Closing Behavioral Health Workforce Gaps: A HRSA Program Expanding Direct Mental Health Service Access in Underserved Areas

A call to action to address rural mental health disparities

“…There is a significant lack of access to specialty mental health care in rural areas in the USA [5]. It is estimated that as many as 65% of nonmetropolitan counties do not have psychiatrists [6], and over 60% of rural Americans live in designated mental health provider shortage areas [13].…”

“…Though the prevalence of serious mental illness and most psychiatric disorders is similar between US adults living in rural and urban areas [3,4], adults residing in rural geographic locations receive mental health treatment less frequently and often with providers with less specialized training, when compared to those residing in metropolitan locations. The reasons underlying this mental health treatment disparity are well documented and include reduced access to providers and limited availability of specialty mental health care in rural areas, lack of trained mental health providers and care coordination in rural medical care, and underutilization of available services [5,6]. In addition, the uptake of innovative approaches to mental health care has not been as consistent in rural areas as it has in metropolitan areas, thus exacerbating already wide differences in access and quality of care [7].…”

“…Rural residents in large part experience substantial disparity in mental health outcomes because their points of dimensional overlap are associated with higher risk for poor mental health outcomes. Rural residents are more likely to be at points of dimensional overlap that include challenges accessing care systems due to geographic isolation, reduced access to and engagement with appropriate providers, lower socioeconomic status, generally lower levels of educational attainment, as well as reluctance to seek help due to discrimination and stigma [3][4][5][6]. Dimensional overlap is distinct from interaction in that the various dimensions may combine in a null, additive, or multiplicative fashion for various levels of analysis (e.g., individuals, families, and communities).…”

The Future of the Behavioral Health Workforce: Optimism and Opportunity

“…Effective workforce development is also critically important for enhancing quality of care. In this issue, Chapel et al 19 highlight the benefits of training workers to use Project ECHO TM 23 The research and programmatic efforts described in these articles have a shared aim of improving access to care in underserved areas and addressing the workforce capacity gaps in our nation's behavioral health workforce. We thank each of the authors for their contributions, dedication, and leadership as well as the American Journal of Preventive Medicine for permitting us to develop this issue.…”

Social workers in integrated health care: Improving care throughout the life course

“…Social work is one of the largest trained groups of professionals able to provide evidence-informed behavioral health treatment and the profession is growing in its expertise in integrated behavioral health. For example, the Health Resources and Services Administration's federal investment in 2014 and again in 2017 to train and expand the behavioral health workforce for practice in integrated settings is further confirmation of the synergies that exist for the social work profession and integrated models of care to help improve health outcomes (Kepley & Streeter, 2018). The focused education and clinical training of social workers in integrated behavioral health aligns with the projected demand for workforce growth; over the next 5 years, a 22% increase is expected for social workers in health care settings (U.S. Department of Labor, 2018).…”