Infrastructure

Developing and maintaining a mental health workforce is a complex process that benefits various forms of infrastructure, which are identified and briefly described below. The published literature on workforce infrastructure in mental health is sparse, but examples and resources are cited if available.

 

State/Regional Workforce Development Structures


Workforce development at the state or regional levels benefits from sustained workforce planning and intervention structures. Several examples are described below. Links to additional information on these structures appear in the Resources section at the bottom of this page. 

The most robust structure of this nature in the mental health field is the Behavioral Health Education Center of Nebraska (BHECN). This state-funded and university-based Center is charged with increasing the size and preparedness of the mental health and addiction workforce within the state. It regularly conducts workforce analyses and provides these to the state legislature. It has developed recruitment and retention initiatives focused on multiple professions, including psychiatry and nursing, with an emphasis on rural Nebraska. BHECN also offers online and in person training, as well as provider coaching using the ECHO model. Core state funding created a base for successful efforts to obtain additional federal grants related to workforce development, thus multiplying the return on the state’s investment. 

The State of Alaska, acting through the Alaska Mental Health Trust Authority, has supported a long-term effort to strengthen the behavioral health workforce. It has commissioned a number of workforce supply and demand studies; recruitment and retention initiatives; and a major, multi-year, effort to promote competency-based training of direct care workers in the fields of mental health, substance use disorders, developmental disabilities, and long-term care. Most recently, the Alaska Mental Health Trust Authority’s Workforce Focus Area has merged with the Alaska Health Workforce Coalition, which addresses the breadth of the state’s health workforce issues.

The Connecticut Workforce Collaborative was a federally-funded, state-based structure for coordinating behavioral health workforce development. The end of federal funding coincided with the 2008 recession and the Collaborative structure was not maintained. However, numerous projects from the Collaborative have been sustained and documentation of the Collaborative structure remains online as a model for others to examine.

 

Technical Assistance Infrastructure


There is a body of knowledge related to workforce development in mental health. The newly created SAMHSA-funded Mental Health Technology Transfer Center Network is designed to provide technical assistance to states and service organizations on effective workforce strategies. 

SAMHSA and HRSA jointly funded the Behavioral Health Workforce Research Center at the University of Michigan to gather, analyze and report data on various aspects of this workforce. The purpose of these data is to improve workforce planning and development efforts. The Center provides technical assistance to the field, as exemplified by its recommended Minimum Professional Data Set for use by states and professional associations in tracking the workforce. 

 

Human Resources and Training Infrastructure


Human resources (HR) and training professionals play a significant workforce development role in organizations of all types. Unfortunately, these areas of expertise are often under-resourced in mental health organizations, especially those organizations that are relatively small. There is not a large body of knowledge unique to HR in mental health, but there are numbers of professional membership and trade associations, which mental health HR staff can access, that offer resources related to best practices in HR. The knowledge base on training within the mental health field is largely focused on training in evidence-based practices (EBPs). As in the HR field, there are professional membership and trade associations that disseminate information and offer varied learning opportunities on best practices in training.  

 

Workforce Planning & Quality Improvement Systems


Workforce development efforts are optimally guided by a workforce plan and the use of data-driven quality improvement processes focused on the workforce. These seem to be in short supply in the mental health field. For example, the NAMI Grading the States report in 2009 found that the majority of states did not have a mental health workforce plan or a plan to increase the diversity of their mental health workforce. This may be due, in part, to the fact that most states do not have a professional position dedicated to mental health workforce planning and development.

 

Information Technology


There are numerous information technology applications customized for the mental health field. These support electronic medical records; personnel management; and worker training, activity tracking, and performance monitoring. 

 

Resources

Alaska Core Competencies for Direct Care Workers in Health and Human Services
http://aktc.org/training-solutions/alaska-core-competencies-for-direct-care-workers/

Alaska Health Workforce Coalition
https://sites.google.com/site/alaskahealthworkforcecoalition/

Alaska Mental Health Trust Authority, Behavioral Health
https://alaskamentalhealthtrust.org/alaska-mental-health-trust-authority/grants/mini-grants/behavioral-health/

Aron, L., Honberg, R., Duckworth, K. et al. (2009) Grading the States 2009: A report on America’s health care system for adults with serious mental illness. Arlington, VA: National Alliance on Mental Illness. 
https://www.nami.org/grades

ASTD – American Society for Training & Development
https://mhttcnetwork.org

Behavioral Health Education Center of Nebraska
https://www.unmc.edu/bhecn/

Behavioral Health Workforce Research Center
http://www.behavioralhealthworkforce.org

Connecticut Workforce Collaborative on Behavioral Health
www.cwcbh.org 

Hoge, M. A., Wolf, J., Migdole, S., Cannata, E., & Gregory, F. (2016). Workforce development and mental health transformation: a state perspective. Community Mental Health Journal, 52, 323–331. doi: 10.1007/s10597-015-9953-6
https://www.ncbi.nlm.nih.gov/pubmed/26410216

Mental Health Technology Transfer Center Network
https://mhttcnetwork.org

Society for Human Resource Management (SHRM)
https://www.shrm.org