Foundational to combatting America’s opioid epidemic is ensuring those who want to receive treatment can access it. Yet, across our country, there’s a growing gap between the supply of workers trained to treat substance use disorder and the demand for help from those who suffer from the disease. Grim statistics tell this story.
Two out of three primary care physicians seeking mental health services for their patients said they couldn’t secure outpatient care in part because of worker shortages. Across the United States, 316,000 people who sought addiction treatment were unable to obtain it. Without action, the problem will get only worse. By 2025, the chasm between the supply and demand of behavioral health professionals is projected to balloon to 238,000 workers.
If we’re going to make headway against the opioid epidemic — undoubtedly one of the greatest health challenges facing our generation — we must find ways to bridge this gap. The burgeoning nature of the opioid epidemic should fuel our collective urgency: for the first time in history, Americans’ odds of dying from an opioid overdose are greater than their chances of being killed in a car accident.
Addressing the talent gap among behavioral health professionals requires confronting long-standing obstacles for those entering the field: high burnout rates, cumbersome licensure processes and financial disincentives like high student loan debt and relatively low pay. Overcoming these will take myriad actors working together on a multi-pronged approach.
Changes to federal law would play a critical role in helping to solve the problem. While there are many types of behavioral health professionals who could treat substance use disorder, under current federal law only licensed clinical social workers can bill Medicare for treatment. Since funding for behavioral health services already is constrained to a handful of sources, such as self-pay, insurance, Medicaid and Medicare and limited grant dollars, this reimbursement limitation impedes other behavioral health professionals who could treat substance use disorder — or get trained to treat it — from doing so.
By opening Medicare reimbursement to these other categories of workers, such as licensed clinical addiction counselors or licensed medical health counselors, it would broaden the funnel of talent to specialize in this treatment area and help infuse the worker pipeline at a time of unprecedented need.
At the same time, locally driven approaches — typically partnerships between public and private actors — offer solutions that can be scaled nationally.
In Indiana, for example, universities, health care providers and workforce development groups are collaborating to create a streamlined pathway for licensed clinical social workers to get dual licensure in treating addiction. That ensures they receive the specialized, addiction-focused training they need, along with the ability to be reimbursed for treating those with substance use disorder.
This effort, known as the Community Behavioral Health Academy, is designed to combat low pay, high student debt, cumbersome licensure processes and other hurdles to attracting and keeping talent in the behavioral health field. Program participants receive up to $10,000 in financial incentives, support with licensure attainment and built-in opportunities for employment. Other communities could look to this model as inspiration in addressing the behavioral health worker gap.
Challenges on the scale of the opioid epidemic historically have played a powerful force in bringing our nation together. Consider that even in the most fragmented political times, American policymakers have united to tackle the opioid epidemic, as shown by a sweeping package of bills designed to combat the nation’s opioid crisis that sailed through Congress late last year.
Our nation’s leaders can build on this momentum by combatting America’s behavioral health talent gap. Let’s work together to solve this pressing problem.
