Ohio’s mental health system ‘in crisis’ due to worker shortages

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Ohio’s behavioral health system desperately needs more counselors, psychologists and other behavioral health workers to meet the increased demand for mental health and addictions services and reduce downtime. waiting times that have lengthened in recent months, according to industry leaders.

The state’s behavioral health system is struggling to keep up with a surge in demand for services at the same time it is hit by a labor shortage that is affecting industries across the country.

“We are in crisis,” said Lori Criss, director of the Ohio Department of Mental Health and Substance Abuse Services (OhioMHAS). “The increased demand for mental health and addictions services far exceeds the available supply of professionals and paraprofessionals who provide these services. »

Lori Criss, director of the Ohio Department of Mental Health and Substance Abuse Services (OhioMHAS)

The gap between supply and demand is resulting in long wait times to see a provider, a shortage of supervised crisis beds across the state, and an inability to maintain partnerships between key collaborators who help connect Ohios in crisis with the help they need.

OhioMHAS Study showed that even before the pandemic, the industry was struggling to keep up with demand.

  • Between 2013 and 2019, more than one in five Ohioans lived with a mental health or addiction disorder.
  • During the same period, the demand for behavioral health services increased by 353% while the workforce only increased by 174%.
  • Nearly 2.4 million Ohioans lived in communities without enough behavioral health professionals.

These stark figures, released in 2021, do not take into account the effects of the pandemic, which began in 2020. Experts say COVID-19 has exponentially worsened an already dismal situation.
“The behavioral health system has never really had as much manpower as it needs, but the extreme post-pandemic disparity is beyond anything I’ve seen,” Criss said.

To address the shortage, Ohio agencies and providers are embracing investment, innovation and creativity in hopes of providing Ohioans with the care they need when they need it.

Governor DeWine’s $85 Million Plan

In May, Ohio Governor Mike DeWine announced an $85 million partnership between OhioMHAS and various institutions of higher education in the state.

The plan aims to increase the number of future behavioral health workers in the pipeline by supporting paid internships and scholarships for students working toward behavioral health certifications and degrees, according to a Press release.

“When we first approached higher education [leaders], we were met with such enthusiasm for this proposal that it was truly inspiring,” Criss said.

The plan will also help remove financial barriers to obtaining the licenses, certifications and exams required for employment in mental health fields, according to the release. The funding will be used to create an Ohio Technical Assistance Center to help students navigate state and federal funding opportunities available to them and help them plan and budget for loan repayment, according to Criss. .

The tricky part is convincing prospective students to pursue a career in behavioral care. That means getting into high schools and colleges to help young people understand that mental health and addictions care has positives that aren’t often highlighted, Criss said.

“We really need to focus on the opportunity to help others and how behavioral health care helps people live their best lives,” Criss said.

Bed allocation

Scott Osiecki, executive director of the Alcohol, Substance Abuse and Mental Health Services (ADAMHS) Board of Cuyahoga County, agrees that attracting new behavioral health workers is important, but he said he was equally important to address some of the reasons people leave the field.

Scott-Osiecki ADAMHS Board of Directors

Scott Osiecki, Executive Director of the Cuyahoga County Alcohol, Drug and Mental Health Services (ADAMHS) Board

Osiecki said he has heard directly from many professionals who report that the training and compensation they receive is not adequate for the stress and trauma they experience in the field.

“People are coming out of college with huge debt and earning less than they could in a supermarket where they would be under a lot less stress,” Osiecki said. “It’s no surprise that there is an exodus from the field.”

This contributes to worker shortages and longer wait times, Osiecki said, pointing to the crisis beds at their facilities in Apple tree, Bellefaire JCB and OhioGuidestone.

In recent years, there have been waiting lists for young people between the ages of 8 and 17 to access these highly supervised spaces for intensive, individualized, short-term therapeutic services.

In 2019 and 2020, the vast majority of people on waiting lists – 70% and 85% respectively – were waiting due to difficulties finding the appropriate facility for the age and gender of the young person in crisis. Less than a third of patients were put on the waiting list due to an inability to staff emergency beds.

In 2021, however, the problem was the staff. Nearly two-thirds of people on the waiting list were unable to get a bed because there were not enough staff to staff the facilities.

“These agencies just can’t operate at full capacity because of the shortage,” Osiecki said.

While stressing that there is no silver bullet, Osiecki said the ADAMHS board has begun to address the financial pressures on those entering or already working in the field. This includes increasing salaries, granting signing bonuses and analyzing various methods of paying a higher overall salary, he said.

Like OhioMHAS, the ADAMHS board is also reviewing the pipeline, creating videos for elementary and high school students to highlight the wide range of positions available in healthcare. behavioral health. Providers have joined forces to create a task force to help provide paid internships for students.

Hopefully these efforts bear fruit, Osieki said, as demand is not expected to falter.

“Calls for crisis support will only increase,” he said. “We need to recruit more staff to better meet the needs of our community.

When demand is a good thing

Although the increase in demand for mental health services has strained the system, some providers say the demand itself is a positive development in the field of behavioral health care.

“We’ve really broadened the acceptance of mental health care, especially within stigmatized communities,” said Allyse Hawkins, Clinical Director of Oriane’s house.

Oriana House provides community corrections services to people who have been involved in the criminal justice system. This includes mental health and addiction counselling, cognitive skills training, and other holistic services for people in halfway houses, community correctional facilities, drug courts, or any other setting where clients are not incarcerated.

Hawkins explained that many Oriana House clients have experienced negative side effects from the shortage of behavioral health workers in Ohio.

“The shortage has affected everything from how quickly we can complete an assessment, to when people can start treatment, to how long they have to wait to get into a group,” Hawkins said.

To help customers access services faster, Oriana House had to think outside the box to present its services in a different way, she said.

Previously, group classes – such as addiction, anger management, bereavement or trauma groups – were closed, which meant that the cohort you started the group with was the same cohort you finished with. some months later. If individuals relapsed or couldn’t complete a session, they were usually unable to stay in the group.

Now those rules have changed.

“We’ve opened up all of our groups to maintain a steady flow of people,” Hawkins said. “It also means a provider can see eight people per hour, instead of just one.”

Oriana House has also adopted telehealth as a counseling option. Although no-shows are a regular and expected occurrence for behavioral health appointments, the current system cannot spare a provider a free hour because it was reserved for someone who did not show up. Now, when people reach out to say they can’t make an appointment, they quickly receive a link to connect them virtually to an advisor.

“The key for us is to be creative without ever sacrificing the level of quality that our customers so desperately need from their suppliers,” Hawkins said.

Immediate assistance

Customers facing long waits were forced to adopt creative solutions to overcome jet lag before they could find professional support.

Archie Green, a Cleveland-based mental health advocate and “Neighborhood Cope Dealer,” wants Ohioans to know that there are a ton of tools at their disposal to navigate those in-between times.

Archie Green

Archie Green, a Cleveland-based mental health advocate, says there are tools that can help manage the wait for behavioral health services.

“Free online guided meditations, physical activity to increase your endorphins, and watching what you’re putting into your body are all things you can do every day,” he said.

A talented hip-hop artist, Green also highlights the power of music as a powerful coping strategy for those going through a crisis.

“I created playlists to talk about how I feel, whether it’s angry, happy, sad, or celebrating,” Green said. “These playlists can help people tap into their emotions or express themselves.”

Although some are experiencing wait times, people in acute distress can call the Ohio Care Line, which people can access by dialing 800-720-9616 or texting “4hope” to 741741. People in crisis will be able to immediately connect with a professional who can help connect them to resources in their area.

“Sometimes that conversation alone can be helpful and reassuring,” said Lori Criss of OhioMHAS.

Criss said she hopes Ohio’s behavioral health staffing crisis will ease through state and local initiatives. There is a general understanding of the state’s needs and support for the work ahead, she said. This puts Ohio in a good position to increase the supply of workers to meet demand.

“It’s hard work, and it’s going to take us a while to really stabilize the system and build what the people of Ohio want and need,” Criss said. “But we got off to a good start.”

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