Hospitals are facing a “daunting” challenge of trying to treat millions of individuals suffering from mental health and substance-abuse disorders with a limited workforce, and simply hiring their way out of the problem probably won’t work.
The reasons fueling said challenge are numerous. A rapidly aging population, for one, is spelling the need for more psychiatrists, while simultaneously causing huge chunks of that workforce to retire. If current trends continue unabated, by 2030, there’s going to be just one geriatric psychiatrist for every 6,000 older Americans grappling with mental illness and drug addiction, according to the Institute of Medicine. America’s raging epidemic of heroin and prescription painkiller abuse is further fanning the behavioral health fire.
With all that in mind, the American Hospital Association just yesterday released a report detailing the current state of the mental health care workforce, and ways to alleviate staffing shortages. One important take-home assignment for hospital leaders is simply beginning to understand the gravity of this resource shortage, and then seeking out nontraditional ways of addressing it, says Pamela Thompson, chief nursing officer of the American Hospital Association. Starting soon is probably the best course of action, she adds.
“The report does have some solutions and we need to start working on those quickly. You can’t create a workforce overnight; it does take some time,” says Thompson, who is also senior vice president of the AHA and CEO of the American Organization of Nurse Executives. “The State of the Behavioral Health Workforce" includes seven steps hospital leaders can begin to take, and the first step isn’t going out and hiring a bigger staff. “It’s not just a matter of creating more psychiatrists,” Thompson adds. “It’s a matter of being innovative in both our delivery system, and the ways in which we’re using roles.”
The seven steps to strengthening your behavioral health care workforce are as follows:
- Assess your current staffing situation and patient population, pinpointing any weaknesses of behavioral health care access and the range of services offered at your hospital.
- Ensure that your workforce is culturally competent and knowledgeable about any socioeconomic determinants of health, or other challenges your service area is facing.
- Train your entire workforce in how to screen for behavioral health concerns and possible interventions, particularly with respect to violent incidents and suicide risk.
- Set up procedures to assess, treat and refer patients to behavioral health services, so that it is happening at the site and time of the visit.
- Utilize interprofessional education and training, alongside team-based care, to begin integrating primary care and behavioral health.
- Contact and establish partnerships with higher education programs in your service area to begin addressing your population’s needs, and enhancing recruitment and retention of such professionals.
- Engage the broader community outside of health care to strengthen transitions and integration with the broader workforce as a population health approach.
No. 7 is another vital takeaway for Thompson. Alleviating workforce shortages is going to require deploying members of the community, alongside doctors and nurses, to help address challenges such as opioid addiction. She points to one example underway in five New Jersey counties to battle the drug epidemic. There, Barnabas Health Institute of Prevention is utilizing recuperating addicts, four years or more into sobriety, as “recovery specialists.”
Such specialists step in to intervene in situations where hospital social workers and other staffers have proven unsuccessful. So far, in 150 cases in which providers have tried convincing recent opioid overdose victims to enter detox or treatment, zero individuals listened. Meanwhile, in less than two weeks, recovery specialists showed a 70 percent success rate, according to the report.
“This is not just a hospital issue; it’s a community issue, and I think behavioral health provides us with an important window into the fact that care isn’t just in a hospital or in a community. For these patients, it encompasses the entire continuum,” Thompson says.