Michigan cannot fill mental health jobs amid COVID. These ideas might help.


Get help where it’s needed most

With a shortage of mental health workersadvocates point to a range of state or federal measures that could improve access to care in underserved areas of the state, including:

University loan repayment:

Expand federal loan programs that provide college loan repayment to primary care medical and behavioral health professionals who stay in underserved areas for at least two years.

the National health service body loan program – a division of the US Department of Health and Human Services – provides medical and behavioral health clinicians with student loan repayment of up to $ 50,000, as well as a competitive salary in return for their service in the urban, rural or tribal areas of the nation with limited access to health care.

The loan program’s approved specialties include psychologists, licensed clinical social workers, psychiatric nurses, marriage and family therapists, and licensed professional counselors.

“On the professional side, there is a real problem with loan forgiveness,” said Robert Sheehan, CEO of the Community Mental Health Association of Michigan. “Most of these people coming out of school have quite a lot of debt. Many of them are leaving the state. Many of them go on to different careers.

In 2019, Michigan university graduates had an average student loan debt of approximately $ 35,000. Debts were even higher for those with master’s degrees, which are required in many areas of the mental health profession.

State loan program for physicians

Support and develop MIDOC, a publicly funded program to expand residency positions in a variety of medical specialties, including family medicine, internal medicine, pediatrics, obstetrics and psychiatry. With Michigan having just over 1,100 psychiatrists in 2016, a federal health study found the state should be 890 psychiatrists short of need by 2030, including a shortage of 100 psychiatrists seeing children.

MIDOCs is offering up to $ 75,000 in loan repayments to medical residents who fill these positions and commit to practice for at least two years immediately following their residency in an underserved rural or urban Michigan setting.

According to its supporters, it has the potential to produce 500 new physicians working in underserved areas of Michigan over the next 10 years.

Authorized by legislation in 2017, MIDOCS is a consortium of medical schools from Central Michigan University, Michigan State University, Wayne State University and Western Michigan University in partnership with the Michigan Department of Health and Human Services .

MIDOCS is funded to the tune of $ 5.4 million for the 2020-2021 fiscal year, with the expectation of continued funding for five years.

Increase the remuneration of direct care workers

Michigan currently lacks 34,000 Michigan direct care workers, who provide everything from home care for the elderly to hands-on care in nursing homes and adult foster homes. In a December response to COVID-19, the Michigan legislature extended a $ 2 an hour wage hike for these workers, which expires in late February. Governor Gretchen Whitmer proposed to make this salary increase permanent in his State of the State address on January 27.

Direct care workers have a national annual turnover rate of around 80 percent, with many leaving jobs that pay $ 12 an hour to work in the retail or fast food industry.

Students Need Help, Michigan Provides Less

Behavioral health experts are particularly worried about the emotional toll of COVID on children.

“We are very concerned about the isolation children are feeling right now in the pandemic,” said Kristin Gietzen, president and CEO of Arbor Circle, a West Michigan nonprofit behavioral health provider that serves approximately 5 000 children and adolescents, in addition to adults.

“The children went through a trauma. They were taken out of their normal life. They are simply not able to engage in the same type of social development that children need.

Indeed, polls indicate an increase reports of depression and feelings of loneliness in children and adolescents during the pandemic.

Even before the virus, a 2019 analysis by the Journal of the American Medical Association Pediatrics found that one in six American children aged 6 to 17 suffered from a treatable mental health disorder like depression, anxiety. or attention deficit hyperactivity disorder. Almost half of these children received no professional advice or treatment.

Gietzen said his agency has 16 vacancies for adolescent and child services, out of a workforce of around 110. The average number of applicants for openings requiring a master’s degree has fallen by 50% compared to the previous year. last year and 70% compared to the previous year.

The agency has openings for four master’s level clinical therapists for a program that connects them with families who have a child in mental health crisis.

COVID-related restrictions are also hampering the program. Gietzen said safety precautions have largely stopped home visits which she says are critical to the success of the program.

“The purpose of the service is to come into the house and observe the interactions with the family and observe the setting and really see what the child’s life is like.

“When you can’t do that, when you end up with a telehealth platform to do your job, you don’t see that many. “

COVID has also exposed the state’s meager investment in mental health supports in schools. Michigan continues to row down nationally for elementary and secondary school counselors.

Michigan schools had a student-to-counselor ratio of 691 to one, the second worst in the country, ahead of Arizona alone, according to a 2018-19 survey by the American School Counselor Association. The national average was 430 students per counselor.

Experts agree that counselors and other mental health professionals can be critical to the psychological well-being of students, especially as the pandemic is adding layers of stress and social isolation to their lives.

To close this gap, the legislature has set aside more than $ 30 million per year since 2019 to help K-12 districts hire more social workers, counselors and psychologists. To date, schools have added about 165 of these positions, according to Diane Golzynski, head of the Michigan Department of Education.

But in a statewide school system of 1.5 million students and more than 500 local school districts, Golzynski said that still leaves a significant void for mental health support and counseling.

She noted that even before the pandemic, youth suicides had climbed for years in Michigan. Suicide is now the second leading cause of death in the state for people aged 10 to 24.

Golzynski said some school districts have been unable to add more professionals even with the additional funds available.

“We’ve had a few positions that stay open for months,” she said.

Therapy gives way to triage

Returning to community care services in the Detroit metro area, adult therapist Ellen Robey said she had a workload of around 100 clients for most of her 18 years at the agency.

Now, she juggles around 270 clients at any given time, including families in crisis, the homeless, those with suicidal thoughts or grieving a family member.

“It’s not like ongoing therapy,” Robey said. “It’s more like a triage in the situation we have right now.”

As the number of cases increases, Robey said the agency has changed appointments to ensure people with mental health crises are dealt with first or quickly referred to the appropriate source.

This inevitably means that Robey cannot devote the time and attention that she wants to customers.

“You can’t provide them the ongoing support like you could before. Sometimes people need help filling out paperwork, but it can be hard to find the time to do it. Even having time for a phone call back is difficult.

“When I arrive on Monday, I have my whole day filled,” said Robey. “From 9:30 am to 6 pm, I’ll be full. “


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