Behavioral health has, perhaps, the most diverse workforce among all health care fields with respect to the types of providers. SAMHSA has identified the following workforce categories (Click here for more information):
The Health Resources and Services Administration (HRSA) and SAMHSA-funded Behavioral Health Workforce Research Center at the University of Michigan is charged with collecting and analyzing data on the nation’s mental health and substance use workforce, and its website offers a range of valuable reports and resources (Click here for their website). Educational requirements and scope of practice data is reported by the Center on all behavioral health provider types across all states. This is housed in an online searchable database that facilitates scope of practice comparisons between states (Click here for the database).
Selected professional associations conduct and report data on their own disciplines. A model in this regard is the Center for Workforce Studies of the American Psychological Association (APA) (Click here for the website). The Center has issued reports on topics such as workforce age, gender, employment, salary, and student debit. One of its publications demonstrates the lack of diversity that characterizes most behavioral health professions. For the psychology workforce, the 2016 data revealed that 86 percent were white, 5% Asian, 5% Hispanic, and 4% black/African American (Click here for more information).
There are multiple sources of data on the number of behavioral health providers in the current workforce, as well as projections of the number needed in the future. There are often significant inconsistencies between the reported findings, since the primary data sources and projection methods used vary greatly.
The Bureau of Health Workforce within HRSA (https://bhw.hrsa.gov/) issued a 2016 report on National Projections of Supply and Demand for Selected Behavioral Health Practitioners: 2013-2025 (Click here for the report). It provided estimates for what the Bureau deemed to be the nine largest disciplines in behavioral health, which included: psychiatrists; behavioral health nurse practitioners; behavioral health physician assistants; clinical, counseling, and school psychologists; substance abuse and behavioral disorder counselors; mental health and substance abuse social workers; mental health counselors; school counselors; and marriage and family therapists. The report estimated that in 2013 there were 834,310 members of the behavioral health workforce in these disciplines. Using SAMHSA data on population need for services, the report estimated that the shortage of professionals in these disciplines could reach as high as 250,510 by 2025. This analysis does not consider other segments of the behavioral health workforce, such as peer specialists or direct care workers (e.g., psychiatric aides or technicians; residential counselors).
The lack of a sufficient number of behavioral health providers is further complicated by the uneven distribution of this workforce. The concept of maldistribution refers to the fact that mental health and substance use providers tend to be concentrated in selected geographic areas, such as the northeastern U.S. and areas of the west coast, with much less concentration in rural areas. It has been estimated that 13% of rural counties do not have a single behavioral health professional of any type and that approximately 60% of mental health provider shortage areas in the nation are in rural or partially rural areas.
HRSA designates formal Health Professional Shortage Areas (HPSAs) for providers of behavioral health care (as well as primary care and dental care). It hosts an online, searchable database of shortage areas (Click here for the database). The federal government addresses these shortages, in part, through loan repayment programs for mental health and substance use professionals who work in these areas at approved sites (Click here for more information).
The Behavioral Health Workforce Research Center has released the following reports on workforce distribution:
Distribution of Psychiatric Subspecialties in the Behavioral Health Workforce
Of the 3,149 counties in the U.S., 1,473 had at least one psychiatrist of any type (46.8%) (Table 1). Predominately, psychiatrists were located within the northeastern U.S.; some small pockets of concentrated psychiatrists practiced along the west coast.
Click here for the report.
Mapping the Supply of the US Psychiatric Workforce
According to the combined data, the size of the psychiatric workforce is 66,740 total providers.
Click here for the report.
Characteristics of the Rural Behavioral Health Workforce
Of the 35 organizations (7.7%) of the organizations that finished the survey, most were community mental health organizations (n=21, 60.0%) or non-profit organizations (n=10, 28.6%).
Click here for the report.