This May, President Biden announced a comprehensive national strategy to address the nation’s mental health crisis. The strategy calls for a shift in how mental health is “understood, accessed, treated and integrated…” and comes at a time we are experiencing an exponential increase in mental health concerns. Recently, more than 40% of American adults presented with symptoms of anxiety and depression – an issue exacerbated by the opioid crisis and COVID-19 pandemic.
To address these increasing mental health needs, the strategy focuses on strengthening the health workforce by adding to the number of mental and behavioral health care providers, a profession currently experiencing a provider shortage. To that end, the Administration has already taken action, in fiscal year (FY) 2021, to address the overall health workforce shortage with an $800-million investment in the National Health Service Corps (NHSC) as part of the American Rescue Plan. This funding allowed the NHSC to recruit the largest class in its history with mental and behavioral health professionals making up a large part of that record number.
The NHSC has long been a part of the nation’s response to public health needs and crises. And as part of its growing expansion, behavioral health was added as an eligible NHSC discipline in 1995. Today 9,300 NHSC mental and behavioral health professionals are providing care to 9.5 million patients across the nation, up 30% from last year’s figure. Of that number, 3,400 or 37% of NHSC mental and behavioral health professionals serve in a rural community in areas hard hit by the mental health and opioid crises.
A diversity of disciplines and clinicians
NHSC mental and behavioral health providers include physicians, nurse practitioners, physician assistants, licensed clinical social workers, licensed professional counselors, marriage and family therapists and psychiatric nurse specialists, among others. This variety of disciplines ensures that primary care patients who need it are diagnosed and receive treatment for mental and behavioral health needs at the most basic health care level where many of the nation’s underserved have their first encounter with a health care provider. Having these providers as part of an integrated health care team at NHSC-approved sites provides patients with a warm-handoff and coordinated care.
With two substance use disorder programs introduced in 2019 to combat the opioid crisis, registered nurses, pharmacists, and substance use disorder counselors were added as eligible disciplines to the NHSC Substance Use Disorder (SUD) Workforce Loan Repayment Program and NHSC Rural Community Loan Repayment Program. The NHSC also added certified registered nurse anesthetists as an eligible discipline for the NHSC Rural Community Loan Repayment Program. In FY 2021, these programs supported more than 4,200 SUD-treatment clinicians.
Clinicians like Molly Greenberg and Arianne Jennings are among those who benefitted from the launch of the NHSC SUD-specific programs, but their Baltimore community enjoys the greater benefit of retaining these experienced providers in their area. Both clinicians work to provide opioid and substance use disorder treatment to the homeless population and others who need them.
The NHSC’s diversity shines through in its behavioral health providers themselves as well. Research shows that patients respond more positively and have better health outcomes when providers who treat and care for them look like they do. The NHSC surpasses the national average in the number of Latino health service psychologists, African-American health service psychologists and Hispanic licensed clinical social workers. And the diversity in NHSC participants continue to grow as the programs engage with and nurture relationships with minority academic institutions, health organizations, and associations.
Where the NHSC serves
With more than a third of NHSC behavioral health providers serving in a rural community, the others provide care in high-need tribal and urban areas of the country. Bureau of Health Workforce (BHW) Clinician Field Strength Dashboards show that, currently, the top five states for these providers are New York, California, Illinois, Missouri, and Connecticut, but there are NHSC behavioral health clinicians serving in all 50 states, Washington, D.C. and five U.S. territories.
Highly qualified to combat the crisis
To further meet the needs of the nation, the NHSC partnered with the Provider Clinical Support System (PCSS) to provide free medications for opioid use disorder (MOUD) training for eligible NHSC clinicians or applicants interested in obtaining DATA 2000 waivers. These waivers allow clinicians to administer medications to assist in the treatment and recovery of patients with opioid use disorders. This fits with the understanding that the most effective treatment for opioid addiction is a comprehensive approach that incorporates medication and behavioral health counseling. As of September 30, 2021, 822 NHSC participants reported that they have a DATA 2000 waiver and more than 4,000 have a substance use disorder treatment credential.
The NHSC continues to be an integral and invaluable element of the nation’s public health care response to underserved community’s needs. Mental and behavioral health providers, as is the case with all NHSC disciplines, continue to serve on the front lines, responding to its mission to “connect primary health care clinicians to people in the United States with limited access to healthcare” and making a difference.