Recruiting and retaining behavioral health workers in rural America: Our report and action guide

Lack of behavioral health workers in rural america

In the U.S., there are not enough behavioral health workers to meet the demand for mental health and substance use services, particularly in rural areas.

Over the past year, the Center for Health and Research Transformation (CHRT) has worked closely with the University of Michigan’s Behavioral Health Workforce Research Center (BHWRC) to explore the approaches states have taken to address this concern through recruitment and retention initiatives.

Throughout 2019, CHRT Health Policy Director Nancy Baum and Lead Healthcare Analyst Jaque King interviewed experts from 47 states to learn which types of behavioral health workers they needed most, to explore the factors that exacerbate shortages, and to discuss state efforts to address this demand for mental health and substance use services.

Through a qualitative analysis of the interview transcripts, Baum and King have isolated an array of approaches including loan repayment programs, pipeline programs, Visa waivers, public-private partnerships, tax credits, tiered certification initiatives, scope of practice expansions, telehealth investments, and more.

Findings from this research are now available in three publications:

Funding for this project was provided by the Health Resources and Service Administration (HRSA) of the U.S. Department of Health and Human Services

Michigan at a crossroads: CHRT highlights key health policy issues for the incoming gubernatorial administration

The Michigan government has jurisdiction over a wide array of health policy issues. From the regulation of insurance products, to oversight of the state’s Medicaid program, to investing in local public health efforts, Michigan policymakers craft policies and budgets that impact the health of millions of Michiganders.

This brief provides an overview of four key and timely health policy topics:

  • Medicaid and the Healthy Michigan Plan;
  • the individual health insurance market and the federal Health Insurance Marketplace;
  • the opioid epidemic; and
  • the integration of services to address the social determinants of health.

It also explores some of the forces influencing our state’s health and discusses policy approaches to today’s health and health care issues.

Read the full brief.


Issue Brief: Bipartisan Budget Act adds $3B for substance abuse, mental health, more

The Bipartisan Budget Act was signed into law on February 9, 2018. While the main purpose of the legislation is to temporarily fund the federal government through March 23, 2018, it also includes an agreement to raise the caps on domestic and military spending for the next two years.

The legislation includes many health care policies, as well. The major policies are described in Health Care Policies in the Bipartisan Budget Act (H.R. 1892).


Access to mental health care in Michigan

One in five Michiganders report having been diagnosed with depression at some point in their lives. Mental health disorders cause more disability among Americans than any other illness group.

Using data from the Cover Michigan Survey and the Michigan Primary Care Physician Survey, both fielded in calendar year 2012, this brief explores issues related to the prevalence of mental health disease, specifically depression and anxiety, and the capacity of the Michigan health care system to serve people with these conditions.

Overall, it is clear that there is high need for mental health services in Michigan and the capacity to serve those in need is not adequate to the task. Without addressing increased capacity for care, the increased mental health coverage provided to many under the Affordable Care Act will do little to help those most in need.

Key findings

  • Depression and anxiety are prevalent in Michigan and higher than the U.S. average. Twenty percent of Michiganders reported ever being diagnosed with depression, compared to 18 percent of Americans. Prevalence is greater when diagnoses of depression and/or anxiety are combined
    • Depression and/or anxiety were reported in Michigan at particularly high rates among those with Medicaid (59 percent) and the uninsured (33 percent).
  • People with depression and/or anxiety had greater difficulty completing everyday activities, including work, than did Michiganders with other or no chronic conditions.
    • Respondents with depression and/or anxiety reported twice as many limited activity days compared to those who reported having other chronic conditions. Respondents with depression and/or anxiety reported an average of five days in which poor health limited their activity.
  • The health care system in Michigan is inadequate to serve adults and children with mental health needs.
    • Fifty-seven percent of primary care physicians reported that availability of mental health services in their community was inadequate for adults and 68 percent reported it was inadequate for children.
      • Adult mental health services in the St. Joseph, Muskegon, and Petoskey regions had the highest inadequacy ratings (89, 82 and 77 percent, respectively).
      • Child mental health services received the poorest ratings in the Muskegon and Petoskey regions (100 and 94 percent respectively).
      • Even in regions where primary care physicians reported the best access (Pontiac and Royal Oak), more than a third noted that access was inadequate.
    • The availability of psychiatric beds in Michigan is extremely low compared to other states—Michigan was ranked 42nd among the 50 states and the District of Columbia in availability of inpatient psychiatric beds.

Read Full Brief Here

Suggested Citation: Smiley, Mary; Young, Danielle; Udow- Phillips, Marianne; Riba, Melissa; Traylor, Joshua. Access to Mental Health Care in Michigan. Cover Michigan Survey 2013. December 2013. Center for Healthcare Research & Transformation. Ann Arbor, MI.