Ohio’s mental health system is ‘in crisis’ due to worker shortages

Ohio’s behavioral health system is in dire need of more counselors, psychologists and other behavioral health professionals to meet growing demand for mental health and addiction services and reduce wait times that have lengthened in recent months, leaders say. in industry.

The state’s behavioral health system is struggling to keep up with a sharp increase in demand for services at the same time it is hit by a worker shortage that is affecting industries across the country.

“We are in a crisis,” said Laurie Criss, director of the Ohio Department of Mental Health and Addiction Services (OhioMHAS). “The increased demand for mental health and addiction services far outstrips the available supply of professionals and paraprofessionals who provide these services.”

Lori Criss, Director of the Ohio Department of Mental Health and Addiction Services (OhioMHAS)

The gap between supply and demand is causing long wait times to see a provider, a statewide shortage of supervised crisis beds, and an inability to maintain partnerships between key collaborators that help connect Ohioans in crisis with the help they need .

The OhioMHAS study showed that even before the pandemic, the industry was struggling to meet demand.

  • Between 2013 and 2019, more than one in five Ohioans lived with a mental or substance use disorder.
  • During the same period, the demand for behavioral health services increased by 353%, while the workforce grew by only 174%.
  • Nearly 2.4 million Ohioans lived in communities without enough behavioral health professionals.

These staggering figures, released in 2021, do not take into account the effects of the pandemic that began in 2020. Experts say that COVID-19 has exponentially worsened an already dire situation.
“The behavioral health system has never had the workforce it needs, but the extreme disparity since the pandemic is beyond anything I’ve seen,” Chris said.

To address the shortage, Ohio agencies and providers are embracing investment, innovation and creativity in hopes of providing Ohioans with the care they need, when they need it.

Governor DeWine’s $85 million plan

In May, Ohio Governor Mike DeWine announced an $85 million partnership between OhioMHAS and various higher education institutions across the state.

The plan aims to increase the number of future behavioral health workers being trained by supporting paid internships and scholarships for students working toward behavioral health certificates and degrees, according to a news release.

“When we first approached higher ed [leaders], We have been met with such enthusiasm for this proposal that it has been truly inspiring,” said Chris.

The plan will also help remove financial barriers to obtaining the licenses, certifications and exams required to work in the mental health field, the release said. The funding will be used to establish an Ohio Technical Assistance Center to help students navigate the state and federal funding options available to them and help them plan and budget for their loan repayments, according to Chris.

The hard part is convincing prospective students to pursue careers in behavioral care. That means getting into high schools and middle schools to help younger people understand that mental health and addiction care has positive aspects that are often not emphasized, Chris said.

“We need to really focus on being able to help others and how behavioral health supports people who are striving to live their best lives,” Chris said.

Bed staff

Scott Osieki, CEO of the Cuyahoga County Board of Alcohol, Drug and Mental Health Services (ADAMHS), agrees that it’s important to attract new behavioral health professionals, but said it’s just as important to turn attention to some of the reasons why people leave a field.

Scott-Osiecki ADAMHS board

Scott Osieki, CEO of the Cuyahoga County Board of Alcohol, Drug Abuse and Mental Health Services (ADAMHS)

Osiecki said he has heard directly from many professionals who report that the training and pay they receive is inadequate for the stress and trauma they endure in the field.

“People come out of college with a huge amount of debt and make less than they would at a supermarket, where they would experience a lot less stress,” Osiecki said. “It is not surprising that there is an exodus in the field.”

That contributes to worker shortages and longer wait times, Osiecki said, pointing to crisis beds at their Applewood, Bellefaire JCB and OhioGuidestone facilities.

For the past several years, there have been waiting lists for youth ages 8 to 17 to access these tightly controlled spaces for intensive, individualized, and short-term therapy services.

In 2019 and 2020, the majority of people on waiting lists – 70% and 85% respectively – were waiting because of difficulty finding a suitable facility for the age and gender of the youth in crisis. Less than a third of patients were placed on a waiting list due to an inability to staff crisis beds.

By 2021, however, the problem was in the personnel. Nearly two-thirds of those on the waiting list were unable to get a bed because there were not enough people to staff the facilities.

“These agencies just can’t operate at full capacity because of the shortage,” Osiecki said.

While stressing there is no quick fix, Osiecki said the ADAMHS board has begun to address the financial pressures on those entering or already working in the field. That includes raising wages, providing signing bonuses and looking at different methods of paying people higher wages overall, he said.

Like OhioMHAS, the ADAMHS board is also looking at the project, creating videos for elementary and high school students to highlight the vast array of positions available in behavioral health. Providers have joined forces to create a taskforce to help secure paid internships for students.

Hopefully those efforts will bear fruit, Osieki said, because demand is not expected to ease.

“The calls for crisis support will only increase,” he said. “We need to bring in more staff to better meet the needs of our community.”

When demand is a good thing

Although the increase in demand for mental health services has strained the system, some providers say the demand itself is a positive development in the field of behavioral health.

“We’ve really expanded the acceptance of mental health care, especially in stigmatized communities,” said Alize Hawkins, clinical director of Oriana House.

Oriana House provides community correctional services for individuals who have been involved in the criminal justice system. This includes mental health and substance use counseling, cognitive skills training, and other comprehensive services for individuals in homes, community-based correctional facilities, drug courts, or any other noncustodial setting.

Hawkins explained that many of Oriana House’s clients have experienced negative side effects from the shortage of behavioral health workers in Ohio.

“The shortage has affected everything from how quickly we can complete assessment to when people can start treatment to how long they have to wait to get into a group,” Hawkins said.

To help clients access services faster, Oriana House had to think outside the box to present its services differently, she said.

Previously, group classes—like substance use, anger management, grief or trauma groups—were closed, meaning the cohort you started the group with was the same cohort you ended with a few months later. If individuals relapse or cannot make a session, they usually cannot remain in the group.

Now those rules have changed.

“We opened up all of our groups to keep a steady flow of people,” Hawkins said. “It also means a provider can see eight people an hour instead of just one.”

Oriana House has also adopted telehealth as a counseling option. Although no-shows are a common and expected occurrence for behavioral health appointments, the current system cannot save a provider an hour for free because it was reserved for someone who did not show up. Now, when people get in touch to say they can’t make an appointment, they’re quickly sent a link to connect them virtually with an advisor.

“The key for us is to get creative without ever sacrificing the level of quality that our customers so desperately need from their suppliers,” Hawkins said.

Immediate support

Customers facing long waits have been forced to adopt creative solutions to bridge the time gap before they can find professional support.

Archie Green, a Cleveland-based mental health advocate and Neighborhood Cope Dealer, wants Ohioans to know that there are many tools at their disposal to deal with these in-between times.

Archie Green

Archie Green, a Cleveland-based mental health advocate, says there are tools that can help manage the wait for behavioral health services.

“Free online guided meditations, endorphin-boosting physical activity and being mindful of what you put into your body are all things you can do every day,” he said.

A talented hip-hop artist, Green also emphasizes the power of music as a powerful coping strategy for those experiencing crisis.

“I put together playlists to say how I feel, whether it’s angry, happy, sad or celebratory,” Green said. “These playlists can help people tap into their emotions or express themselves.”

Although some are experiencing waiting periods, those in dire need can call the Ohio Care Line, which people can access by dialing 800-720-9616 or texting “4hope” to 741741. Those who who are in crisis will be able to immediately connect with a professional who can help connect them to resources in their area.

“Sometimes just that conversation can be helpful and comforting,” said Laurie Criss of OhioMHAS.

Chris said he hopes Ohio’s behavioral health crisis will ease as a result of state and local initiatives. There is a broad understanding of the state’s needs and support for the work ahead, she said. This puts Ohio in a good place to increase the supply of workers to meet the demand.

“This is hard work, and it’s going to take some time for us to really stabilize the system and build what Ohioans want and need,” Chris said. “But we’re off to a great start.”

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