States Forced to Get Creative to Recruit More Behavioral Health Workers

Recruiting workers to fill vacancies remains one of behavioral health’s most formidable challenges. As the industry looks for creative solutions to tackle the problem, some believe that the mission to do so begins with getting enough prospective employees excited about growing in the profession.

Emil Slane is the deputy commissioner and chief fiscal officer of the New York State Office of Mental Health, and he feels that a major issue among many revolves around competitive wages.

“Most people don’t go into this area of work for money, they go in because they want to make a difference,” Slane said during a recent webinar hosted by the National Council for Mental Wellbeing. “But at the same time, we’ve got to make sure that we pay livable wages and that we can retain and maintain the workforce.”


Maintaining a sufficiently staffed workforce also comes amidst worsening behavioral health conditions during the pandemic, as more than a third of Americans live in areas with industry provider shortages.

“Access is key,” Slane added,” [W]e all see demand going up, and there’s pockets of challenges.”

Tackling the workforce shortage

Another area touched upon during the webinar — which discussed policy solutions for building the behavioral health workforce — was higher education debt.


Americans owe more than $1.75 trillion in student loan debt, according to the Federal Reserve. And while the pay rate of psychologists has jumped by about 5% over the last year — at the high end of generally accepted pay increases — mental health workers’ wages in the same time span have risen by only around 1%.

Slane pointed out that New York operates a loan forgiveness program for psychiatrists serving areas of the state where there are health care shortages. The amount awarded by the program for each participant is $150,000.

Regarding other mental health professionals, Slane mentioned that the state has established recruitment pipeline programs with the State University of New York and City University of New York systems, along with enacting measures such as reserving $4 million in incentives to would-be workers who are pursuing credentials.

New York also has a fellowship program with many schools in the state that operate social work programs. Slane said that the state is not only looking to triple its investment in the program, but use it as a framework for creating programs targeting other mental health disciplines.

“We’re looking to expand that type of work to other disciplines … to address some of the front door challenges of recruiting people to the field,” he said.

Using credentialed professionals to plug the industry workforce gap is also happening in states like Delaware, according to Alexia Wolf.

Wolf is the chief of social determinants and support services with the Delaware Department of Health and Social Services. Wolf works for the department’s division of substance abuse and mental health, and has been involved in the launch of a pilot program in Black and Hispanic communities that use so-called “community ambassadors” to work with individuals dealing with behavioral health concerns.

The ambassadors include community health workers as well as peer support staff, who receive training to provide services to individuals who might be reluctant to ask for behavioral health assistance due to longstanding cultural stigmas.

“If someone they’re supporting takes a step forward and a couple of steps back, the ambassador can still be there as a net for that person, to make sure that they don’t fall through the cracks or get lost to the system,” Wolf said during the webinar.

Wolf mentioned that her department is looking into developing partnerships with colleges and universities in the state that could provide ambassadors with educational opportunities to supplement their training. She also said that the ambassador program gives substantial consideration to wages and compensation, in order to further the interest of those looking at long-term careers in that line of work.

“We gave a lot of thought into the hourly rate and the benefits and the time off for these individuals,” Wolf noted. “And so we’re very hopeful that these positions are the start of five-, 10- or 15-year careers in the field.”

Rachel Johnson-Yates is the deputy director and chief of staff for the Indiana State Division of Mental Health and Addiction, and she also participated in the webinar, detailing efforts that she and her colleagues have been undertaking to buffer the behavioral health workforce.

When it comes to recruiting a solid pipeline of would-be workers into the industry, Johnson-Yates believes there is room for improvement in attracting those from traditionally underrepresented communities. In the Hoosier State, she said she is working to change that.

“In Indiana, we’ve been having a lot of conversations with various … groups, talking to groups in the African American community, in the Mexican American community, [and] in the Muslim community,” Johnson-Yates said during the webinar. “[We] say, ‘Hey, what is mental health engagement [and] crisis engagement looking like in your communities? What are [the] barriers?’”

From those conversations, Johnson-Yates said she finds that many are unaware of jobs available, such as opportunities to become community or peer support workers.

“We have a lot of people with lived experience that don’t have a clue that … mental health work is even a pathway that would … be attainable,” she said.

Johnson-Yates is encouraged by the possibility of funding being allocated to the state’s community college system, which would establish partnerships with high schools and middle schools to raise awareness among students about future behavioral health careers.

“We will be working to develop and allocate funding very strategically,” she added. “[We are] potentially looking at how might we be able to offer opportunities for mentoring, or job shadowing, or early credentialing in helping create pathways that are attainable and financially viable for students.”

Wolf hopes such proactive efforts — along with other measures like a prospective loan forgiveness program — can also help make Indiana’s clinical practitioner workforce more inclusive, as her department is currently looking at ways to make that a reality with community mental health centers.

“We are working on doing a deep dive in our community mental health centers in terms of their processes, practices and their work around equity and inclusion in Indiana,” she said. “90% of our clinical practitioners are Caucasian, which is not even close to reflective of the populations that we are serving.”