Oswalt: Exciting progress in reducing Virginia’s mental health workforce shortage | columnists

Deborah Oswalt

Sometimes the overwhelming nature of a large complex problem hinders its solution. That could certainly apply to the mental health crisis Virginia is currently experiencing.

The COVID-19 pandemic and societal stressors have triggered depression, anxiety, panic disorder and other mental illnesses in an extraordinary number of Virginians of all ages across the state.

The exploding demand for mental health services cannot be met by the dwindling number of behavioral health professionals in the public and private sectors.

Fortunately, the Virginia General Assembly has stepped up to address this troubling shortage through a series of initiatives for the mental health workforce included in the just-passed state budget. This will help bring relief to many Virginians through a variety of approaches, including several innovative ones.

Problem #1: 61% of psychiatrists in Virginia are 55 years of age or older and 54 communities have no psychiatrist. Not surprisingly, these mostly rural locations score much worse than the state as a whole on key behavioral health indicators. Unfortunately, the pipeline to replace those who are retiring is not producing even enough psychiatrists to sustain the current insufficient psychiatrist population. To counteract this situation, the General Assembly has funded 10 new psychiatric residencies.

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Problem #2: The number of Licensed Clinical Social Workers (LCSWs) and Licensed Professional Counselors (LPCs) is insufficient to meet the demand for counseling and the other therapies they are trained to provide.

The new state budget includes two innovative initiatives that will immediately increase the availability of counseling services and will ultimately add more than 200 licensed therapists to the mental health professionals practicing in Virginia.

One addresses a significant financial barrier to admissions of Masters of Social Work (MSW) and Masters of Counseling (MC) graduates by paying for oversight of the clinical hours required for admission. Many master’s graduates cannot afford the fees for 100 to 200 hours of required supervision, and Virginia consequently loses the advantage of having a robust corps of talented therapists. The new initiative, Boost 200, will test the impact and value of government payment for monitoring 100 MSWs and 100 MCs. Applicants who practice in any of Virginia’s 93 localities that have a shortage of mental health professionals (such as much of the Roanoke Valley and west), or who are colored or bilingual, will be given priority.

The other inventive approach provides an opportunity to address the vast array of student mental health problems in Virginia’s colleges and universities. The General Assembly, through grants from the State Council on Higher Education for Virginia, has provided funding for college student health centers to hire MSWs or MCs. The required guidance will be available under supervision in the short term and Virginia will attract more LCSWs and LPCs in the long term.

Problem #3: Many children suffer from depression, anxiety and other mental health problems. Pediatricians typically do not have the training to treat them and are not equipped to manage mental health in their offices.

The General Assembly provided additional funding for the creative and effective Virginia Mental Health Access Program, which gives pediatricians the training and tools they need to help children with mental health challenges. This includes year-round educational opportunities and access to child and adolescent psychiatrists on call 40 hours a week. It also provides nursing navigation and pointers to needed resources.

A robust workforce of licensed behavioral health professionals is essential to making the required mental health services available in both the public and private sectors. No single initiative can address the current and growing scarcity. The multidimensionality of solutions and strategies requires a multi-pronged approach with cross-sector commitment, focus and investments of time, money and attention directed towards initiatives that deliver measurable results. To determine the most effective ways to expand the behavioral health workforce, the General Assembly has directed the Office of the Governor to appoint a member of the Executive Branch to serve as an advisor to Virginia’s health workforce development and has allocated some funding to support the effort.

Virginia is a “can do” state. It has been successful whenever its leaders focused on improving the Commonwealth’s performance or ranking. The new behavioral workforce initiatives included in the budget just passed by the General Assembly are a wonderful start to filling the shortage of these valuable and needed professionals. We are on our way.

Oswalt is the founding director of the Virginia Health Care Foundation in Richmond, a public-private partnership. The Foundation’s mission is to improve access to primary health care for uninsured and medically underserved Virginians through innovative programs and service delivery models.

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