At the State and Federal Level, We Have Many Options to Address Workforce Shortage

If I were an economist, perhaps I would have the answers to explain the vexing workforce shortage so many mental health and substance use treatment organizations face today.

But I’m not. I’m a social worker.

However, it does not seem that economists have figured out what’s behind the current workforce shortages in our country, and we’re all searching for answers.

So, we’ve proposed some solutions at the National Council, because we all know the workforce shortage is responsible for creating new barriers to access at a time when more people are seeking mental health and substance use treatment. In other words, the timing of this shortage is awful.

Research published earlier this month in the journal The Lancet illustrates the global impact of the pandemic on mental health. In their meta-analysis, they found an increase of 26% from 2019 to 2020 in the number of people reporting that they experienced anxiety.

Our own research at the National Council found that 78% of our members are seeing increased demand for services compared to three months ago, and 62% have longer waitlists. In addition, 97% of our members told us they are having difficulty recruiting new employees.

While we may not fully understand why these problems persist, we’re working hard to solve them so we can help the people and communities that rely on the mental health and substance use treatment organizations represented by the National Council.

Our collective wellbeing is at stake.

New Recommendations

While we’re always working with our allies on Capitol Hill on federal solutions, we’re also working with Health Management Associates (HMA) to develop recommendations for state governments to help mental health and substance use treatment organizations achieve more stability. Measures to improve recruitment and retention, reduce regulatory and administrative burdens and opportunities to take advantage of existing policies and programs to optimize the delivery of mental health and substance use treatment across the country.

Improving Medicaid and non-Medicaid funded program reimbursement rates will allow employers to boost salaries and other financial incentives that will help with recruitment and retention.

Eliminating administrative barriers and revising antiquated policies that prevent widespread adoption of evidence-based models such as integrated care, the psychiatric consult model, team-based care, and the expansion of the peer workforce will also provide immediate benefits for those providing care and those receiving care.

Our first policy paper with HMA includes many more recommendations, but the theme is clear: States have numerous levers at their disposal to help mental health and substance use treatment organizations, improve the delivery of care and promote the collective wellbeing of people and communities.

Legislative Proposals

We must be able to fulfill our obligation to provide treatment, so we have proposed two key pieces of legislation that would immediately expand access to lifesaving mental health and substance use care for Medicare beneficiaries by allowing Medicare to reimburse providers for their services.

The Mental Health Access Improvement Act (S. 828/H.R. 432) would allow marriage and family therapists and mental health counselors to receive reimbursement from Medicare for their services, adding an estimated 225,000 providers to the Medicare behavioral health workforce.

The Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act (S. 2144/H.R. 2767) allows for the participation of peer support specialists in the provision of integrated behavioral health services to Medicare beneficiaries. The legislation also provides a comprehensive definition of peer support specialists in the Medicare program.

We Need Workers… and Political Will

Our virtual advocacy event on October 19, Hill Day at Home, illustrated just how many mental health and substance use treatment organizations are determined to raise awareness about workforce shortages. Our panel on the topic, “Workforce Shortage in America: Discussing Innovative Solutions and Areas of Opportunity,” was among the most well-attended sessions we presented.

It’s plainly obvious that the mental health and substance use workforce shortage requires immediate attention.

It’s equally apparent that the workforce issue is also a healthcare issue. The lack of workers throughout mental health and substance use treatment organizations – psychiatrists, nurse practitioners, social workers, case managers and more – limits the ability to provide care.

As The Lancet pointed out in its recent research, the need is greater than ever. There is no excuse for allowing the workforce shortage to continue, and we have state and federal solutions to help alleviate those shortages.

We just need to find the political will to act.

Our collective wellbeing depends on it.


Charles Ingoglia, MSW
(he/him/his) President and CEO
National Council for Mental Wellbeing
See bio