Workforce Implications of Behavioral Health Care Models: Final Report

Workforce Implications of Behavioral Health Care Models: Final Report

Published: Mar 30, 2021
Publisher: Office of Behavioral Health, Disability, and Aging Policy Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services

Stefanie Pietras

Key Findings
  • Workforce efficiencies common across various behavioral health models include: (1) using staff with lower levels of training and credentials to augment service provision; (2) permitting staff to perform all functions within their scope of practice; (3) directing consumers to the appropriate staff or level of care; (4) using technology to extend provider reach; and (5) increasing capacity for nonmental health and SUD providers to treat people with mental health and SUD conditions.
  • Utilizing PMHNPs to perform the full range of functions permitted within their scope of practice may increase access to behavioral health care.
  • Using behavioral health mobile apps to augment clinical treatment may increase the efficiency of behavioral health care, potentially enabling clinicians to see more clients over time and increase access to care.
  • Crisis services strive to quickly stabilize individuals in less intensive settings using a mix of staff with strong engagement and support skills; they may reduce the demand for higher-cost professionals who would otherwise be needed in greater numbers if conditions were to escalate without this strong and timely recovery-oriented focus.

Mental health and substance use disorders (SUD) are among the leading causes of disability in the United States. Despite their prevalence, many people who require behavioral health services do not receive care, potentially due in part to behavioral health workforce shortages. Workforce shortages are projected to continue in coming years; therefore, it is critical to identify ways to more effectively use the workforce to increase access to care and better meet the needs of those with mental health disorders and SUD. Through a targeted environmental scan, interviews with subject matter experts, and virtual case studies, this project investigated promising behavioral health models to expand the delivery of services by, in part, reorganizing or transforming the behavioral health workforce, and the barriers and facilitators to their widespread adoption. The project identified and described workforce efficiencies across common behavioral health service delivery models and focused in-depth on three promising models: (1) psychiatric mental health nurse practitioners; (2) behavioral health mobile applications; and (3) crisis services. Findings suggest that each of these models offer some potential for increased workforce efficiencies and—with changes to funding and other policies--could increase provider supply and access to more appropriate levels of care.

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