Report finds ‘workforce crisis’ is causing long waits for mental health care in Massachusetts

A new report suggests a “workforce crisis” is affecting mental health care in Massachusetts, leading to longer waits for outpatient treatment and fewer people receiving care.

The Association for Behavioral Healthcare report released Tuesday said the average wait time in the state for an initial mental health assessment by a licensed clinician is over two months. He found that more licensed clinicians leave their positions than are hired.

The report’s findings were based on surveys of 37 agencies that represent 124 outpatient clinic sites across Massachusetts. The clinic sites served nearly 93,000 people in the 12 months leading up to the polls last October and November.

Almost all clinics reported increased wait times with nearly 14,000 people on waiting lists. According to the report, the average wait for an assessment or therapy for children and young people was three weeks longer than for adults. Clinics also reported serving 11% fewer people in 2021 than before the coronavirus pandemic began, despite COVID’s growing demand for mental health services.

“Access to outpatient mental health services continues to decline,” the report said. “Without substantial new private and public sector investment and the implementation of bold strategies, access will fall further and result in a system-ending labor shortage for ambulatory care and health services. acute mental.”

The factor that largely explains the long waits, according to the survey, was the shrinking workforce. The report found that for every 10 master’s-level mental health clinicians hired, 13 similarly qualified clinicians left in 2021. Nearly half of outpatient clinics said it took at least nine months to fill an Independent Certified Clinician position. ABH members reported that each clinician served at least 40 people and that many left their jobs because of salaries.

“We’re concerned that what the data is showing us is that maybe a generation of people just did the math and decided they didn’t want to get into this field,” said Lydia Conley, president and CEO of the Association for Behavioral Health Care. “That’s what was so concerning about the study – is it the harbinger of a really significant impact on the delivery system right now?”

Conley said many clinicians leave clinics to work in acute care hospitals, where salaries are often higher. The state has also increased the number of acute psychiatric hospital beds in response to a dramatic increase in the number of mental health patients admitted to hospital emergency rooms. But Conley said it contributed to worker shortages by creating “a potential revolving door” for workers to travel to more acute settings, leaving outpatient clinics with fewer resources and fewer staff.

“This pressure from ER boarding is causing new beds to be created, and beds are badly needed, but what it does is redirect that shrinking workforce to those settings” , Conley said. “So if we don’t do anything to really rethink outpatient services and invest in outpatient services, we’re never going to address the root cause of boarding school.”

Conley said the state has made efforts to improve mental health care, pointing to new legislation and Gov. Charlie Baker’s “Roadmap for Behavioral Health Reform,” which called for the creation of mental health centers. community and emergency care for mental health. The ABH report said the state’s efforts provide “solid frameworks on which to build.”

The report made several recommendations, including rebalancing health spending toward behavioral health and primary care and increasing repayment rates and student loan repayment programs for some clinicians.

Additionally, the report called for greater transparency from commercial insurers about reimbursement rates to clinicians and enabled them to provide a more comprehensive assessment of the state’s mental health workforce.

Michael A. Bynum