Unique Nebraska Initiative Boosts Behavioral Health Workforce 17%, Inspires Other States

Since 2010, Nebraska has increased its behavioral health workforce by 17%, and a targeted training center is largely to thank. 

The Behavioral Health Education Center of Nebraska (BHECN) was established by the state legislature in 2009 in an effort to draw more people into the behavioral health field — and to keep them there — amid serious workforce shortages.

Although Nebraska still has a ways to go before its behavioral health labor force is up to capacity, BHECN’s success thus far has caught the attention of other states — such as Illinois — who are interested in following suit. 

Beyond Nebraska and Illinois, behavioral health workforce shortages exist nationwide, leaving providers understaffed and patients without timely access to care. In fact, by 2025, the field could be short by more than 250,000 full-time workers, according to projections highlighted by the National Council for Behavioral Health.

But thanks to BHECN, Nebraska is trending in the opposite direction.

While shortages still exist there, the number of advanced practice psychiatric nurses and physician assistants in the state have increased dramatically since 2010, up 59% and 67% respectively.

To bolster the workforce, the center provides training and education to behavioral health students and professionals statewide on topics such as telehealth, curriculum development and more. It also conducts labor research and development.

In addition, BHECN, which is part of the University of Nebraska Medical Center, has leaned into collaborative care to help combat access issues for patients.

In partnership with the Munroe-Meyer Institute (MMI), BHECN has established 43 integrated behavioral health-primary care clinics across the state, 25 of which are in rural areas. In addition to providing services for patients, the clinics also serve as training sites for behavioral health interns. 

MMI is a center out of the University of Nebraska Medical Center dedicated to education, research and services for people with intellectual and developmental disabilities.

Despite Nebraska’s overall spike in behavioral health workers, increases weren’t guaranteed across the board. In fact, 81 of the state’s 93 counties have a dearth of mental health professions, according to federal criteria. 

And since 2010, the number of psychiatrists and addiction counselors in the state has actually decreased — by 6% and 20%, respectively. 

“It’s still not enough to meet the needs,” BHECN Director Marley Doyle told NET Nebraska, the state’s public broadcasting news source. “And so ideally we would have an increase in all of the categories.”

BHECN is financed by a combination of state funding, federal and state grants and foundation money. You can read more about the center’s financing and results in BHECN’s fiscal year 2018-2019 legislative report.

Opportunities in Illinois

After experiencing ongoing behavioral health worker shortages in their own state, Illinois legislators decided to follow in Nebraska’s footsteps — or at least explore the option to do so.

Last year, lawmakers passed a bill that developed the Illinois Behavioral Health Workforce Education Center Task Force. For the past several months, the group has been exploring whether the state should develop a behavioral health education center modeled after the one in Nebraska.

As the group’s research comes to an end, members say they’ll be recommending that Illinois follow Nebraska’s lead.

“The report will go in to legislators recommending the center be funded, and then a whole other group of stakeholders will be assembled if it passes,” Janet Liechty — a social work professor at the University of Illinois who is part of the task force — said last week at the Community Behavioral Healthcare Association (CBHA) of Illinois’s 47th Annual Conference.

CBHA is a trade organization representing about 90 community behavioral health organizations across the state of Illinois.

“We’re hoping that this idea will go forward,” Liechty said. “We think the benefits of it could be very good for the state.” 

Those benefits would go beyond bolstering the workforce, Liechty and her fellow task force member panelists explained.

The center could also help create a more detailed breakdown of Illinois’ behavioral health workforce, allowing the state to collect information on where professionals practice, what specialties they have and what payers they accept, among other factors. Such data would help better inform workforce development initiatives statewide, panelists explained. 

On top of that, the center could also present opportunities to improve access to behavioral health services in rural communities as well as for children, while promoting integrated care and allowing clinicians to operate at the top of their licenses, according to task force members.

While it’s unclear how the center would be financed, panelists suggested pulling state funding from multiple areas of the budget, such as public health and economic development, among other sources.

The Illinois task force is set to make their recommendations to the state before the end of the year.