There are several factors influencing the number and type of behavioral health professionals in the workforce:
Insufficient pipeline of professionals entering the field
The current rate of growth in the behavioral health workforce isn’t enough to meet demand. Merritt Hawkins estimates that with nearly 60% of all practicing psychiatrists at least 55 years old, the industry could soon see a disproportionately high retirement rate compared to the number of psychiatrists entering the field. For many, behavioral health has become an unappealing sector of health care to join, especially considering increased acuity and demand of behavioral health needs as a result of Covid-19.
There is also a significant lack of representation of professionals with marginalized identities entering the workforce, making it difficult for some patients who wish to see a provider of a similar background. Being a professional with a particular identity doesn’t guarantee the ability to deliver culturally humble or sensitive care—all behavioral health professionals must be able to provide culturally sensitive care for all patients. However, a diverse workforce provides more choice for patients who prefer to see a similarly identifying provider or need care in certain languages.
Inadequate and cumbersome reimbursement
Reimbursement structures for behavioral health care professionals are highly variable across states, professions, and payers. Participating in multiple health plans involves considerable paperwork for clinicians in return for reimbursement levels that may not feel worth the administrative burden. According to data from MACPAC, 1 only 62% of psychiatrists accept commercial or Medicare insurance, just 35% accept Medicaid, while other clinicians don’t accept insurance at all.
Emotional labor and burnout
Behavioral health work is challenging and requires a significant amount of emotional labor from professionals. Along with other factors, emotional exhaustion from this field of work has contributed to 78% of psychiatrists reporting symptoms of high levels of burnout. 1 Without adequate support, the workforce is primed for rapid burnout and higher levels of turnover.
Policy and credentialing limitations
Federal and state policies regulate which behavioral health professionals can be reimbursed for certain types of care, along with where and how they may deliver that care. For example, policies may prevent a clinician in one state from delivering tele-behavioral care to a patient in a different state. The pandemic loosened these restrictions, for some temporarily and others permanently.
1 Medicaid and CHIP Payment and Access Commission (MACPAC).
1 Data from The American Journal of Psychiatry.