Steps Necessary to Address Our Behavioral Health Workforce Challenges

NRI Board Member, Ron Manderscheid, PhD advocated for establishing a national infrastructure to address the systemic challenges to the behavioral health workforce. Here are a summary of his remarks made at the Workshop on Addressing Challenges Across the Behavioral Health Continuum of Care held on July 10-11, 2024, which was hosted by the Forum on Mental Health and Substance Use of the National Academies of Science, Engineering, and Medicine. 

Ronald W. Manderscheid, adjunct professor at the Johns Hopkins Bloomberg School of Public Health and principal at Capstone Solutions Consulting Group, advocated for establishing a national infrastructure to address the systemic challenges to the behavioral health workforce. He argued that the fragmented nature of behavioral health services requires a coordinated and centralized approach to improve outcomes and ensure equitable access to care.

Manderscheid outlined the rationale for creating a “home” for the behavioral health workforce at the national level. He pointed out that it has been 30 years since SAMHSA had national leadership authority around this workforce and 20 years since it last produced a national strategic plan on behavioral health human resources. After reviewing the history of fragmentation of federal agency leadership, he emphasized that the “system,” characterized by a lack of coordination among various federal and state agencies and service providers, leads to inefficiencies and disparities in care. He proposed creating a National Office on Behavioral Health Workforce Practice, which, with adequate staff and budget, could serve as a central body to streamline workforce efforts, integrate services, and provide a unified strategy for addressing behavioral health needs across the country. He emphasized the importance of g consistent national leadership and coordination in addressing workforce challenges. Manderscheid highlighted several key functions this national office structure could perform: 

• coordination of services to ensure that behavioral health services are integrated with primary care, public health, and social services; 
• a policy development office responsible for developing and implementing policies that support the workforce, including strategies for expansion, training, and retention; 
• centralized funding and more efficient resource allocation, ensuring that funds are directed toward programs and initiatives that have the greatest impact; 
• data collection and research—playing a key role in collecting data on behavioral health trends, workforce needs, and service use to help identify areas where additional resources are needed; and 
• advocacy and public awareness to support behavioral health initiatives by leading campaigns to reduce stigma, promote mental health literacy, and advocate for the rights of individuals with behavioral health conditions.

Additionally, he advocated for developing a National Center on Behavioral Health Workforce Excellence, which would share best practices, promote innovation, and create a strategic plan for the behavioral health workforce. 

Manderscheid acknowledged several challenges to establishing a national office. These include potential resistance from agencies and partners that may view this as a threat to their authority or funding. Additionally, he noted the significant difficulties presented by the need to secure the necessary Congressional support and ongoing appropriations to establish and sustain the office. Despite these challenges, Manderscheid argued that the potential benefits of a centralized office would far outweigh the potential obstacles. He urged collaborators to come together to advocate for it as a necessary step to address the nation’s growing behavioral health needs.

Manderscheid said a first step would be to convene interested groups to build consensus and create a strategic plan, emphasizing that this initiative would require a series of short, intermediate, and long-term actions and would likely take 5 or more years to fully develop.