Low wages, student debt create shortages in behavioral health workforce

A recent report shows that low wages and high student debt levels are driving shortages and turnover

Courtesy of kaiserpermanente.org

According to a recent report by the Washington Workforce Training & Education Coordinating Board’s Behavioral Health Workforce Advisory Committee, low wages and high student debt levels are driving shortages and turnover among counselors, social workers, psychologists and other behavioral health workers in Washington.

Experts recommend state lawmakers consider two strategies to fight the ongoing shortage in Washington’s behavioral health workforce: Help raise wages and address student loan debt. A recent report shows some mental health counselors have average loan debt of $145,000, and make about $59,000 a year, for example.

These strategies were recommended by the Behavioral Health Workforce Advisory Committee in a new report, according to a news release from the Washington Workforce Training & Education Coordinating Board. The committee includes many of the state’s leading behavioral health care experts and is one of several that advises Washington leaders on current workforce challenges and solutions.

Washington’s Workforce Training and Education Coordinating Board has led efforts to address behavioral health workforce barriers since 2016 and manages this advisory committee.

Demand for drug and alcohol counseling and mental health services has increased since the pandemic. At the same time, a lack of providers has made access to this care difficult for many Washington families.

The report recommends:

-Address low wages by advocating for increased Medicaid reimbursement rates and a new statewide reimbursement plan for services funded by the federal government. This model, if adopted, would help behavioral health clinics raise wages for counselors and social workers, for example.

-Boost state funding for behavioral health education loan repayment programs.

-Increase state funding to administer and evaluate the Washington Health Corps program, which includes the loan repayment program.

-Require employers and state officials to provide more information about the federal Public Service Loan Forgiveness program to help qualifying health care workers have their federal loans forgiven after 10 years.

-After studying results of a pilot project, fund scholarships for behavioral health students who agree to work in facilities that serve Washington residents with the greatest needs after graduation. 

-Increase awareness that providers who work in community settings such as homeless shelters and supportive housing can count those hours toward loan repayment programs.

Sean Moore, senior healthcare project manager with Workforce Southwest Washington (WSW), said that the report from the state’s workforce training and education coordinating board is correct and the shortages are being seen in Southwest Washington.

“A master’s degree in social work has the honor of holding last place in wages for those entering the profession,” Moore said. “Many of our local businesses struggle to attract and retain talent. As for those with the higher degrees, most of the opportunities are in state/local government/schools, where wages are not known to be high. Private practice or leadership is the only way up for earning more at this point.”

To try and meet the demand for workers, Moore said there are three new Behavioral Health Apprenticeships here in Washington. They train to entry level jobs, which pay only in the low-to-mid $20/hour range. Moore said that WSW’s workforce partners in Portland will host a Behavioral Health Hiring event in January to attract attention to opportunities.

Nick Norman, business relationship manager with Mindful Therapy Group (which opened in office in Vancouver last January), said issues such as low compensation and high education cost certainly impact the desire for students to enter the mental health field. He said that even more, they are seeing shortages in the behavioral health workforce due to providers leaving the profession altogether.

“Community mental health agencies often offer low wages and require clinicians to maintain caseloads that are too large to do quality clinical work,” Norman said. “This drives clinicians to private practice where they often have to refuse to accept insurance due to the low reimbursement rates, which is not maintainable either.”

However, Norman said that at Mindful Therapy Group they don’t see the same issues due to how they have structured their organization.

“We operate under the assumption that mental health clinicians offer a valuable service and that they deserve to be compensated accordingly,” Norman said. “Our clinicians are all private practitioners, so they retain the right to make decisions for their practice and to trust their clinical judgment in how they care for their patients. We work with insurance companies under a group contract, which allows us to negotiate higher reimbursement for our clinicians and ensure that they can make a sufficient income. This allows them to maintain a realistic caseload and ensure that they are providing high-quality mental healthcare to their patients.”

“Wages and student loan debt are major barriers to solving Washington’s behavioral health workforce shortage,”said Eleni Papadakis, executive director of the state’s Workforce Board. “Community clinics in rural and underserved areas are especially impacted. This means less help for Washington families when and where they need it the most. Addressing this challenge requires more than investing in loan repayment programs. We need a comprehensive strategy to both retain our current workforce and reduce the cost of education for students considering this field.”

The report also analyzed the results of the state’s investment to strengthen the behavioral health workforce in recent years.

The state has twice moved to increase federal Medicaid reimbursement rates; increased investments in the student loan repayment program for behavioral health providers; provided relief funds for community-based clinics; and created new programs to help primary care doctors connect with mental health experts and other resources to help patients.

Joanna Yorke-Payne
Joanna Yorke is the managing editor of the Vancouver Business Journal. She has worked in the journalism field since 2010 after graduating from the Edward R. Murrow College of Communication at Washington State University in Pullman. Yorke worked at The Reflector Newspaper in Battle Ground for six years and then worked at and helped start ClarkCountyToday.com.

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