incentives contribute to a lack of workers. Further issues include providers who are not representative of the populations they serve. The absence of shared experiences or commonalities can therefore be a deterrent for some. The largest reason, however, stems from simply a lack of behavioral healthcare workers themselves.
Despite psychology being one of the most popular undergraduate majors, few choose to go further into the field to become licensed as behavioral health workers. This is due in part to the requirements necessary to offer treatment, which is further schooling, often in the form of a master’s or doctoral degree. The incursion of additional debt is a barrier to many, as are the low reimbursement rates collected after graduation. Should one make it through their schooling, there is still the issue of licensure, which often requires a supervisor to watch over them as they gain clinical hours. This is no simple task, as it generally takes thousands of hours to earn their license to practice independently and supervision itself can be expensive as the trainee must pay for it out-of-pocket.
“The largest reason, however, stems from simply a lack of behavioral healthcare workers themselves.”
Furthermore, behavioral health shares the worrying trend of health professions having higher suicide and suicidal ideation rates. This could be due to the amount of providers who have mental illnesses themselves, such as depression, yet do not seek help for it. Additionally, the onset of post-traumatic stress disorder (PTSD) can often be the result of vicarious trauma shared by their patients. The high-stress environment often leads to burnout, with large swaths of the profession leaving to pursue less taxing careers. Thus a self-perpetuating cycle is created, with high patient caseloads driving provider burnout, which results in a larger amount of work for those remaining in the field.
That is not to say that this problem is unfixable. With the right toolset, such as incentivizing this new generation of behavioral health workers to advocate for changes to make these careers more sustainable, we can begin to bridge this lapse in mental health coverage.
More programs to expand loan forgiveness by the government in exchange for time served would ease the burden of the cost of schooling, as well as provide areas lacking coverage with more support. Further, standard regulations across the country would make it easier for providers to continue their jobs as their life situations change, rather than having to start from scratch or merely cease working in the mental health industry. This could lead to more opportunities for telehealth, which would ease the burden of patients needing to travel in person to get the help they need.
“With the right toolset, such as incentivizing this new generation of behavioral health workers to advocate for changes to make these careers more sustainable, we can begin to bridge this lapse in mental health coverage.”
Mental health is not going away. Patients need all the help they can get, and that starts by advocating for the changes necessary to sustain our behavioral health workforce.
