Community Initiatives for Collective Impact (CI4CI)

Merced County Report: The Health and Equity Impacts of a Workforce for Mild and Moderate Behavioral Health

What Happens When We Do Not Have Enough Professionals to Help?
The Health and Equity Impacts of a Workforce for Mild and Moderate Behavioral Health
A Summary Report of Findings from a Health Impact Assessment
Conducted in Merced County, 2018-2019

Between 2018 and 2020, a local team of health providers, educators, researchers, and community advocates implemented a Health Impact Assessment to understand the impact of workforce shortages related to mild to moderate behavioral health (MMBH) concerns. This report shares the findings from this project and offers specific recommendations to address MMBH workforce shortages.

This project was supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, with support from the California Endowment. The views expressed are those of the authors and do not necessarily reflect the views of the Health Impact Project, The Pew Charitable Trusts, the Robert Wood Johnson Foundation, or the California Endowment.

Summary of Report Recommendations
Local health care organizations acknowledge the community demand for behavioral health services and for increasing the workforce. Action on these recommendations can impact workforce shortages.

Recommendations for Local Advocates and Advocacy Groups for Behavioral Health

  1. Educate family, friends, and the community to recognize the role of addressing everyday stressors for mental and behavioral health and advocate for addressing these stressors.

  2. Advocate for acceptable insurance reimbursement for behavioral health services, both for amount and type of services and reimbursement rate for services.

  3. Advocate for health insurance carriers to critically review and address gaps in their behavioral health provider networks serving Merced County.

  4. Advocate for organizations that provide behavioral health services to provide supervised training hours required for licensure of new behavioral health providers (e.g., LCSWs, LMFTs).

  5. Encourage early-career development for diverse language and cultural groups to pursue MMBH careers.

Recommendations for Health Organizations That Can Offer Supervision for Licensing Hours

  1. Create local training opportunities for masters-level MMBH graduates (e.g., ACSWs, AMFTs) to complete their required licensing hours quickly and advance to become licensed clinical behavioral professionals (e.g., LCSWs, LMFTs).

  2. Attend to preparing behavioral health staff that can address the cultural and linguistic needs of Merced County as training opportunities for licensing are developed.

  3. Use the current context created by the DCHS (i.e., county fines and sanctions for workforce shortages and the statewide committee to address the shortages) to channel administrative support, funding and other resources into policies and programs that transition ACSWs and AMFTs into fully employed LCSWs, AMFTs, and other required behavioral health positions.

  4. Advocate for acceptable insurance reimbursement for behavioral health services with potential supplemental reimbursement to support training upcoming behavioral health providers.

  5. Assure primary care providers can identify and address MMBH concerns, including appropriate referral to local services.

A collaborative effort to reflect and take action on the lessons from this HIA can make an impact on population health and community development of Merced County.

The MMBH HIA team welcome comments and reflections to this report on this post.

Link to Full Report (PDF)